Diabetic Ketoacidosis (DKA)

Condition Basics

What is diabetic ketoacidosis (DKA)?

Diabetic ketoacidosis (DKA) happens when the body does not have enough insulin and can't get the sugar it needs for energy. When the body can't use sugar for energy, it starts to use fat for energy. This process makes fatty acids called ketones. The ketones build up in the blood and change the chemical balance in your body.

This problem can be very dangerous and needs to be treated. Without treatment, it can lead to a coma or death.

DKA occurs most often in people with type 1 diabetes. But people with type 2 diabetes also can get it. DKA can be caused by many things. It can happen if you don't take enough insulin. It can also happen if you have an infection or illness like the flu. Sometimes it happens if you are very dehydrated.

DKA can only be treated with insulin and fluids. These are often given in a vein (IV).

What causes it?

If you have diabetes, sometimes your blood sugar level may get high before you know something is wrong. Diabetic ketoacidosis can be caused by many things. It can happen if you don't take enough insulin. It can also happen if you have an infection or illness, like the flu. Sometimes it happens if you are very dehydrated.

Without enough insulin, the cells in the body can't get the sugar (glucose) they need for energy. So the body starts to break down fat and muscle for energy. This produces ketones, or fatty acids. The ketones enter the bloodstream and cause the chemical imbalance called diabetic ketoacidosis. It can be life-threatening.

What are the symptoms?

Symptoms of diabetic ketoacidosis include blurred vision, trouble staying awake or being woken up, fast and deep breathing, breath that smells fruity, belly pain, not feeling hungry, vomiting, and feeling confused. Anyone who has these symptoms needs emergency treatment.

How is diabetic ketoacidosis treated?

If the symptoms of diabetic ketoacidosis are severe, you may need to be treated in an intensive care unit. Treatment includes fluids given through a vein (intravenous, or IV) and insulin. IV fluids treat dehydration and balance electrolytes. Insulin lowers blood sugar and keeps the body from producing ketones.

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Current as of: April 13, 2022

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Rhonda O'Brien MS, RD, CDE - Certified Diabetes Educator

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