What is DKA? (Diabetic Ketoacidosis)

Learn about Beyond Type 1’s DKA Awareness Campaign.

What is DKA?

Diabetic ketoacidosis (DKA) is a complication from diabetes that can be serious and life-threatening. DKA can develop in many people with type 2 diabetes prior to be diagnosed, but it can also occur after diagnosis if you don’t have enough insulin in your system. When the body is not receiving enough insulin to break down glucose, it forces the body to start breaking down fat as fuel. Ketones are then released into the body.

In small amounts—like the amount that develops during a ketogenic diet—ketones are not dangerous. In people with diabetes who do not have enough insulin in their system, ketone levels can rise to life-threatening levels and need to be treated immediately.

Dangers of DKA

DKA can lead to coma, or even death if the level of ketones in the body are high enough.

Causes can include:

• Lack of insulin
• Consistent high blood sugar levels (hyperglycemia)
• Lack of food in the system due to illness/nausea
• Overnight low blood sugars (hypoglycemia)
• Infection
• Dehydration

Symptoms & Warning signs of DKA:

 Early symptoms

• High levels of ketones in urine
• Very high blood glucose levels
• Frequent urination
• Dehydration
• Extreme thirst

More extreme warning signs

• Constant fatigue
• Flushed skin
• Nausea or stomach pain
• Vomiting
• Shortness of breath
• Fruity smell on the breath
• Disorientation

How to test for ketones

Ketone strips (urinalysis) can be purchased at any pharmacy. Follow the directions given in the instructions insert, and match the result on the stick with the accompanying color chart. Some blood glucose meters can also check for ketones, so check with your healthcare provider about which may be best for you.

When to test for ketones

• If you are experiencing any of the symptoms listed above
• If you have a flu or any other kind of virus (recommended to test every four to six hours)
• If your blood glucose levels are consistently higher than 13.3 mmol/L240 mg/dL 

When to see a doctor

If tests shows high levels of ketones, or if you experience any extreme symptoms, contact a doctor immediately.

How to prevent DKA

DKA is prominent when you are ill, due to factors such as stress hormones and dehydration. To avoid going into DKA be sure to take precautions such as:

• Drinking lots of water
• Take the appropriate doses of insulin as instructed by your doctor
• Eat what you can
• Test blood sugar often
• Test for ketones

If you believe you may be developing dangerous levels of ketones due to high blood sugars and too little insulin, call 911. Talk to your healthcare team about adjusting your diabetes management regimen to help you prevent the development of ketones.

Read about DKA at diagnosis – stories and more resources.

Read about how to manage DKA – personal stories of DKA and helpful guides.