Topic Overview
What is diabetic ketoacidosis (DKA)?
Diabetic
ketoacidosis (DKA) is a life-threatening condition that develops when cells in
the body are unable to get the sugar (glucose) they need for energy, such as
when you have
diabetes and do not get enough insulin. Without
insulin, the body cannot use sugar for energy. When the cells do not receive
sugar, the body begins to break down fat and muscle for energy. When this
happens,
ketones, or fatty acids, are produced and enter the
bloodstream, causing the chemical imbalance (metabolic acidosis) called
diabetic ketoacidosis.
What causes DKA?
Ketoacidosis can be caused by not
getting enough insulin, having a severe infection or other illness, becoming
severely
dehydrated, or some combination of these things. It
can occur in people who have little or no
insulin in their bodies (mostly people with
type 1 diabetes but it can happen with
type 2 diabetes) when their blood sugar levels are
high.
What are the symptoms?
Your blood sugar may be
quite high before you notice symptoms, which include:
- Flushed, hot, dry skin.
- Blurred
vision.
- Feeling thirsty.
- Drowsiness or difficulty
waking up. Young children may lack interest in their normal
activities.
- Rapid, deep breathing.
- A strong, fruity
breath odor.
- Loss of appetite, belly pain, and
vomiting.
- Confusion.
When diabetic ketoacidosis is severe, you may have
a hard time breathing, your brain may swell (cerebral edema), and there is a
risk of coma and even death.
How is DKA diagnosed?
Laboratory tests, including
blood and urine tests, are used to confirm a diagnosis of
diabetic ketoacidosis. Urine dipstick tests for
ketones are available for home use. Keep some nearby in case your blood sugar
level becomes high.
How is it treated?
When
ketoacidosis is severe, it must be treated in the hospital, often in an
intensive care unit. Treatment involves giving insulin and fluids through a
vein and closely watching certain chemicals in the blood (electrolytes). It can take several days for your blood
sugar level to return to a target range.
Who is at risk for DKA?
If you have type 1
diabetes, you are at risk for DKA if you do not get enough insulin, have a
severe infection or other illness, or become severely dehydrated. In some cases
DKA can be the first sign of diabetes.