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Diabetic Ketoacidosis (DKA) - Topic Overview

What is diabetic ketoacidosis (DKA)?

Diabetic ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are unable to get the sugar (glucose) they need for energy, such as when you have diabetes and do not get enough insulin. Without insulin, the body cannot use sugar for energy. When the cells do not receive sugar, the body begins to break down fat and muscle for energy. When this happens, ketones, or fatty acids, are produced and enter the bloodstream, causing the chemical imbalance (metabolic acidosis) called diabetic ketoacidosis.

What causes DKA?

Ketoacidosis can be caused by not getting enough insulin, having a severe infection or other illness, becoming severely dehydrated, or some combination of these things. It can occur in people who have little or no insulin in their bodies (mostly people with type 1 diabetes but it can happen with type 2 diabetes) when their blood sugar levels are high.

What are the symptoms?

Your blood sugar may be quite high before you notice symptoms, which include:

  • Flushed, hot, dry skin.
  • Blurred vision.
  • Feeling thirsty.
  • Drowsiness or difficulty waking up. Young children may lack interest in their normal activities.
  • Rapid, deep breathing.
  • A strong, fruity breath odor.
  • Loss of appetite, belly pain, and vomiting.
  • Confusion.

When diabetic ketoacidosis is severe, you may have a hard time breathing, your brain may swell (cerebral edema), and there is a risk of coma and even death.

How is DKA diagnosed?

Laboratory tests, including blood and urine tests, are used to confirm a diagnosis of diabetic ketoacidosis. Urine dipstick tests for ketones are available for home use. Keep some nearby in case your blood sugar level becomes high.

How is it treated?

When ketoacidosis is severe, it must be treated in the hospital, often in an intensive care unit. Treatment involves giving insulin and fluids through a vein and closely watching certain chemicals in the blood (electrolytes). It can take several days for your blood sugar level to return to a target range.

Who is at risk for DKA?

If you have type 1 diabetes, you are at risk for DKA if you do not get enough insulin, have a severe infection or other illness, or become severely dehydrated. In some cases DKA can be the first sign of diabetes.

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WebMD Medical Reference from Healthwise

Last Updated: May 21, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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If the level is below 70 and 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.

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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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