Diabetic Ketoacidosis 

What Is Diabetic Ketoacidosis (DKA)? 

Diabetic Ketoacidosis, or DKA, is a potentially life-threatening complication of diabetes.  

DKA occurs when your body doesn’t have enough insulin. Without enough insulin, your cells can’t use glucose for energy, so your body starts breaking down fat instead. 

This process produces substances called ketones. 

When ketones build up too much, they make your blood more acidic, and that can lead to DKA. 

Who is at Risk of Developing DKA? 

DKA is most common in people with type 1 diabetes. That is because people living with type 1 diabetes have reduced capacity to produce insulin and eventually, make little to no insulin at all.  

DKA is less common for people living with type 2 diabetes, but it can still happen.  

 If DKA occurs, it’s most likely to happen during illness, trauma, surgery, or with certain medications.  

Health professionals will be able to further assist individuals on a case-by-case basis.   

Other risk factors 

For people living with diabetes, things like missing insulin doses, developing infections (like urinary tract infections), heart attack, stroke, or physical trauma can all trigger DKA.  

What Are the Signs and Symptoms of DKA? 

Early symptoms may include: 

• Feeling very thirsty 
• Needing to urinate a lot 
• Feeling weak or tired 
• Nausea or stomach pain  

If things get worse, you might see: 

• Fast, deep breathing  
• Flushed skin 
• Breath that smells fruity 
• Confusion or drowsiness 
• Vomiting or stomach-ache  

If you spot these signs, it’s an emergency. You should get medical help immediately.  

How is DKA Treated? 

Hospital Care 

People with DKA usually need hospital treatment. In many cases, they go to an intensive care or a closely monitored ward.  

• Fluids 
  Doctors give fluids through an intravenous (IV) drip to rehydrate the body. This helps dilute the glucose in the blood. 

• Electrolyte Correction 
  Electrolytes (like potassium) get low when ketones build up; these may need to be replaced carefully.  

• Insulin 
  Insulin is given via an IV to stop the fat breakdown and reduce ketones.  

• Treat the Cause 
  Doctors will look for and treat whatever triggered the DKA (such as an infection or missed insulin dose).  

• Monitoring 
  Blood glucose, ketones,  electrolytes, and the level of acidity are carefully monitored while in hospital.  

Can DKA Be Prevented? 

Yes. There are things people can do to reduce their risk of DKA: 

• Check  glucose levels regularly, especially if you’re feeling unwell. Frequent  checking of your glucose levels will help to catch concerns early. You can speak with your health care team about how often and when to check. 
• Use a blood ketone monitor. If you don’t have one, you can get one through your local pharmacy.

Speak to your health care team to ensure you understand: 

• What having ketones means 
• How to  check for ketones 
• How to treat ketones  
• When to go to hospital

Stick to your insulin plan:

Take insulin as prescribed, even when you feel well.