Diabetic Ketoacidosis: An in-depth study of the cause!

If you’re suffering from Diabetic Ketoacidosis or is even planning to test Diabetic Ketoacidosis- we know you must be going through a hard time. The confusion, the tension, the after-effect plan must be taking a toll on your life.[1]

Diabetic Ketoacidosis can be kept under control

Here we have written an in-depth study of Diabetic Ketoacidosis (in layman’s term) to help you understand the causes, the symptoms, and the conditions. Let’s get into it.[2]

What is Diabetic Ketoacidosis?

Diabetic Ketoacidosis (DKA), also known as ketones, is the build-up acids in the blood. It happens when the blood sugar level in the body increases, and insulin level falls.[3]

The build-up of ketones in the blood is toxic and can lead to severe conditions-that can be life-threatening like coma and even death, if not treated immediately.

 Point to note: Ketoacidosis should never be confused with ketosis, which is harmless and can occur due to a deficient carbohydrate diet or fasting.[4]

Diabetic Ketoacidosis or DKA is common among type1 diabetes and rare among type 2 diabetes and gestational diabetes.

Symptoms of Diabetic Ketoacidosis

 Diabetic Ketoacidosis is a serious condition. Here are a few of the symptoms:

  • Frequent urination
  • Extreme Thrust
  • High blood sugar levels
  • Above 240 mg/dL
  • High levels of ketones in the urine
  •  You feel queasy.
  • You are throwing up constantly.
  • Confusion
  • Abdominal pain
  • Your breath smells fruity
  • Fatigue
  • Flushed face
  • You have a hard time breathing
  • Dry mouth and skin

DKA is a medical emergency. When you already have diabetes and any time you notice these symptoms, you must call your doctor or visit an emergency room right away!

What are the causes of DKA?

DKA, or Diabetic Ketoacidosis, is the rise of blood sugar levels and fall in the insulin levels. Lack of insulin in the body means sugar cannot get into the cell. But your cells need sugar for energy. The lack of insulin causes the rise in the glucose level.[5]

On the other hand, the body starts to burn fat into a usable fuel to get energy. This process leads to the build-up of Ketones. When too many Ketones develop, your blood becomes acidic and is poisonous to the body.[6]

High glucose levels in the blood can also make you urinate frequently-draining out the fluids. This drainage of fluid can often lead to dehydration.[7]

Another cause of diabetic Ketoacidosis is frequently missing insulin doses, eating poorly, or feeling stressed. Any infection or other illnesses such as urinary tract infection or pneumonia can also lead to DKA.[8]

Patients with type      1  diabetes are more prone to diabetic Ketoacidosis, whereas, for type 2 diabetes, chances are less.[9]

Questions to ask your doctor!

If you’re going for a check-up with the doctor related to your blood sugar level, take note of these questions.[10] Ask these questions to your doctor to get a clear idea about the condition of diabetic Ketoacidosis:

  • I’m a non-diabetic, but I have noticed some symptoms of diabetic Ketoacidosis. Does it mean I should for a diabetic check-up?
  • Does exercising and healthy reduces my chances of getting diabetic Ketoacidosis?
  • At times it’s hard for me to keep a check on my sugar levels. Am I prone to Ketoacidosis?
  •  What should be my reaction when I start to witness symptoms of diabetic Ketoacidosis?
  • Anytime I fall sick, do I need to check my blood sugar level?
  • Is it safe for me to exercise?
  • What is the best way to keep the ketone level at bay?
  • I missed an insulin dosage. Should I go a blood sugar level and ketone test right away?

Who are under the threats of possible diabetic Ketoacidosis?

The risk of diabetic Ketoacidosis increases if[11]:

  • You already have type 1 diabetes
  •  Under the age of 19
  • Stressed
  • Have been through some trauma, either emotional or physical
  • Have a high fever
  • Smoke
  • Suffered from a stroke or heart attack
  • If you suffer from alcohol or drug addiction

DKA is less common among people with type 2 diabetics. However, some people are “ketone prone” can have higher chances of getting DKA.[12]

How is diabetic Ketoacidosis diagnosed?

The treatment of diabetic Ketoacidosis is initiated by a series of tests, including a sample of your urine.[13] A test of your blood sugar levels may also be needed. Including these, other few tests can also be recommended by the doctor to diagnose DKA:

  • Basic bloodwork, including sodium and potassium, to assess the metabolic function of your body.
  • Arterial blood gas
  • If you are sick for a long time, then a chest x-ray or other test forms may also be recommended by your doctor to check for signs of infections, such as pneumonia.

What is the treatment of diabetic Ketoacidosis?

Diabetic Ketoacidosis is treated by combining different approaches to balance the insulin level and the blood sugar level of the body. If you’ve never been diagnosed with diabetics but DKA, your health practitioner will make a treatment plan for diabetes to restrict DKA from reappearing.[14]

 If you’re suffering from any illness or infection, your health practitioner will apply medication with antibiotics. Other than these, there are a few ways to treat diabetic Ketoacidosis.[15]

  1. Insulin therapy: Until your blood sugar level falls below 240 mg/, insulin needs to be injected into your blood.[16] Once the blood sugar level is in control and falls under the acceptable range, the doctor will help you keep a DKA check in the future.
  1. Fluid replacement‏: If you visit the hospital to treat your DKA, the doctor may recommend some fluid they can be taken orally. But you’ll also need to inject fluids with the help of an IV. Fluid replacement helps to treat dehydration, which is another cause of higher blood sugar levels.
  1. Electrolyte replacement: This process is usually done through an IV. When the insulin level of the body falls, the electrolytes in the body can become abnormally imbalanced. Electrolytes are electrically charged to minerals that help your body, including the nerve and the heart, to function correctly.

 Can diabetic Ketoacidosis be prevented?

YES! Diabetic Ketoacidosis can be prevented. The most important way to prevent DKA is by keeping a track of your diabetes.[17]

  •  Be regular and on time with your diabetes medications.
  • Follow a good meal plan and keep yourself hydrated.
  • Take your blood sugar frequently.

Bottom Line

DKA is serious but is preventable. Keep track of your overall health and your daily diet and lifestyle. Anytime you witness something serious, talk to your doctor immediately and never leave it for later.[18]

It’s your health, and you should be responsible for it. Remember, “Health is Wealth.


[1] https://www.ncbi.nlm.nih.gov/books/NBK534848/

[2] Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metab. Clin. Exp. 2016 Apr;65(4):507-21. [PubMed]

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