- What Is It
- When to See a Doctor
Diabetic ketoacidosis (DKA) is a serious but potentially preventable and treatable complication of diabetes. The mortality rate for DKA is about 2%. Mortality rates in older individuals are higher, at about 10%-20%, due to existing comorbidities.
Because it typically takes hours for DKA to become life-threatening, you can survive the condition by acting quickly and receiving timely medical treatment.
Depending on the severity of the DKA, it may take several days before it is fully treated. However, it is often corrected (blood sugar less than 200 mg/dL and blood pH higher than 7.3) within 24 hours of appropriate treatment.
What is diabetic ketoacidosis?
Diabetic ketoacidosis (DKA) can develop when there is an absolute insulin deficiency in the body. This causes blood sugar levels to spike to a dangerous level and leads to an overload of blood ketone levels due to the rapid breakdown of fats by the liver, causing metabolic acidosis. This causes progressive multiple organ dysfunction.
People with type I diabetes are mostly affected, but people with type II diabetes who are on insulin can also develop DKA. DKA is more common in women, young adults, and children.
How does diabetic ketoacidosis occur?
The two major causes of diabetic ketoacidosis (DKA) in people with type I diabetes are high blood sugar levels and low insulin levels.
- Insulin is the hormone that assists the entry of sugar molecules into the cells. In the absence of insulin, cells cannot utilize glucose as an energy source.
- Without enough insulin, the liver undergoes a rapid fat breakdown (for fuel production), a process that produces acids called ketones, making the blood acidic (low pH).
- These ketones are usually used by muscles and the heart. When ketones are produced too quickly and accumulate in the blood, they can be toxic to the body and eventually lead to ketoacidosis.
- Because the cells in the body can only function in a narrow range of pH, any acidotic change hampers cell metabolism and can trigger shock-like symptoms.
Other causes of DKA include:
- Heart attack or stroke
- Missed insulin doses
- Physical injury or surgery
- Alcohol or drug use
- Certain medicines, such as some diuretics and corticosteroids
DKA in people with type II diabetes is less severe and usually triggered by prolonged uncontrolled blood sugar, missing medication doses, or a severe illness or infection. This is because even in those who are insulin-dependent in type II diabetes, tiny amounts of insulin are still mostly being released in the body.
What are the signs and symptoms of diabetic ketoacidosis?
Diabetic ketoacidosis (DKA) can develop acutely, meaning that it has a severe and sudden onset. Sometimes, it is the first sign of diabetes in people who have not yet been diagnosed.
Early symptoms may include:
- Increased thirst
- Dryness of the mouth
- Frequent urination
- High blood glucose (blood sugar) levels
- High levels of ketones in the urine
If untreated, more severe symptoms can appear quickly, including:
- Nausea, vomiting, or abdominal pain
- Dry or flushed skin
- Excessive dryness of mouth
- Constant fatigue
- Fruity-smelling breath
- Blurred vision
- Muscle stiffness or aches
- Fast, deep breathing
- Confusion or difficulty paying attention
When to see a doctor for diabetic ketoacidosis
Elevated ketones are a sign of diabetic ketoacidosis (DKA), which is a medical emergency and needs to be treated immediately.
You can detect ketones with an over-the-counter ketone test kit, a simple urine test that can be taken every 4-6 hours when:
- Attachment Theory: What It Is, Stages & the Different Attachment Styles
- Gentle Parenting: What It Is, Techniques & Discipline
- U.S. Nursing Homes Fail to Report Many Serious Falls, Bedsores: Study
- The Younger You Get Diabetes, the Higher Your Risk for Dementia Later
- FDA Grants Full Approval to Paxlovid to Treat COVID-19
- More Health News »
How is diabetic ketoacidosis treated?
Diabetic ketoacidosis is treated in the emergency room or hospital. Treatment will likely include:
- Fluid replacement
- Electrolyte replacement
- Insulin therapy
- Medicines for any underlying illness
Can you prevent diabetic ketoacidosis?
