What Is Ketoacidosis – Life Saving Info You Need To Read

What Is Ketoacidosis

Diabetic Ketoacidosis (DKA) is a condition in which the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production. When bodily fluids become acidic, some of the body’s systems stop functioning properly. It is a serious condition that will make you violently ill and it can kill you.

DKA only happens when you don’t have enough insulin in your body to process high levels of glucose in the blood.

DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it’s important to be aware of the risk and know what to do if DKA occurs.

Signs Of Diabetic Ketoacidisos

Signs of DKA can appear quickly and may include: 

  • frequent urination
  • extreme thirst
  • high blood sugar levels
  • high levels of ketones in the urine
  • nausea or vomiting
  • abdominal pain
  • confusion
  • fruity-smelling breath
  • a flushed face
  • fatigue
  • rapid breathing
  • dry mouth and skin

Test your ketones when your blood sugar is over 15 mmol/l / 240 mg/dL. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes.

Call your doctor or go to the emergency room right away if that doesn’t work, if you have any of the symptoms below and your ketones aren’t normal, or if you have more than one symptom.

  • You’ve been throwing up for more than 2 hours.
  • You feel queasy or your belly hurts.
  • Your breath smells fruity.
  • You’re tired, confused, or woozy.
  • You’re having a hard time breathing.

What Causes DKA

It usually happens because your body doesn’t have enough insulin. Your cells can’t use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood.

An infection or other illness can cause your body to produce higher levels of certain hormones, such as adrenaline or cortisol. Unfortunately, these hormones counter the effect of insulin — sometimes triggering an episode of diabetic ketoacidosis. Pneumonia and urinary tract infections are common culprits.

Other possible triggers of diabetic ketoacidosis include: Physical or emotional trauma, Heart attack, Alcohol or drug abuse, particularly cocaine, Certain medications, such as corticosteroids and some diuretics

Depending on the illness, blood glucose can go up very high and you actually need more insulin. This is usually with infections, colds, etc. Illnesses that cause nausea, vomiting or diarrhea will often send blood sugars low and you may need to cut back on insulin doses. However, it is important to never stop giving insulin completely!

Treatment Of DKA

DKA is usually treated in hospital.

Treatments include:

  • insulin, usually given into a vein
  • fluids given into a vein to re hydrate your body
  • nutrients given into a vein to replace any you’ve lost

You’ll also be closely monitored for any life-threatening problems that can occur, such as problems with the brain, kidneys or lungs.

Preventing DKA

It is no surprise that good blood glucose control is the best way to keep blood glucose levels low enough to avoid DKA.

However, because infections are responsible for many DKA episodes, you should be extra vigilant about your blood glucose levels when you sense that you may be coming down with an illness.

When ill, follow these guidelines:
1. Check blood glucose and urine ketones every two to four hours.

2. Continue taking insulin, even if you’re too ill to eat. A sick body needs extra insulin.

3. Stay hydrated by drinking 8 ounces of caffeine-free fluids every hour.

4. Take in calories even if you’re vomiting or your blood glucose levels are high by alternating 8 ounces of sugar-free fluid per hour with 8 ounces of sugar-sweetened fluid. Vomiting with moderate to high ketones? Go to an emergency room.

5. Contact your provider if blood glucose is over 250 mg/dl for six or more hours or you have urine ketones that long. Record glucose and ketone readings, and symptoms, for your provider.


The methods of treating DKA in a hospital have become very advanced. Only about 1 percent of adults with DKA who get the proper care end up dying from it. Plus, there are no long-term complications from DKA, “If you get insulin, you get better.”

Thank you for reading

Garry (Type 1)

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