What Is Diabetic Ketoacidosis and How to Recognize It

People with diabetes might run out of insulin which can cause a buildup of ketones in the body. This condition, known as diabetic ketoacidosis (DKA), can be life-threatening if not recognized and treated on time.

In this condition, the cells in the body can’t get the glucose (sugar) they need to produce energy due to lack of insulin. So, the glucose stays in the blood. Since cells are unable to produce energy without sugar, they have to break down muscle and fat for that purpose.

This results in a ketone or fatty acid production. The ketones enter the blood, leading to metabolic acidosis (chemical imbalance), known as diabetic ketoacidosis.

This condition usually affects those with type 1 diabetes. However, it can also occur in people with type 2 diabetes.

Here are the symptoms, causes, treatment, and prevention of diabetic ketoacidosis.

Symptoms of Diabetic Ketoacidosis

Besides high blood glucose levels, you might notice the following symptoms:

• Blurry vision
• Hot, flushed, dry skin
• Difficulty waking up or drowsiness
• Increased thirst and frequent urination
• A strong, fruity smell of your breath
• Rapid, deep breathing
• Confusion
• Belly pain, loss of appetite, and vomiting

Causes of Diabetic Ketoacidosis

The major cause of diabetic ketoacidosis is insufficient levels of insulin in the body which leads to breaking down of fat for energy. This, in turn, leads to release of ketones in the body.

Here are few things that increase the chances of DKA in those with diabetes:

• missing doses of insulin
• infection like UTI, pneumonia, or flu
• a surgery or injury
• binge drinking
• steroid medication and other medicines
• pregnancy
• using illegal drugs
• menstruation
• stress

How to Diagnose Diabetic Ketoacidosis

You can do a urine or blood test to check if you have diabetic ketoacidosis. Also, there are tests for home use. Don’t forget to keep tests strips at home in case your blood glucose becomes high.

This condition is characterized by high blood sugar levels, metabolic acidosis (increased anion gap), and ketosis along with secondary metabolic derangement.

Usually, the serum blood glucose is increased (RBS higher than 250 mg/dL), serum bicarbonate is less than 10 mmol/L, serum ketones (ketones in the blood) on urinalysis are positive, and arterial PH between 6.8 and 7.3. However, these numbers depend on the severity of the ketoacidosis.

How to Treat It

This condition is usually treated in hospital where you can stay for a few days until you have normal levels of ketones in the body. The treatments include giving insulin, nutrients, and fluid through the vein to rehydrate and replenish your body with the lost nutrients.

Also, doctors check the patients for possible life-threatening problems connected to lungs, kidneys, and brain.

How to Prevent It

Here are some tips to lower your risk of diabetic ketoacidosis:

• check your blood glucose levels regularly to notice and address increase quickly
• do a test for ketones if you take insulin
• don’t change your treatment plan – keep taking insulin unless your doctor tells you to stop
• if you’re sick, take extra care to prevent dehydration and blood sugar spikes
• consult your doctor before taking any medication as some can raise the risk of diabetic ketoacidosis
• if you can’t reduce your blood sugar levels for a longer time, consult your healthcare provider for an advice