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Diabetic ketoacidosis, also known as DKA, is a life-threatening complication of diabetes. Caused by severe insulin deficiency. Without insulin, the body cannot move sugar into cells for energy, so instead it breaks down fat and releases harmful chemicals called ketones, which accumulate and make the blood more acidic.
A large accumulation of ketone bodies can quickly lead to serious illness. Additionally, some people, including children, may have DKA before they are diagnosed with diabetes, especially if they have type 1 diabetes.
DKA is more likely to occur in people with type 1 diabetes, people with any type of diabetes who use insulin, and people who take SGLT2 inhibitors, but it is more likely to occur in people who take pills or have a diagnosis. It can also occur in people who have not received it. DKA can affect people with type 2 diabetes and other types of diabetes, who may instead develop a hyperosmolar hyperglycemic state (HHS).
It is important to be able to identify the signs and symptoms of DKA so that it can be treated quickly.
This page explains:
What causes DKA?
What are the signs and symptoms of DKA?
Is there a DKA review?
Check your ketone bodies and blood sugar levels
What is the treatment for DKA?
What can you do to avoid DKA?
What causes DKA?
For some people, including some children, suddenly becoming seriously ill with DKA may be the reason they discover they have type 1 diabetes in the first place.
If you have already been diagnosed with diabetes, possible causes of DKA include:
- Have an illness such as a chest infection, influenza, or urinary tract infection (UTI)
- High blood sugar levels caused by growth spurts or puberty
- Not taking your insulin or forgetting your dose
- If your insulin pump is not working properly or has been accidentally removed
- surgery or injury
- have a heart attack or stroke
- Hyperglycemia due to menstruation.
In some cases, there are not always obvious triggers for DKA, which can be worrying and confusing. However, if you suspect that you or your child has DKA, it is important to get it. get medical help immediately.
What are the signs and symptoms of DKA?
DKA is diagnosed through a blood test at the hospital. Signs and symptoms include:
Test results that may indicate DKA include:
- High blood sugar levels – can only be confirmed by a finger prick test or continuous blood sugar monitor.
- High levels of ketones (chemicals) in the blood or urine, which can only be confirmed with a handheld ketone monitor or urine ketone test.
Symptoms of DKA include:
- I'm very thirsty
- need to pee more often
- Feeling tired and sleepy
- confusion
- blurred vision
- abdominal pain
- feel or get sick
- Sweet or fruity scented breath, like nail polish remover or pear drop sweets
- faint.
These symptoms are sometimes called a “diabetic attack,” but this can also refer to other things, such as: Hypoglycemia. You may notice these signs develop over a 24-hour period, but they can appear sooner, especially in children or if you use an insulin pump. If you notice any of these symptoms, it is a sign that you need to see a doctor right away.
Please share this information with a friend, relative, or someone who cares for your child, such as a teacher or childcare worker. This is so that the symptoms of DKA can also be identified.
In this video, Kate talks about when her son became critically ill with DKA and shortly thereafter was diagnosed with type 1 diabetes.
In her video, Kate mentions 4T, the four most common signs of type 1 diabetes. they are:
- toilet – Frequent trips to the toilet, bedwetting by the child that was previously dry, or the baby's diaper becoming heavier.
- I'm thirsty – I'm so thirsty that I can't quench my thirst.
- tired – I feel more tired than usual.
- thinner – Losing weight or looking thinner than usual
Is there a DKA review?
No, there is no screening for DKA because it is a rapid-onset disease rather than a long-term disease. If you treat type 1 diabetes or any other type of diabetes with insulin or insulin, you should check it at home. If you are using certain other diabetes medications, if you feel unwell or have high blood sugar levels.
However, there are research studies that screen for risk of type 1 diabetes. You can check the details and register.
Check your ketone bodies and blood sugar levels
blood test
If you have signs of DKA, check your blood sugar levels right away. If you have undiagnosed diabetes or do not have testing equipment at home to test your blood sugar levels or ketone bodies, but you are experiencing signs and symptoms of DKA, you should seek immediate medical attention.
If your blood sugar levels are high (usually 13 or higher) or if you feel really sick, check the following: Ketones. You can check ketone bodies in your blood and urine. Blood tests show ketone body levels in real time, while urine tests show ketone body levels from several hours ago.
If you have type 1 diabetes, you should get a free blood ketone monitor from the NHS. If you have high levels of ketones in your blood and suspect DKA, you should seek immediate medical attention. Find your nearest A&E.
If you think you should have a ketone meter and don't have one yet, find out more about whether you need to get a ketone test or provide urine test strips or a blood monitor if you have diabetes. Talk to your team.
If you are not informed about when to do a ketone test or what results require action, you should discuss this with your diabetes team. If your ketone levels are above 3 mmol, you should seek immediate medical attention.
“Jane had been diabetic for about 20+ years and no one ever mentioned the word ketones or that handheld ketone meters were available. At that time, it's probably unthinkable to die needlessly.'' Read Douglas' story.
What is the treatment for DKA?
Early signs of DKA, if caught quickly, can often be treated with additional insulin and fluids. However, if this is not the case, DKA requires emergency hospital treatment and can be life-threatening.
Treatment for DKA includes:
- Receiving insulin intravenously
- Fluids are given intravenously to keep the body hydrated
- Nutrition is given intravenously to replace what has been lost.
You will also be closely monitored to ensure there are no serious problems with your brain, kidneys, heart, or lungs.
Once you are healthy enough to eat and drink, and tests show that your body has safe levels of ketones, you can be discharged from the hospital.
What can you do to avoid DKA?
You can avoid DKA by monitoring your blood sugar levels regularly and changing your insulin dosage depending on your blood sugar levels and what you eat.
When you're sick, your blood sugar levels may be higher than normal, putting you at risk for DKA. Therefore, it is a good idea to work with your medical team to come up with some sick day rules. when you are sick.
These usually include drinking more sugar-free liquids, taking more insulin, and checking your blood sugar levels more often than usual. The amount of additional insulin needed varies from person to person. Your diabetes team can help you find the right dose for you (or your child).
We recommend contacting your doctor or diabetes team if:
- I feel fine, but my blood sugar and ketone readings are higher than normal.
- I don't feel well, but my blood sugar and ketones are only slightly higher than normal.
- you are often sick
“Being DKA taught me that it is so important to listen to your body. No matter how many medical professionals you visit, whether it's your GP, your diabetes specialist, or a family friend who works in the field,… As you know, you can look at your body and know what feels right and what doesn't. When it comes to diabetes, it's very important to trust your instincts.
Amber, 21, had DKA.
Get support
If you have any concerns about managing your diabetes, you can always call our helpline on 0345 123 2399 for assistance. Alternatively, you can visit forums filled with people who want to offer support and share their experiences with diabetes.
