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Quick Facts

Diabetic Ketoacidosis

By The Manual's Editorial Staff,

Diabetes is a disease in which your blood sugar (glucose) levels are too high.

What is diabetic ketoacidosis (DKA)?

Diabetic ketoacidosis is a serious complication of diabetes. It's often called DKA.

With DKA, your blood sugar goes up, acids called ketones build up in your blood, you lose a lot of fluid, and your body chemistry doesn't work right. You need treatment right away.

  • People with type 1 diabetes are more likely to have DKA

  • DKA may be the first sign that you have diabetes

  • Treatments include IV fluid and insulin

  • Without treatment, DKA can cause coma and death

What causes DKA?

Your body needs insulin to use blood sugar for energy. If you don't have enough insulin (for example, because you have untreated type 1 diabetes), your blood sugar goes up a lot because the sugar can't get into your cells. Your body burns fat for energy instead. Broken-down fat goes to your liver and is turned into acids called ketones. The ketones build up in your blood and urine.

A high level of ketones in your blood can make you very sick.

If you have diabetes, you're more likely to get DKA if:

  • You stop taking your insulin

  • Stop following your diet so the insulin you're taking isn't enough

  • You get sick, and your body is under extra stress

Common triggers of DKA include:

  • Infections, such as pneumonia or urinary tract infection

  • Pancreatitis (sudden swelling of your pancreas)

  • Certain medicines

  • Drinking too much alcohol or taking street drugs

What are the symptoms of DKA?

Symptoms include:

  • Unusual thirst

  • Urinating (peeing) more than usual

  • Losing weight for no clear reason

  • Feeling sick to your stomach or throwing up

  • Feeling weak and tired

  • Belly pain

  • Deep, fast breathing

  • Fruity-smelling breath (like nail polish remover)

DKA can lead to coma or death if not treated.

How can doctors tell if I have DKA?

Doctors do:

  • Blood tests to check your blood sugar, the level of ketones in your blood, and levels of certain electrolytes (minerals, such as sodium and potassium, that help with many important body functions)

To find problems that might be causing your DKA, doctors may do tests such as:

  • Chest x-ray

  • Urine tests

  • ECG (a test that measures your heart’s electrical currents and records them on a piece of paper)

How do doctors treat DKA?

DKA is a medical emergency. You'll need to go to the hospital and may need to stay in the intensive care unit (ICU).

Doctors treat DKA with:

  • Fluids and electrolytes into your vein

  • Insulin into your vein

  • Blood tests every few hours to check your sugar, ketones and electrolyte levels to be sure they're going back to normal

Doctors also treat whatever other problem caused the DKA.