Diabetic Ketoacidosis: What it is and How to Treat it

Diabetes Care|Jan.08, 2020

You know that maintaining healthy glucose levels is important in proper diabetes management.

But did you know that poor diabetes management can lead to serious health effects that extend beyond high or low blood sugar levels?

One such effect is Diabetic ketoacidosis. Here's what you need to know.

What Are Ketones?

To understand diabetic ketoacidosis, you have to understand what ketones are.

Your body burns carbohydrates for fuel. When your body doesn't have enough carbohydrates, it turns to another energy source: fat. When your liver breaks down fat for fuel, it creates ketones as a byproduct. This is a natural process called ketogenesis. This is a normal condition that occurs periodically, according to the National Portal of Health, but it can become a serious problem if it's sustained.

What is Diabetic Ketoacidosis?

Burning fat for fuel is a good thing if you're trying to lose weight, and ketones often form as a result of a low-carbohydrate diet. But too many ketones is a problem — especially if you have diabetes.

People with diabetes form ketones the same way as people who don't have diabetes. And if your blood sugar levels are normal, the presence of ketones isn't necessarily a cause for concern. But when your insulin levels are low, your cells can't effectively use glucose for energy, so your body begins to break down fat for energy. Ketones make your blood acidic; when your blood gets too acidic, it leads to diabetic ketoacidosis, a very dangerous and possibly life-threatening situation.

How Do I Know if I Have Diabetic Ketoacidosis?

Diabetic ketoacidosis usually develops slowly, but the signs can come on quickly — sometimes within a day, the Mayo Clinic says. If you have diabetes, keep an eye out for the following symptoms of diabetic ketoacidosis:

  • Excessive thirst
  • Frequent urination
  • Vomiting or nausea
  • Stomach pain
  • Fatigue or weakness
  • Trouble breathing
  • Fruity-smelling breath
  • Confusion
  • Elevated blood sugar
  • Elevated ketone levels in your urine

If you experience vomiting, you should seek immediate medical attention.

If you have type 1 diabetes, you're at a higher risk of developing ketoacidosis, says a study published in BMJ Open. Missing an insulin injection can also lead to ketoacidosis.

When Should I Seek Emergency Treatment?

Diabetic ketoacidosis is a serious side effect of diabetes. Its symptoms can come on quickly, and can sometimes be your first indication that you may have the disease. You should go to the emergency room immediately if you experience any symptoms of diabetic ketoacidosis, especially if you have been vomiting, have elevated blood sugar levels that aren't responding to home diabetes care, or if your urine or blood ketones are high. Seeking medical care early can minimise the serious effects of ketoacidosis, which could include diabetic coma or death.

To make a diagnosis, your physician will test for healthy glucose levels, ketones and electrolyte levels, according to Harvard Health. They may also check to see if you have an infection. If they determine you have diabetic ketoacidosis, you may need to be treated in the hospital.

How Can I Prevent Diabetic Ketoacidosis?

There are many things you can do to prevent diabetic ketoacidosis, the Mayo Clinic says. Proper diabetes management is critical, so be sure to regularly monitor your blood sugar level and have your doctor adjust your insulin dosage as necessary.

If you've been sick or stressed out, you should check your blood sugar level often. You might also try testing your ketone levels at home with an over-the-counter urine testing kit. These tests determine your levels using strips similar to the ones used for blood testing.

The American Diabetes Association notes that you should check your urine for ketone levels when your blood glucose is above 240 mg/dL. Ask your doctor for guidance on when and how to test for ketones.

If you have diabetes, it's important to know the symptoms of diabetic ketoacidosis. But with proper diabetes management to ensure that you maintain healthy glucose levels, you should be able to avoid this serious complication.


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