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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 because there is not enough insulin.

When the sugar cannot get into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood and remove it from the body through urine.

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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:

  • Flushed, hot, dry skin.
  • Blurred vision.
  • Feeling thirsty and urinating a lot.
  • 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.

How is DKA diagnosed?

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.

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