Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones.
Diabetic ketoacidosis develops when your body is unable to produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as an alternate fuel. This process produces a buildup of toxic acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.
If you have diabetes or you’re at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care.
Sugar is a main source of energy for the cells that make up your muscles and other tissues. Normally, sugar enters your cells with the help of insulin. If you don’t have enough insulin in your body, your body won’t be able to use sugar properly for energy. This prompts the release of hormones that break down fat as an alternate fuel. In turn, this process produces toxic acids known as ketones. Excess ketones accumulate in the blood and eventually “spill over” into the urine.
Diabetic ketoacidosis is usually triggered by:
- An illness. An infection or other illness can cause your body to produce higher levels of certain hormones, such as adrenaline or cortisol. Unfortunately, these hormones work against insulin — sometimes triggering an episode of diabetic ketoacidosis. Pneumonia and urinary tract infections are common culprits.
- A problem with insulin therapy. Missed insulin treatments or inadequate insulin therapy can leave you with too little insulin in your system, triggering an episode of diabetic ketoacidosis.
- Other possible triggers of diabetic ketoacidosis may include:
- Physical or emotional trauma
- High fever
- Heart attack
- Alcohol or drug abuse, particularly cocaine
Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice:
- Excessive thirst
- Frequent urination
- Nausea and vomiting
- Abdominal pain
- Weakness or fatigue
- Shortness of breath
- Fruity-scented breath
More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include:
- High blood sugar level (hyperglycemia)
- High ketone levels in your urine
When to see a doctor
If you feel ill or stressed, or you’ve had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit.
Contact your doctor immediately if:
You’re vomiting and unable to tolerate any food or liquid
Your blood sugar level is higher than your target range and doesn’t respond to home treatment
Your urine ketone level is moderate or high
Seek emergency care if:
Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 millimoles per liter (mmol/L)
You have ketones in your urine and can’t reach your doctor for advice
You have multiple signs and symptoms of diabetic ketoacidosis — excessive thirst or frequent urination, nausea and vomiting, abdominal pain, shortness of breath, fruity-scented breath, confusion
Remember, untreated diabetic ketoacidosis can be fatal.