Diabetic ketoacidosis, or DKA, is a serious complication of diabetes. It happens when your body doesn’t have enough insulin, which prevents your cells from using glucose for energy. Instead, your body starts to break down fat, which leads to a buildup of acids called ketones in your blood. When ketones accumulate, they can make your blood too acidic, which can be life-threatening if not treated quickly.
The Underlying Causes of Diabetic Ketoacidosis
Diabetic ketoacidosis is most common in people with type 1 diabetes. This can be because of missed insulin doses or a problem with an insulin pump. Illnesses and infections, such as pneumonia or urinary tract infections, can also trigger DKA by making your body need more insulin than usual.
Sometimes, DKA is the first sign that someone has type 1 diabetes. Although it’s less common, people with type 2 diabetes can also get DKA, especially if they have a severe illness that puts a lot of stress on their body. Certain medications, like corticosteroids and some diuretics, can also increase the risk of DKA.
Recognizing the Warning Signs
The symptoms of DKA can develop slowly, but if you’re vomiting, they can appear within a few hours. Early signs often include being very thirsty, having a dry mouth, and needing to urinate more often than usual. You might also have high blood sugar levels and high levels of ketones in your urine.
As DKA gets worse, you might start to feel tired all the time, have dry or flushed skin, and feel sick to your stomach. Nausea, vomiting, and abdominal pain are common as the condition progresses. You might also have trouble breathing, and your breath might have a fruity smell. It can also become hard to concentrate, and you may feel confused.
The Body’s Chemical Cascade
Diabetic ketoacidosis starts when your cells don’t get the glucose they need for energy because of a lack of insulin. The body starts to break down fat for fuel at a fast rate. This process releases acids called ketones into your bloodstream.
When ketones build up in your blood, they make it more acidic. At the same time, because your cells can’t use glucose, it builds up in your blood, causing high blood sugar. The combination of high blood sugar and high ketone levels is what leads to DKA.
Medical Intervention and Recovery
If you have DKA, you’ll need to be treated in a hospital. The main goals of treatment are to replace fluids, correct electrolyte imbalances, and lower your blood sugar with insulin. You’ll likely get fluids through an IV to help you rehydrate and balance your blood chemistry.
You’ll also get insulin through an IV to bring your ketone levels down and help your cells start using glucose again. As your body responds to treatment, your doctor will also give you electrolytes, like potassium, to prevent complications. Recovery from DKA involves careful monitoring and a slow return to your normal insulin routine.
Strategies for Prevention
You can prevent DKA by managing your diabetes well. This means taking your medications as prescribed and keeping your blood sugar in a healthy range. It’s also a good idea to check your blood sugar regularly, especially when you’re sick or stressed.
If you have diabetes, it’s helpful to know how to check for ketones in your urine or blood. If your ketone levels are high, it may be a sign that you need more insulin. Having a “sick-day plan” with your doctor can also help you know what to do if you get sick and your blood sugar is high.