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What are the Warning Signs of Diabetic Ketoacidosis?

What are the Warning Signs of Diabetic Ketoacidosis?

Diabetic ketoacidosis (DKA) is a complication of type 1 diabetes. This develops when the body starts to run out of insulin, and instead relies on stored fat alone for energy. If not found and treated immediately, it can cause death.

When the cells don’t get enough glucose, the body burns fat for energy. This produces ketones. High levels of ketones cause the blood to become acidic, consequently, poisoning your body.

While DKA can happen to anyone with type 1 diabetes, it can also affect people with type 2 diabetes. If you’re at risk, it’s important to learn what are the warning signs of diabetic ketoacidosis, as well as your treatment options.

What causes diabetic ketoacidosis?

Before knowing what are the warning signs of diabetic ketoacidosis, let’s find out what can possibly trigger the disease. Diabetic ketoacidosis happens when there is not enough insulin in the body. When the body breaks down fat for energy, it releases acids known as ketones. Too much of these can poison the blood.

Now, insulin production can be affected by:

An underlying illness

High levels of hormones, such as adrenaline and cortisol are released if you have certain diseases or infections, like urinary tract infection (UTI). These hormonal imbalances can reverse the effect of insulin.

Sudden changes in insulin therapy

For example, missed treatments can leave the body not enough insulin to sustain.

There are rare occasions when diabetic ketoacidosis can also be caused by trauma, cardiac issues, drug abuse, and even medications, like corticosteroids.

What are the warning signs of diabetic ketoacidosis?

Typically, diabetic ketoacidosis develops slowly. However, if vomiting occurs, the condition can worsen in just a few hours. This is because you’re losing a lot of body fluids.

Early symptoms of the disease often include:

  • Flu-like symptoms, such as nausea, fatigue, and headaches
  • Excessive thirst or very dry mouth
  • Frequent urination
  • High blood sugar level, usually goes above 240 mg/dL

Then, symptoms like the following would come after

  • Breath smells fruity
  • Difficulty in breathing
  • Dry or flushed skin
  • Problems with concentration
  • Passing out

If you experience any of these, contact your health care provider immediately. Remember, diabetic ketoacidosis can be fatal, especially if not treated immediately.

How to check for ketones?

Now that we’ve identified what are the warning signs of diabetic ketoacidosis, let’s know more about its diagnosis and treatment.

If you have type 1 diabetes, you should have a blood or urine ketones testing kit. Use this especially when your sugar level goes above 240 mg/dL. Make sure that you consult with your medical team first before taking any kits.

The same goes for when you experience flu-like symptoms, check for ketones every four to six hours.

If you do happen to have high levels of ketones, go to the hospital immediately. Diabetic ketoacidosis can act fast, especially if you’ve already vomited twice in the last four hours.

Preventative measures for DKA

Make sure to follow these tips to reduce your risk and getting the worst of the disease:

Check your blood sugar level regularly

Make it a habit to monitor your blood sugar, to make sure that it stays within a healthy range. Do this at least every three to four hours.

Stick to your treatment plan

Don’t alter your insulin intake without your doctor’s recommendation. Any sudden changes might leave your body with not enough insulin.

Check your ketone level

Use over-the-counter urine ketone tests to confirm if there is an excess in your ketone level. This is prevalent when you have a fever, for example.

Observe a proper diet

Help manage your diabetes by eating healthy, and taking only prescribed medications.

Key Takeaways

Diabetic ketoacidosis is a life-threatening condition, so be prepared to act quickly. Be ready to seek medical attention as soon as you notice an increase in sugar levels, accompanied by symptoms like vomiting.

The sooner you get treated, the less likely complications will arise. Follow your diabetes treatment plan and observe a healthy lifestyle.

Learn more about Diabetes Complications here.


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Diabetic Ketoacidosis, https://www.nhs.uk/conditions/diabetic-ketoacidosis/, Accessed April 23, 2021 

Diabetic Ketoacidosis (DKA): Symptoms & Prevention,  https://www.jdrf.org/t1d-resources/about/symptoms/ketoacidosis/, Accessed April 23, 2021 

DKA (Ketoacidosis) & Ketones, https://www.diabetes.org/diabetes/complications/dka-ketoacidosis-ketones, Accessed April 23, 2021 

Diabetic ketoacidosis, https://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/symptoms-causes/, Accessed April 23, 2021 

Diabetic ketoacidosis in children and adolescents, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413392/, Accessed April 23, 2021

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Written by Honey Buenaventura Updated May 06, 2021
Fact Checked by Hello Doctor Medical Panel