In every issue of WebMD the Magazine, we ask our experts to answer readers' questions about a wide range of topics. In our January-February 2011 issue, we asked WebMD's diabetes expert, Michael Dansinger, MD, to answer a question about the link between prediabetes and diabetes.
Q: At my last checkup, my doctor told me I have prediabetes. Does that mean I'll ultimately develop diabetes?
A: Almost everyone who develops type 2 diabetes develops prediabetes first. But not everyone who has prediabetes...
Because the cells cannot receive sugar for energy, 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, especially children) when their blood sugar levels are high.
What are the symptoms?
Your blood sugar may be quite high before you notice symptoms, which include:
Laboratory tests, including blood and urine tests, are used to confirm a diagnosis of diabetic ketoacidosis. Tests for ketones are available for home use. Keep some test strips 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 your vein and closely watching certain chemicals in your blood (electrolytes). The doctors and nurses will watch you closely to be sure that your brain does not swell as the fluids treat your dehydration.
It can take several days for your blood sugar level to return to a target range.