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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.

Other Places To Get Help

Organization

American Diabetes Association (ADA)
1701 North Beauregard Street
Alexandria, VA  22311
Phone: 1-800-DIABETES (1-800-342-2383)
Email: AskADA@diabetes.org
Web Address: www.diabetes.org
 

The American Diabetes Association (ADA) is a national organization for health professionals and consumers. Almost every state has a local office. ADA sets the standards for the care of people with diabetes. Its focus is on research for the prevention and treatment of all types of diabetes. ADA provides patient and professional education mainly through its publications, which include the monthly magazine Diabetes Forecast, books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also provides information for parents about caring for a child with diabetes.


References

Other Works Consulted

  • Cooppan R, et al. (2010). Acute complications. In RS Beaser, ed., Joslin's Diabetes Deskbook: A Guide for Primary Care Providers, 2nd ed., pp. 419–443. Boston: Joslin Diabetes Center.
  • Eisenbarth GS, Buse JB (2011). Type 1 diabetes mellitus. In S Melmed et al., eds., Williams Textbook of Endocrinology, 12th ed., pp. 1436–1461. Philadelphia: Saunders.
  • Masharani U, German MS (2011). Pancreatic hormones and diabetes mellitus. In DG Gardner, D Shoback, eds., Greenspan's Basic and Clinical Endocrinology, 9th ed., pp. 573–655. New York: McGraw-Hill.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer David C.W. Lau, MD, PhD, FRCPC - Endocrinology
Last Revised May 21, 2012

Last Revised: May 21, 2012

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & David C.W. Lau, MD, PhD, FRCPC - Endocrinology

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