What is Diabetic Ketoacidosis and How to Recognize it

Those 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 a 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 those with type 2 diabetes. Here are the symptoms, causes, treatment, and prevention of diabetic ketoacidosis.

Symptoms of Diabetic Ketoacidosis

Besides high blood glucose levels, people 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 on our 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 the breaking down of fat for energy. This, in turn, leads to the release of ketones in the body. Here are a few things that increase the chances of DKA in those with diabetes:

• Missing doses of insulin;
• An infection like UTI, pneumonia, or flu;
• Surgery or injury;
• Binge drinking;
• Steroid medication and other medicines;
• Pregnancy;
• Using illegal drugs;
• Menstruation;
• Stress.

How to Diagnose Diabetic Ketoacidosis

People can do a urine or blood test to check if they have diabetic ketoacidosis. Also, there are tests for home use. Don’t forget to keep test strips at home in case the 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 ketoacidosis.

How to Treat It

This condition is usually treated in a hospital where people can stay for a few days until they have normal levels of ketones in the body. The treatments include giving insulin, nutrients, and fluid through the vein to rehydrate and replenish the body with the lost nutrients. Also, doctors check the patients for possible life-threatening problems connected to the lungs, kidneys, and brain.

How to Prevent It

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

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