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Ketoacidosis (preferred term is Diabetic Ketoacidosis, commonly abbreviated as DKA)

What is it?

This is a severe complication associated with hyperglycemia. When your body lacks insulin – either because of missed doses or an increase in insulin demand that can come with fever, infection, or unusual stress – two things happen. Blood glucose levels rise, which causes excess urination as the body excretes water in order to try to dissolve the glucose. This can lead to increased urination and dehydration. Second, because the body cannot metabolize glucose, it begins to burn fat for energy. Normal byproducts of fat metabolism are acidic substances called ketones. When fats are the main source of energy, ketones accumulate in the blood and in urine. They change the body’s chemical balance to the acidic range, a condition known as ketoacidosis. It is life threatening but reversible with prompt treatment. It is more common in people with type 1 diabetes, although it may occur in type 2 patients as well.

What are the symptoms?

You will have an increased need to urinate and may become dehydrated and extremely thirsty. Ketosis starts slowly and gradually builds up. Common symptoms include loss of appetite, stomach pain, nausea and vomiting, and deep and rapid breathing. Others signs are a flushed face, dry skin and mouth, fruity breath odor, a rapid and weak pulse, and low blood pressure. You may test for ketones in your urine with special test strips that are available in drugstores.

What is the treatment?

Emergency treatment is required. You should drink fluids and inject insulin right away. Check with your doctor or healthcare provider immediately to determine how much fluid and insulin you should take. If you are unable to keep fluids down because of nausea or vomiting, it can become a critical medical emergency. Patients who do not get fluids and insulin right away may lapse into a coma.

Related information Ketone testing

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