Diabetic Ketoacidosis (DKA)
Insulin lets glucose get into the body's cells. Without enough insulin, the body can't use glucose for energy and starts to use fat for fuel. This can happen, for example, when someone skips doses of insulin or when the need for insulin suddenly increases (for example, due to stress or illness) and the doses are not adjusted.
When the body uses fat for energy, chemicals called ketones are released into the blood, causing diabetic ketoacidosis (DKA). Some of the ketones, like extra glucose, exit the body through urine.
But high levels of ketones in the blood can be a problem because they cause the blood to become acidic. Too much acid in the blood throws off the body's chemical balance.
Diabetic ketoacidosis is a very serious — but completely preventable — condition that can lead to coma or death if it's not treated quickly. It happens more often in people with type 1 diabetes, but can sometimes happen in people with type 2 diabetes.
Signs & Symptoms of Diabetic Ketoacidosis
Symptoms of diabetic ketoacidosis usually don't start all at once — they usually come on slowly over several hours. Signs and symptoms include:
- fatigue (extreme tiredness)
- excessive thirst/urination
- dry mouth and dehydration
These symptoms are caused by the sustained hyperglycemia (usually lasting several hours) that typically happens before someone develops diabetic ketoacidosis.
If the person isn't treated, these symptoms can happen:
- abdominal pain
- nausea and/or vomiting
- fruity (acetone) breath odor
- rapid, deep breathing
- confusion
- unconsciousness ("diabetic coma")
Checking for Diabetic Ketoacidosis
How do you know if your child has diabetic ketoacidosis? The signs and symptoms can mimic or be triggered by other illnesses, like the flu. So, it's very important to check your child's blood sugar levels and urine ketones during illness — especially if there are high blood sugar readings — or if your child has symptoms of diabetic ketoacidosis.
Because high levels of ketones in the blood cause ketones to appear in the urine, ketones can be checked at home by testing a sample of your child's urine. If the urine test for ketones is negative, it generally means that symptoms are not due to diabetic ketoacidosis. If the urine test is positive, contact your child's diabetes health care team.
Tests done by a lab or hospital can confirm whether a child has diabetic ketoacidosis, if necessary. Some newer blood glucose meters also offer the option of testing blood for ketones. Ask the diabetes health care team if such a meter is a good idea for your child.