Learn About Diabetic Ketoacidosis

What is the definition of Diabetic Ketoacidosis?

Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. It occurs when the body starts breaking down fat at a rate that is much too fast. The liver processes the fat into a fuel called ketones, which causes the blood to become acidic.

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What are the alternative names for Diabetic Ketoacidosis?

DKA; Ketoacidosis; Diabetes - ketoacidosis

What are the causes of Diabetic Ketoacidosis?

DKA happens when the signal from insulin in the body is so low that:

  • Glucose (blood sugar) can't go into cells to be used as a fuel source.
  • The liver makes a huge amount of blood sugar.
  • Fat is broken down too rapidly for the body to process.

The fat is broken down by the liver into a fuel called ketones. Ketones are normally produced by the liver when the body breaks down fat after it has been a long time since your last meal. These ketones are normally used by the muscles and the heart. When ketones are produced too quickly and build up in the blood, they can be toxic by making the blood acidic. This condition is known as ketoacidosis.

DKA is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or the stress of surgery can lead to DKA in people with type 1 diabetes.

People with type 2 diabetes can also develop DKA, but it is less common and less severe. It is usually triggered by prolonged uncontrolled blood sugar, missing doses of medicines, or a severe illness or infection.

What are the symptoms of Diabetic Ketoacidosis?

Common symptoms of DKA can include:

  • Decreased alertness
  • Deep, rapid breathing
  • Dehydration
  • Dry skin and mouth
  • Flushed face
  • Frequent urination or thirst that lasts for a day or more
  • Fruity-smelling breath
  • Headache
  • Muscle stiffness or aches
  • Nausea and vomiting
  • Stomach pain
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What are the current treatments for Diabetic Ketoacidosis?

The goal of treatment is to correct the high blood sugar level with insulin. Another goal is to replace fluids lost through urination, loss of appetite, and vomiting if you have these symptoms.

If you have diabetes, it is likely your health care provider told you how to spot the warning signs of DKA. If you think you have DKA, test for ketones using urine strips. Some glucose meters can also measure blood ketones. If ketones are present, call your provider right away. Do not delay. Follow any instructions you are given.

It is likely that you will need to go to the hospital. There, you will receive insulin, fluids, and other treatment for DKA. Then providers will also search for and treat the cause of DKA, such as an infection.

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What is the outlook (prognosis) for Diabetic Ketoacidosis?

Most people respond to treatment within 24 hours. Sometimes, it takes longer to recover.

If DKA is not treated, it can lead to severe illness or death.

What are the possible complications of Diabetic Ketoacidosis?

Health problems that may result from DKA include any of the following:

  • Fluid buildup in the brain (cerebral edema)
  • Heart stops working (cardiac arrest)
  • Kidney failure
When should I contact a medical professional for Diabetic Ketoacidosis?

DKA is a medical emergency. Call your provider if you notice symptoms of DKA.

Go to the emergency room or call 911 or the local emergency number if you or a family member with diabetes has any of the following:

  • Decreased consciousness
  • Fruity breath
  • Nausea and vomiting
  • Trouble breathing
How do I prevent Diabetic Ketoacidosis?

If you have diabetes, learn to recognize the signs and symptoms of DKA. Know when to test for ketones, such as when you are sick.

If you use an insulin pump, check often to see that insulin is flowing through the tubing. Make sure the tube is not blocked, kinked or disconnected from the pump.

Food and insulin release
Oral glucose tolerance test
Insulin pump
What are the latest Diabetic Ketoacidosis Clinical Trials?
Clinical Use of an Emergency Manual by Resuscitation Teams and Impact on Performance in the Emergency Department

Summary: The study will systematically evaluate how an emergency manual-a collection of checklists and fact sheets-affects the performance of resuscitation teams during the management of priority one patients in an emergency department.

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A Randomised Crossover Study Comparing Hybrid Closed-loop Insulin Delivery Using Ultra-rapid Acting Insulin to Hybrid Closed-loop Insulin Delivery Using Standard Rapid-acting Insulin in Children With Type 1 Diabetes in the Home Setting (FAST-Kids)

Summary: The main objective of this study is to determine whether 24/7 hybrid closed-loop insulin delivery under free living conditions applying faster insulin aspart (FiAsp) is superior to 24/7 hybrid closed-loop insulin delivery applying standard insulin aspart in very young children with type 1 diabetes. The closed-loop system consists of three components: the continuous glucose monitor (CGM), the insul...

What are the Latest Advances for Diabetic Ketoacidosis?
Choice of Bariatric Surgery in Patients with Obesity and Type 1 Diabetes Mellitus? an Up-to-Date Systematic Review.
The safety of sotagliflozin in the therapy of diabetes mellitus type 1 and type 2: A meta-analysis of randomized trials.
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Multicenter, Randomized Trial of a Bionic Pancreas in Type 1 Diabetes.
Who are the sources who wrote this article ?

Published Date: February 01, 2022
Published By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

American Diabetes Association Professional Practice Committee. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S17-S38. PMID: 34964875 pubmed.ncbi.nlm.nih.gov/34964875/.

Atkinson MA, Mcgill DE, Dassau E, Laffel L. Type 1 diabetes. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 36.

Maloney GE, Glauser JM. Diabetes mellitus and disorders of glucose homeostasis. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 118.