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Diabetes Ketoacidosis: It’s symptoms, treatment and complications

By Nikita Banerjee +2 more

Diabetes Ketoacidosis is a serious health complication and potentially life-threatening condition that affects people with diabetes. In most cases, it is those with type 1 diabetes that suffers from this. Only in very few cases, those who have type 2 diabetes been affected by diabetic ketoacidosis, but it is not as severe. The condition is usually the first sign of an undiagnosed type 1 condition. It can also happen to someone who has a previously diagnosed type 1 diabetes but underwent a trauma or an injury of some kind.

Causes of Ketoacidosis in Diabetes

When the body has low levels of insulin, it cannot metabolize the glucose in the body as it needs insulin to be transported to the cells. The liver keeps producing glucose and releasing it into the blood. This leads to high sugar levels which trigger the body to break down fats to release energy. This leads to an increased amount of ketones in the blood which are acidic. These create a chemical imbalance in the blood and affect the entire system. The condition is known as diabetic ketoacidosis.

Symptoms of Diabetes Ketoacidosis

Most signs and symptoms of diabetic ketoacidosis develop within 24 hours. You will find:
  1. Increased thirst
  2. Decreased alertness
  3. Excessive urination
  4. Dry skin and mouth
  5. Rapid, deep breathing
  6. Nausea and vomiting
  7. Excessive fatigue
  8. Breathlessness
  9. Headaches
  10. Flushed face
  11. Stomach ache
  12. Fruity-smelling breath
  13. Muscular aches
If your blood sugar is more than 240mg/dL, you should check your urine with a urine test strip. Also, if you exhibit any of the above symptoms, ask someone to test your ketones level. Try to reduce your glucose levels.It would be an emergency if you:
  1. Have been vomiting for more than a couple of hours.
  2. If your stomach hurts.
  3. If you feel confused and woozy.
  4. If you cannot breathe.
  5. If your sugar level is more than 300mg/dL consistently.

Risk Factors of Diabetes Ketoacidosis

There are certain risk factors for diabetic ketoacidosis.
  1. Illness
Sometimes having an infection or an illness triggers the body to produce certain other hormones. These can counteract the effect of insulin. Common infections that cause this are urinary tract infections and pneumonia.
  1. Issues with Insulin
If you are missing your insulin treatments or getting too little of it compared to what your situation demands, you could be susceptible to diabetic ketoacidosis.
  1. Heart attack
  2. Emotional trauma
  3. Alcohol
  4. Drug abuse
  5. Certain medications like diuretics or corticosteroids
  6. Have Type 1 diabetes

Treatment for Ketoacidosis

Diabetic Ketoacidosis is treated by giving insulin and electrolytes (to replace the ones lost through urination and vomiting) through injections or intravenously till your body attains the balance. Your doctor may evaluate your insulin dosage and recommend steps to prevent the situation from occurring again.

Complications of Diabetes Ketoacidosis

If you don’t treat Ketoacidosis, you could suffer from very serious complications.
  1. Hypoglycemia
When the treatment is administered to the patient with diabetic Ketoacidosis, he is given insulin as part of the treatment. This could lead to low glucose levels as insulin is injected into him.
  1. Hypokalemia
The electrolytes administered to treat diabetic Ketoacidosis can cause a drop in the potassium levels in the body. This can severely affect the heart and the nerves in the body.
  1. Cerebral Edema
When the brain tries to adjust to the quickly shifting sugar levels in the blood, it can cause swelling. This usually occurs in small kids with type 1 diabetes.
  1. Cardiac Arrest
  2. Kidney Failure
If left untreated, the situation can make the patient go into a coma and in some cases, even cause death.

Prevention of Diabetes Ketoacidosis

Good blood sugar control will help your body to maintain the chemical balance and thus, prevent diabetic Ketoacidosis. Preventing the condition is the best strategy. Here’s what you can do.
  1. Eat Healthily
The best way to avoid diabetic ketoacidosis is by eating healthy so that the glucose levels do not shoot up. Eat your meals on time and instead of three heavy meals, have six small meals. Fresh fruits and vegetables and whole grains should be an essential part of your diet.
  1. Stay Active
Another holistic way to keep your sugar levels in check is by exercising regularly. Even a half an hour of walk daily produces tremendous benefits. You could also try out yoga, swimming or aerobics to stay healthy.
  1. Manage Your Diabetes
Keep your blood glucose levels in check by eating healthy, staying active and taking your medication on time. It is surprising how many cases of diabetic ketoacidosis occur because the patient forgot or skipped taking their medication on time.
  1. Watch Your Sugar Levels
Monitor your glucose levels frequently every day and more so when you are ill or undergoing a stressful period.
  1. Make Adjustments to Your Insulin Dosage
Learn from your doctor how to evaluate and adjust your insulin dosage according to the changing demands of your body.
  1. Learn How to Check Ketone Levels
You could buy over-the-counter ketone urine test kits. Check your urine for ketones when you are under stress or are ill. Seek emergency medical care if your ketone levels are high. If the ketone levels come low, then increase your insulin dosage after consulting the doctor.
  1. Check Your Insulin  
Ensure that your insulin medication hasn’t crossed the expiry date. It should not be clumpy but should either be clear or have an even cloudy appearance. If you use a pump, check for leaks and the tube for air bubbles.
  1. Be Prepared
If the situation is beyond your control and if the high sugar levels are not reducing or the ketones are increasing in the urine, rush to the hospital. Have someone around you trained for such emergencies.


Diabetes can create serious complications. The best way to prevent diabetic Ketoacidosis is to control blood sugar levels. Take good care of yourself and follow your diabetes treatment plan efficiently. Take your anti-hyperglycemic medications on time and monitor your blood sugar levels frequently.Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

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