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Diabetic Ketoacidosis (DKA)

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Diabetic ketoacidosis (DKA) 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 starts with high ketone levels, often when 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 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 how your body works.

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).

Warning Signs

When your blood glucose is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot, test your ketones. 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 need insulin through an IV to bring your ketones down and fluids to get you hydrated and balance your blood chemistry again. 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 glucose 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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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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