Diabetic Ketoacidosis – Symptoms and Causes
Overview
When managing diabetic ketoacidosis, several products and services can help with prevention, monitoring, and treatment:
- Blood glucose meters: These devices check sugar levels regularly.
- Ketone test strips: Used to detect ketones in urine or blood.
- Continuous glucose monitors (CGMs): Provide real-time sugar level tracking.
- Insulin pumps: Deliver insulin automatically throughout the day.
- Medical alert bracelets: Inform others about your diabetes status in emergencies.
- Diabetes education programs: Teach proper management techniques.
- Telehealth services: Allow remote consultations with healthcare providers.
Regular use of these tools, combined with proper medical care, can help reduce the risk of developing this serious diabetes complication. Always follow your healthcare provider’s recommendations for managing your condition.
Signs and Symptoms
Diabetic ketoacidosis (DKA) symptoms typically develop rapidly, sometimes within just 24 hours. For some people, these symptoms may be their first indication of diabetes.
Common symptoms include extreme thirst, frequent urination, nausea and vomiting, and stomach pain.
People may also feel unusually weak or tired, have trouble breathing, or notice a fruity smell on their breath. Confusion is another warning sign.
Home testing can reveal:
- High blood sugar levels
- High ketone levels in urine
When to Call for Medical Help
If you’re sick, stressed, or recovering from illness or injury, check your blood sugar levels often. Having a store-bought urine ketone test kit at home is also helpful.
Contact your doctor right away if:
- You’re vomiting and unable to keep food or drinks down
- Your blood sugar stays above your target range despite home treatment
- Your urine test shows moderate or high ketone levels
Get emergency medical care immediately if:
- Your blood sugar measures above 300 mg/dL (16.7 mmol/L) in more than one test
- You have ketones in your urine and can’t reach your doctor
- You experience multiple symptoms of diabetic ketoacidosis, including:
- Extreme thirst
- Frequent urination
- Nausea and vomiting
- Stomach pain
- Weakness or fatigue
- Breathing difficulties
- Fruity-smelling breath
- Confusion
Warning: Diabetic ketoacidosis is a serious condition that can be fatal if not treated promptly. Don’t delay seeking medical attention if you notice these warning signs.
Causes
Diabetic ketoacidosis occurs when the body lacks enough insulin to properly use sugar for energy. This shortage forces the body to break down fat as an alternative fuel source, producing acids called ketones.
When ketones build up in the bloodstream and eventually appear in urine, ketoacidosis develops.
Several factors can trigger this dangerous condition:
Illness and Infections
- Pneumonia
- Urinary tract infections
- Other infections that cause hormone changes
When you’re sick, your body produces stress hormones like adrenaline and cortisol. These hormones work against insulin’s effects, sometimes leading to ketoacidosis.
Insulin Problems
- Missed insulin doses
- Insufficient insulin treatment
- Malfunctioning insulin pumps
Medical Conditions
- Heart attack
- Stroke
- Inflammation of the pancreas
- Pregnancy complications
Other Triggers
- Physical trauma (serious injuries)
- Emotional trauma (severe stress)
- Alcohol consumption
- Drug use, especially cocaine
- Certain medications, including:
- Corticosteroids
- Some diuretics (water pills)
The risk becomes greater when people with diabetes don’t follow their treatment plan or don’t recognize early warning signs.
Risk Factors
People with type 1 diabetes face the highest risk of diabetic ketoacidosis. Those who regularly skip their insulin doses are also at greater danger. While less common, this condition can affect individuals with type 2 diabetes as well.
In some cases, diabetic ketoacidosis might be the first indication that someone has diabetes, leading to their diagnosis.
Treatment Risks
Treatment for high ketone levels in diabetes can sometimes lead to unwanted effects:
Low Blood Sugar: Insulin helps move sugar from blood into cells. This can make blood sugar drop too fast, causing hypoglycemia.
Potassium Deficiency: The fluids and insulin used for treatment may reduce potassium to dangerous levels. This can affect your heart rhythm, muscle function, and nerve signals.
Brain Swelling: Correcting blood sugar too quickly can cause fluid to build up in the brain. Children with newly diagnosed diabetes face a higher risk of this complication.
Without proper treatment, a diabetic crisis with high ketones can lead to unconsciousness and can be fatal. This is why prompt medical care is essential when symptoms appear.
Preventing Diabetic Ketoacidosis
Taking steps to prevent diabetic ketoacidosis is vital for people with diabetes.
Daily Diabetes Management
- Eat healthy meals regularly
- Exercise appropriately
- Take medications or insulin as prescribed by your doctor
- Keep all medical appointments
Blood Sugar Monitoring
Regular checking of blood sugar levels is essential, especially during illness.
Most people need to check their levels 3-4 times daily, but you may need more frequent monitoring when sick or under stress.
Insulin Adjustments
Work with your healthcare team to understand when and how to adjust your insulin.
Your dosage needs may change based on:
- Current blood sugar readings
- Meal content and timing
- Physical activity levels
- Illness or stress
Ketone Testing
Purchase a urine ketone test kit from your local pharmacy.
Test for ketones when:
- You feel ill
- You’re under significant stress
- Your blood sugar stays above your target range
If your test shows moderate or high ketone levels, seek medical help immediately.
Even low ketone levels might require additional insulin.
