A persistent high blood glucose (sugar) levels can lead to a condition known as diabetic ketoacidosis (DKA). This is a serious and life-threatening condition that happens when there is a severe lack of insulin in the body. When there is no insulin in the body, the body cannot use glucose for energy, and the body starts to break down other body tissue as an alternative energy source. The body will start burning fat uncontrollably while blood glucose levels rise. This causes a harmful substance called ketones to build up in the body. Ketones are poisonous chemicals which build up and, if not spotted and treated, can cause the body to become acidic – hence the name ‘acidosis’.
The body will try to reduce the amount of acid by increasing the rate and depth of breathing, but the body soon tires out and the increased breath rate and dept cannot control acidosis. The increase in blood glucose in the urine can also cause loss of water and salt and lead to dehydration.
DKA mainly affects people with type 1 diabetes but can affect anyone who depends on insulin. very rare cases, those controlling their diabetes with diet or tablets have developed DKA.
If you have diabetes, certain things can make DKA more likely to occur. These things include not sticking to your treatment plan and missing doses of insulin, having an infection, injury or surgery, binge drinking, being pregnant, being on your period, taking certain medicines, e.g. steroid medication and using illegal drugs.
Symptoms of diabetic ketoacidosis
Symptoms include dehydration, hunger, feeling very thirsty, abdominal (tummy) pain, fruity smelling breath, rapid or deep breathing, confusion, decreased consciousness, frequently passing urine, feeling very tired or sleepy and nausea and vomiting.
Prevention of diabetic ketoacidosis
Check your blood sugar regularly so you can spot and treat an increase quickly
stick to your treatment plan and make sure you always take your insulin
take extra care when you’re unwell
be careful taking new medicines and always consult with a doctor or pharmacist first, as some medicines can increase the risk of DKA
DKA usually develops over 24 hours but can come on faster. DKA is usually (but not always) accompanied by high blood glucose levels. If your levels are consistently above 11mmol/l you should check for ketones. Ketone levels can be checked using home-testing kits.
Blood ketone test reading and meanings.
A reading lower than 0.6mmol/L is a normal.
A reading of 0.6 to 1.5mmol/L slightly increased risk of DKA.
A reading of 1.6 to 2.9mmol/L increased risk of DKA.
A reading of 3mmol/L or over very high risk of DKA and should get medical help immediately
Urine ketone test reading and meanings.
A result of more than 2+ means there’s a high chance you have DKA.
When to get medical help with diabetic ketoacidosis
Go to your nearest hospital immediately if you suspect you have DKA, especially if you have a high level of ketones in your blood or urine. DKA is an emergency and needs to be treated in hospital immediately.
Treatments for diabetic ketoacidosis
DKA is usually treated in hospital.
Fluid to rehydrate your body
Potassium and phosphate replacement rehydration and other nutrients to replace any you’ve lost
Nwasom is a pharmacy graduate and a pharmacist currently practising in the United Kingdom. I have great experience communicating with patients and their family as gained through working as a pharmacist in both the hospital and community pharmacy sector. I love writing so it was a natural thing to try and pass medical and health information on through writing.