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NOTE:
unless noted otherwise, all medical/health advice has been given by non-medically qualified personnel. All advice given on this site is designed to support and not replace any advice given by your personal physician. If you have questions or concerns about individual health matters or the management of your diabetes, please consult your diabetes care team.
unless noted otherwise, all medical/health advice has been given by non-medically qualified personnel. All advice given on this site is designed to support and not replace any advice given by your personal physician. If you have questions or concerns about individual health matters or the management of your diabetes, please consult your diabetes care team.
Diabetic ketoacidosis or 'DKA' develops when there is a severe shortage of
insulin in the body. If it is not treated in a timely fashion then DKA can
result in coma and death.
Ketoacidosis is the most common cause of death related to diabetes in young people. Yet nearly all deaths due to ketoacidosis can be prevented by better blood glucose control and an understanding of the condition.
When does it happen?
People with Type 1 diabetes are more likely to develop DKA because they no longer produce any insulin.
DKA is most likely to develop if:
When insulin is in really short supply and cells cannot access glucose from the blood the body turns to its fat stores for an alternative source of fuel. Breakdown products of fats, known as ketones, are released into the bloodstream and start to accumulate. Normally ketones are excreted in the urine, but if they are being produced in excess, the kidneys cannot cope. A build up of ketones in the body makes the blood dangerously acidic and if the condition is not treated promptly it can result in coma and eventually death.
What are signs and symptoms?
Since DKA usually occurs when the blood glucose level is high, the usual symptoms of thirst, frequent urination and tiredness are often the first signs of impending trouble.
Ketones in the urine are an important sign and can be measured with a dip- stick. If moderate levels of ketones in the urine persist for longer than a few hours and are accompanied by any other symptoms then you should seek advice from your doctor.
Ketones can often be smelt on the breath - a characteristic fruity (sweet but acidic) smell, similar to that of pear drops.
In addition, the skin may become dry, eyesight blurred and breathing deep and rapid. Nausea and stomach pain may lead on to vomiting. Vomiting is always a danger signal in diabetes and this is generally the stage at which you should seek emergency help.
Confusion or lack of attention can lead to drowsiness, which is followed by loss of consciousness and, if left untreated, death. It is vitally important to get treatment sooner rather than later; if you suspect DKA then do not hesitate to call your doctor or the emergency services or go straight to your nearest Accident and Emergency department.
How is ketoacidosis treated?
Ketoacidosis needs hospital treatment with intravenous fluids, insulin and other substances, in order to rehydrate the body and restore the body's chemical balance.
The body often becomes quite resistant to the effects of insulin during ketoacidosis, so you may need high levels of insulin to bring blood glucose levels under control.
You may initially be treated in an intensive care unit, where you can be closely monitored.
Avoiding ketoacidosis
The main way of avoiding ketoacidosis is by maintaining good control of blood glucose levels at all times.
You are most likely to be at risk of DKA during periods of illness, particularly if you have flu, a chest infection or severe stomach upset with vomiting.
Test your urine for ketones whenever your blood glucose levels persistently remain in the teens.
Testing for ketones
Ketones are easily detected with a simple urine test, using a special dip- stick.
Simply pass the strip through a stream of urine, keep time and match the strip against the colour chart provided with the strips. Make sure that you follow the instructions carefully, particularly in terms of timing the colour change. Ignore any changes after the allotted time.
Always ensure you have some strips available and make sure they have not passed their expiry date. Remember to include ketone strips in your travel pack when going away.
NEVER skip your insulin injections or drastically reduce your insulin dose, even if you are not eating.
Drink plenty of sugar-free fluids when you are ill.
Follow sick day guidelines and make sure that you call for help sooner rather than later.
Low levels of ketones
Small amounts of ketones are nothing to worry about and are naturally produced in people who do not have diabetes, particularly when losing weight or going for quite long periods without eating. However, persistent ketones at mild-to-moderate levels in people with diabetes are a sign that the body does not have enough insulin.