Diabetic ketoacidosis (DKA) is a serious condition, but you can take steps to help prevent it:
- Manage your blood sugar levels through diet, exercise, medications, and self-care
- Monitor your blood sugar often, especially when you are sick
- Try to keep your blood sugar levels in the target range as much as possible
- Take medicines as prescribed, even if you feel fine
- Check ketone levels when you are ill or stressed
- Stay hydrated
- Exercise regularly
- Check for insulin leaks and expired insulin
- Talk to your doctor to adjust your insulin dosage based on your diet, activity level, or overall health
- Be prepared to seek emergency care if your blood sugar is high and you have excess ketones in your urine
Health Solutions From Our Sponsors
Centers for Disease Control and Prevention. Diabetic Ketoacidosis. https://www.cdc.gov/diabetes/basics/diabetic-ketoacidosis.html
American Diabetes Association. Diabetes & DKA (Ketoacidosis). https://www.diabetes.org/diabetes/dka-ketoacidosis-ketones
WebMD. Diabetic Ketoacidosis. https://www.webmd.com/diabetes/ketoacidosis
Cleveland Clinic. Diabetes-Related Ketoacidosis (DKA). https://my.clevelandclinic.org/health/diseases/21945-diabetic-ketoacidosis-dka
Top Can You Survive Diabetic Ketoacidosis Related Articles
Diabetes Tips: Managing and Living With DiabetesIf you have either type 1 or type 2 diabetes, you need to approach life differently. Learn nutrition tips to control blood sugar, ways to manage your insulin, hyperglycemia triggers like stress, and what to do when traveling with diabetes. Discover the various symptoms of diabetes, how they put your body at risk, and steps you can take to live better with diabetes.
Body Blood Sugar LevelsHigh blood sugar can be a sign of diabetes or prediabetes. The drugs that treat it sometimes cause low blood sugar too. WebMD helps guide you through the effects of both.
Diabetes (Type 1 and Type 2)Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
12 Ways Sugar Harms Your BodyThe bitter truth: How too much sugar can harm your physical and mental health.
Diabetic KetoacidosisDiabetic ketoacidosis (DKA) is a complication of type 1 diabetes that is life threatening. If a person thinks they may have diabetic ketoacidosis they should seek medical care immediately. Diabetic ketoacidosis happens when a person's insulin levels in the blood become dangerously low.
Symptoms of diabetic ketoacidosis include dehydration, abdominal pain, confusion, and nausea and vomiting.
Diabetic ketoacidosis needs medical treatment. It cannot be treated at home.
Insulin Pump for DiabetesAn insulin pump is designed to deliver insulin directly to a patient with diabetes. They are about the size of a standard beeper. The pump is attached to under the skin (usually on the abdomen). The amount of insulin required will depend on lifestyle (exercise, sleep patterns, activity level, and diet).
Diabetes: What Raises and Lowers Your Blood Sugar Level?Want to lower your blood sugar? Learn to better control your glucose levels by preventing blood sugar spikes and swings to avoid neuropathy and other diabetes complications. Find foods that lower blood sugar, and identify foods and activities that raise high blood sugar risks.
Type 1 Diabetes (Symptoms, Causes, Diet, Treatment, Life Expectancy)Type 1 diabetes mellitus (juvenile) is an auto-immune disease with no known cause at this time, although there are a few risk factors. Symptoms of type 1 diabetes include frequent urination, unintentional weight loss, dry and itchy skin, vision problems, wounds that heal slowly, and excessive thirst. Type 1 diabetes is diagnosed with blood tests. A healthy lifestyle and controlling blood glucose levels can improve life expectancy.
Type 1 Diabetes QuizWhat are the causes of type 1 diabetes? Take this quiz and challenge your knowledge of causes, symptoms, diagnosis and treatments for this common condition, formerly known as juvenile diabetes.
Diabetes Urine TestsUrine tests for individuals with diabetes is important to check for diabetes-related kidney disease and severe hypoglycemia. With proper monitoring of blood glucose levels, diabetic-kidney disease can be avoided.
What Does High Ketones in Blood Mean?If you have diabetes, high ketone levels in your blood or urine could mean that you have diabetic ketoacidosis, which can be life-threatening. But healthy people on a keto diet may also have high ketone levels but without any significant problems.
What Is the Survival Rate of Diabetic Ketoacidosis?With appropriate and timely treatment, the survival rate of DKA is quite high at over 95%. Survival rates are poorer in the elderly and those with known organ damage.
What Tests Are Done for Diabetes?Diabetes can cause serious complications if left untreated, which is why timely diagnosis is important. Learn about tests for type II, type I, and gestational diabetes.
What Tests Should Be Done for Diabetes?Testing for diabetes is important because early detection and treatment can help maintain healthy blood glucose levels and lower the rate of premature death. Learn the ten best tests to diagnose diabetes here.
Why Are Ketones Bad?Ketones, also called ketone bodies or keto acids, are a type of water-soluble compound produced from the fat breakdown in the body. Although ketones are a normal product of metabolism, they may be produced in excess in certain situations, such as diabetes.