Diabetic Ketoacidosis

ketoacidosisDiabetic ketoacidosis and diabetic acidosis, is a serious health condition that can be life threatening to people with diabetes. Typically, diabetics with type 1 diabetes are affected, but people with type 2 can experience the condition as well.

While there are various levels of acidosis that may not require seeing a doctor, hospitalization is often needed.

The big problem with this condition, unfortunately, is that many people learn about the first time, after they experience. Don’t let this happen to you!

What is it? What are the Causes?

First, let’s take a look at how the body is supposed to run. Typically, the body uses glucose, or blood sugar, as its fuel or energy. The pancreas produces insulin which is a substance that helps the body’s cells convert the glucose from the blood into the necessary energy on a cellular level.

In diabetics, the pancreas does not produce the necessary insulin or produces very little. As such, type 1 diabetics (and some type 2) must take insulin injections.

Next, let’s take a look what happens when someone gets diabetic ketoacidosis. When a diabetic does not get the necessary insulin, the body will begin to use fat as its source of energy.

Two things happen when this occurs:
First: Glucose builds up in the blood, as there is no insulin to convert it into energy. Often the blood sugar levels will soar past 240 mg/dL.

Second: A substance called ketones is produced when the fat is processed into energy.

Ketones are a waste product of this process. When too many ketones build up in your body, you get diabetic acidosis.

Diabetic ketoacidosis is often the first sign that someone has type 1 diabetes. The reason is that the condition is serious enough that it prompts a person to actually seek medical help. Other diabetic symptoms are often more subtle and ignored.

Serious illnesses, such as a heart attack, stroke and pneumonia can also cause ketoacidosis.

What are the Symptoms?

As discussed above, your blood will have elevated blood sugar and ketone levels. However, if you have not been diagnosed with diabetes yet, you may not be testing your blood sugar or ketone levels. Nonetheless, if you are at the hospital and the doctor is unsure of a diagnosis, you may want to suggest one or both of these tests.

Other symptoms or signs of diabetic ketoacidosis include, but are not limited to the following:

  • Rapid and/or Deep Breathing
  • Dry Mouth and Skin
  • Flushed
  • Fruity breath (Odor from the ketones your body is trying to expel)
  • Vomiting or Nausea
  • Stomach pain
  • Fatigue
  • Frequent urination (1+ days)(your body is trying to expel the increased ketones)
  • Frequent Thirst (1+ days)(your body is trying to replace the fluid lost through increased urination)
  • Mental Confusion, Stupor, or Other Decreased Consciousness
  • Coma or Unconsciousness
  • Muscle stiffness or aching
  • Shortness of breath

Unfortunately, many of these symptoms or signs could be indicative of any number of conditions. If you are experiencing any of these, you should strongly consider going to the hospital.

Assuming you make the call to go to the hospital, what next? As stated above, a blood glucose test and a ketone test can be done. There are other tests as well that may indicate diabetic acidosis or be affected by the condition:

  • Arterial blood gas
  • Blood Pressure
  • Amylase blood test
  • Potassium blood test
  • CO2 Measurement
  • Potassium urine test
  • Magnesium blood test
  • Phosphorus blood test
  • Sodium blood test
  • Sodium urine test
  • Urine pH balance

What is the Treatment?

Step one is obviously to go to the hospital. Usually, insulin will be given to start lowering your blood sugar and reverse the process of using fat (thus producing ketones) as your body’s fuel source.

Your body usually will also be expelling massive amounts of fluid, so fluid replacement is critical. Other treatments include:

  • Potassium Supplements
  • Identification of any underlying infection or illness (stroke, pneumonia, heart attack, etc.)
  • Antibiotics (if an infection is found)


If you did not know you have diabetes, ketoacidosis can be a challenge to avoid. Most non-diabetics won’t have even heard of this condition.

However, if you do have diabetes, then you must be ever vigilant for its signs and symptoms. Additionally, if you are concerned about ketoacidosis, you may want to consider a ketone testing kit or ketone test meter.

By Erich Schultz – Last Reviewed March 2012.