Ketones in the urine in the early morning may be a sign of nighttime hypoglycaemia; try testing your blood glucose level between 2 and 3 a.m. to see if this is the case.
Ketones are common during pregnancy, especially during the morning and when complicated by morning sickness.
Ketoacidosis is the most common cause of death related to diabetes in young people. Yet nearly all deaths due to ketoacidosis can be prevented by better blood glucose control and an understanding of the condition.
When does it happen?
People with Type 1 diabetes are more likely to develop DKA because they no longer produce any insulin.
DKA is most likely to develop if:
- Insulin doses are drastically reduced
- An injection is missed altogether
- The body needs more insulin than usual because it is fighting an infection
When insulin is in really short supply and cells cannot access glucose from the blood the body turns to its fat stores for an alternative source of fuel. Breakdown products of fats, known as ketones, are released into the bloodstream and start to accumulate. Normally ketones are excreted in the urine, but if they are being produced in excess, the kidneys cannot cope. A build up of ketones in the body makes the blood dangerously acidic and if the condition is not treated promptly it can result in coma and eventually death.
What are signs and symptoms?
Since DKA usually occurs when the blood glucose level is high, the usual symptoms of thirst, frequent urination and tiredness are often the first signs of impending trouble.
Ketones in the urine are an important sign and can be measured with a dip- stick. If moderate levels of ketones in the urine persist for longer than a few hours and are accompanied by any other symptoms then you should seek advice from your doctor.
Ketones can often be smelt on the breath - a characteristic fruity (sweet but acidic) smell, similar to that of pear drops.
In addition, the skin may become dry, eyesight blurred and breathing deep and rapid. Nausea and stomach pain may lead on to vomiting. Vomiting is always a danger signal in diabetes and this is generally the stage at which you should seek emergency help.
Confusion or lack of attention can lead to drowsiness, which is followed by loss of consciousness and, if left untreated, death. It is vitally important to get treatment sooner rather than later; if you suspect DKA then do not hesitate to call your doctor or the emergency services or go straight to your nearest Accident and Emergency department.
How is ketoacidosis treated?
Ketoacidosis needs hospital treatment with intravenous fluids, insulin and other substances, in order to rehydrate the body and restore the body's chemical balance.
The body often becomes quite resistant to the effects of insulin during ketoacidosis, so you may need high levels of insulin to bring blood glucose levels under control.
You may initially be treated in an intensive care unit, where you can be closely monitored.
Avoiding ketoacidosis
The main way of avoiding ketoacidosis is by maintaining good control of blood glucose levels at all times.
You are most likely to be at risk of DKA during periods of illness, particularly if you have flu, a chest infection or severe stomach upset with vomiting.
Test your urine for ketones whenever your blood glucose levels persistently remain in the teens.
Testing for ketones
Ketones are easily detected with a simple urine test, using a special dip- stick.
Simply pass the strip through a stream of urine, keep time and match the strip against the colour chart provided with the strips. Make sure that you follow the instructions carefully, particularly in terms of timing the colour change. Ignore any changes after the allotted time.
Always ensure you have some strips available and make sure they have not passed their expiry date. Remember to include ketone strips in your travel pack when going away.
NEVER skip your insulin injections or drastically reduce your insulin dose, even if you are not eating.
Drink plenty of sugar-free fluids when you are ill.
Follow sick day guidelines and make sure that you call for help sooner rather than later.
Low levels of ketones
Small amounts of ketones are nothing to worry about and are naturally produced in people who do not have diabetes, particularly when losing weight or going for quite long periods without eating. However, persistent ketones at mild-to-moderate levels in people with diabetes are a sign that the body does not have enough insulin.
Ketones in the urine in the early morning may be a sign of nighttime hypoglycaemia; try testing your blood glucose level between 2 and 3 a.m. to see if this is the case.
Ketones are common during pregnancy, especially during the morning and when complicated by morning sickness.
