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What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too.

What Causes DKA?

It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system.

People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction.

DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration.

Warning Signs

Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes.

Call your doctor or go to the emergency room right away if that doesn't work, if you have any of the symptoms below and your ketones aren't normal, or if you have more than one symptom.

  • You've been throwing up for more than 2 hours.
  • You feel queasy or your belly hurts.
  • Your breath smells fruity.
  • You're tired, confused, or woozy.
  • You're having a hard time breathing.

Treatment and Prevention

You may have to go to the hospital. You'll probably get insulin through an IV to bring your ketones down and fluids to get you hydrated and bring your blood chemistry back into balance. If you don't treat ketoacidosis, you could pass out, go into a coma, and possibly die.

Your doctor may change your insulin dose, or the kind you use, to prevent it from happening again. You should drink more water and sugar-free, non-alcoholic beverages.

Good blood sugar control will help you avoid ketoacidosis.

  • Take your medicines as directed.
  • Follow your meal plan closely.
  • Keep up with your exercise program.
  • Test your blood sugar regularly.

Make sure your insulin hasn't expired. Don't use it if it has clumps. Insulin should either be clear or evenly cloudy with small flecks.

If you're on an insulin pump, look closely for insulin leaks, and check your tube connections for air bubbles.

Talk to your doctor if your blood sugar levels are often out of your target range.

WebMD Medical Reference

Reviewed by Michael Dansinger, MD on October 22, 2014

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