Diabetic Ketoacidosis (DKA)
DKA particularly affects people with type 1 diabetes
Diabetic ketoacidosis (DKA) is a dangerous complication faced by people with diabetes which happens when the body starts running out of insulin. Particularly affecting people with type 1 diabetes, DKA may also affect those with type 2 diabetes.
- Read about Diabetes and Ketones
What is diabetic ketoacidosis?
DKA occurs when the body has no insulin to use, and switches to burning fatty acids and producing acidic ketone bodies. These can cause particularly severe illness.
What causes diabetic ketoacidosis?
DKA is caused by particular underlying problems.
These may include intercurrent illnesses, pregnancy, inadequate insulin administration, stroke, cocaine use or myocardial infarction.
What are the symptoms of DKA?
Diabetic ketoacidosis may itself be the symptom of undiagnosed diabetes. There are thought to be around a million undiagnosed diabetics in the UK alone.
Typical symptoms of diabetic ketoacidosis include:
- Vomiting
- Dehydration
- Deep laboured breathing (called kussmaul breathing)
- Confusion and sometimes even coma
Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period, with the first sign often being hyperglycaemia.
Another big word you come across (hopefully you don't) if you have diabetes is ketoacidosis. In fact, there is a specific ketoacidosis related to diabetes, which is called diabetic ketoacidosis or DKA. When this happens, you're in quite an advanced state and will require medical intervention.
You will be very dehydrated, you might be slurring your speech, might be unable to coordinate how you move. It's well known that people who are suffering from hypoglycemia or hyperglycemia can come across as if they're drunk so that's something you want to avoid.
Another symtpom of ketoacidosis is that you can smell ketones on your breath. Acetone is a fruity smell and that is another sign that you're going into ketoacidosis.
Diabetic ketoacidosis is when you have a high amount of ketones in your blood and your urine and your body goes into metabolic acidosis. Although if you're getting anywhere close to this, you should be getting immediate medical attention.
DKA is the primary cause of people with diabetes being brought into hospital. If you're aware of it you might be able to prevent it. At the end of the day, it'll make you feel rubbish, you'll probably end up in hospital and you'll lose a couple of days in a NHS ward which is lovely - but if you can avoid that, everyone will be happier.
Kussmaul respiration - deep, laboured breathing - is often a signal. Diabetic coma is the most serious symptom of DKA.
How is diabetic ketoacidosis diagnosed?
Diabetic ketoacidosis is usually diagnosed using blood and urine tests. When high blood sugar levels are present, other forms of ketoacidosis can be discounted.
How serious is diabetic ketoacidosis?
DKA is a genuinely serious medical emergency. Without urgent treatment, this diabetes complication can lead to death. With adequate and rapid intervention and treatment, mortality rates are lowered to around 5%.
How is diabetic ketoacidosis treated?
Treatment of diabetic ketoacidosis involves administering intravenous fluids to correct dehydration.
Insulin is also required to instantly suppress the ketone bodies that the body manufactures.
Treatment of other underlying causes of DKA must also be addressed, including infections.
Close observation of the patient to quickly identify and prevent complications is essential.
How do I avoid diabetic ketoacidosis?
The best way to prevent diabetic ketoacidosis is to keep tight blood glucose control at all times. By regularly testing your blood sugar levels at home you should be able to gauge how to manage your glucose levels.
If you ever feel unwell or abnormal, you should test your blood sugar levels at once.
If blood sugar levels are high, check your urine for ketones using specific test strips. Some blood glucose meters may even be able to check for blood ketones. If you detect ketones and your blood sugar levels are also high, contact your doctor or emergency services at once.
