How to Avoid Diabetic Ketoacidosis

A Diabetes Complication Caused by Hyperglcyemia

Diabetic ketoacidosis (DKA) is a possible complication of diabetes caused by extreme hyperglycemia, or high blood glucose.  It is a serious and potentially life-threatening complication, one that you should work hard to avoid when you have diabetes.  Diabetic ketoacidosis mainly affects people with type 1 diabetes, but it is a very rare possible complication for people with type 2 diabetes.

Your doctor and certified diabetes educator will teach you how to recognize and manage diabetic ketoacidosis. It's critical to know and recognize the signs and symptoms of DKA, as well as how to treat it.

What Is Diabetic Ketoacidosis?
Diabetic ketoacidosis happens when your blood glucose level gets too high—usually higher than 300 mg/dL.  Because people with type 1 diabetes do not have the insulin to process this extra glucose, their body cannot break down this glucose to create energy.

To create energy for itself, the body starts to aggressively break down fat. Ketones or ketoacids are a byproduct of this process.

Your body can handle a small amount of ketones circulating in your blood. However, the sizeable amounts from DKA are toxic.

Diabetic Ketoacidosis Causes
Illness, infections, stress, injuries, neglecting diabetes care (not properly taking your insulin, for example), and alcohol consumption can cause DKA.

Diabetic Ketoacidosis Symptoms
Initial symptoms of DKA include a stomach ache, nausea, and vomiting. One problem with DKA is that people could mistake it for an illness that typically gets better over time like the flu or food poisoning.

Other symptoms of diabetic ketoacidosis include:

  • fruity breath (when fat is broken down by the body, it creates a chemical called acetone that smells fruity)
  • fatigue
  • frequent urination
  • intense thirst
  • headache

If you feel any of these symptoms, you should check your blood glucose level. If your blood glucose is too high (250 mg/dL or higher), you may be suffering from DKA.

Diabetic Ketoacidosis Diagnosis
If you have type 1 diabetes, you should always have ketone strips handy.  These are used to test urine for the ketone level.

If your (or your child’s) blood glucose level is above 250 mg/dL, then you can confirm diabetic ketoacidosis using a ketone urine strip.  It will turn a deep purple if the ketone level is too high.

There are also blood glucose meters available that also test for ketones. Ask your doctor or diabetes educator for a recommendation.

What Should I Do If I Suspect DKA?
Talk to your doctor now about how to manage different ketone levels in your body. Slight ketones may be treated at home, while higher levels indicate the possibility of DKA and require medical intervention. As a general rule, if your blood glucose level is too high (above 250 mg/dL) and you have confirmed high levels of ketones with a ketone test, you should seek emergency care at a hospital.

The doctors and nurses there will use insulin and IV fluids to treat the ketoacidosis episode. If your blood glucose levels do not stabilize, you may have to stay for a few days to bring them down.

Diabetic Ketoacidosis Prevention
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.

Updated on: January 16, 2019
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Ketoacidosis: A Diabetes Complication