Diabetic Ketoacidosis

What is Diabetes Ketoacidosis (DKA)?

Diabetic ketoacidosis is a serious and life threatening condition that impacts primarily type 1 diabetics but can also occur in type 2 diabetics.

How does it occur?

It happens when your body can’t produce enough insulin to help your body’s cell absorb the glucose in your blood to provide energy to your body. So instead your body starts breaking down your fat. Your fat gets broken down by the liver for your body to use as fuel, usually occurs when you go a long period of time between meals.

When your liver breaks down the fat it produces acids called ketones. If fat is broken down too quickly, a buildup of ketones occurs in the bloodstream causing your blood to become acidic. Ketones can overflow from the bloodstream into your urine. If there is a prolonged buildup of ketones in the blood, it could lead to death.

How do I know if I have DKA?

Symptoms occur quickly, usually within 24 hours.

  • Excessive and prolonged thirst
  • Stomach pain
  • Fruity-scented breath
  • Frequent urination
  • Weakness or fatigue
  • Confusion
  • Nausea and vomiting
  • Shortness of breath
  • Dehydration
  • Headache
  • Deep, rapid breathing
  • Flushed face
  • Muscle stiffness

For more specific signs, you can use home testing kits to test for high blood sugar level or high ketone levels in your urine.

What should I do when I start showing symptoms?

Contact your doctor immediately if you are vomiting or unable to tolerate food or liquid, your blood sugar level is higher than your target range and home treatment is not helping, or if you have moderate to high ketone level in your urine.

Seek emergency care if your sugar is consistently higher than 300 mg/dL, you have ketones in your urine and are not able to reach your doctor for advice, or you show any of the other signs of DKA.

How can I prevent DKA?

  • Commit to managing your diabetes. Eat a healthy diet, engage in regular physical activity, take your oral medication and/or insulin every day as needed.
  • Monitor your blood sugar. Check 3 to 4 times per day, more if you are ill or under extreme stress.
  • Adjust your insulin as needed. Contact your doctor or diabetes educator to learn how to adjust your insulin.
  • Check your ketone level.
  • Be prepared to act quickly.


Mayo Clinic
Medline Plus

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