Diabetic ketoacidosis, often referred to as ketoacidosis or simply DKA, is a short term complication of high blood glucose levels in people with diabetes.

It most commonly occurs in people with type 1 diabetes but it can also affect some people with type 2 diabetes who are also reliant on insulin (insulin-dependent).

Ketoacidosis is a serious medical condition and can advance very quickly within a matter of hours, or sometimes as quickly as within one hour.

It is therefore important to know whether you are at risk of ketoacidosis and, if so, to be able to spot the signs and react accordingly.

What causes diabetic ketoacidosis?

Ketoacidosis occurs when the body starts running out of insulin – the hormone responsible for regulating levels of blood sugar.

Without enough insulin, the cells cannot access glucose from the blood and so the body responds by breaking down protein and fat to produce an alternative form of energy called ketones.

Whilst the body can cope with lower levels of ketones, higher levels can turn the blood acidic and pose an immediate danger to health, often causing severe illness.

Am I at risk of ketoacidosis?

People with type 1 diabetes or LADA (Latent Autoimmune Diabetes of Adulthood) who require insulin injections are most at risk of developing ketoacidosis.

Type 2 diabetics who need to take meal time insulin (short or rapid-acting insulin) in addition to long term (basal) insulin may also be at risk.

What the signs of diabetic ketoacidosis?

The symptoms of ketoacidosis include:

If you have any of the symptoms of ketoacidosis contact your health care provider immediately. Early detection and treatment is vital in cases of DKA, as failure to treat the condition quickly can lead to  loss of consciousness and increase the risk of coma.

If your health care provider is not available go to your nearest hospital emergency room, but do not drive there yourself.

Checking for ketones

Because ketoacidosis can become very serious in a short space of time, it is important to know how to check your ketone levels.

You should check for ketones if you:

  • Have any of the symptoms of ketoacidosis
  • Have a blood sugar level reading of more than 240 mg/dl
  • Are ill – during bouts of illness, it is recommended that you check ketone levels every 4 to 6 hours

If you test your ketone levels and get a high ketone level reading, or the results from two consecutive tests, a few hours apart,  show moderate ketone levels, you must call your health care provider.

Preventing diabetic ketoacidosis

Because ketoacidosis is caused by having not enough insulin in the body, it can be prevented by:

  • Making sure you always have your insulin treatment with you when leaving home
  • Taking your insulin doses on time, and
  • Testing your blood glucose levels regularly.

If you are regularly getting high blood glucose levels over 240 mg/dl, speak to your health care provider who will be able to advise you ways to improve your diabetes control.