Diabetic Ketoacidosis

I must admit I found the topic of Diabetic Ketoacidosis to be the scariest. I believe the biggest reason for this was my lack of understanding. I know it is a very serious and life-threatening complication of Type 1 Diabetes but I was totally unaware of how to prevent it.

I must say learning the facts about Ketoacidosis has really eased my mind and helped me be more confident when our grandson is in my care. Our daughter is very good about passing along any changes in his treatment after each doctor visit which I am so thankful for.

I hope that sharing what I learned about Diabetic Ketoacidosis will help you understand that it can often be prevented. If it does occur quick medical treatment will go a long way towards having a positive successful treatment.

Let’s dive in and learn the facts about Diabetic Ketoacidosis.

What Is Ketoacidosis

Diabetic Ketoacidosis (DKA) is a severe complication of Type 1 Diabetes that is life-threatening. Although it is quite rare, it can also occur in some people with Type 2.

DKA happens when your blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body.

Don’t confuse Ketoacidosis (a life-threatening complication of Type 1 Diabetes) with Ketosis (the harmless result of a low carb diet). DKA only happens when you don’t have enough insulin to process the glucose in the blood.

DKA happens when your blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body.

Diabetic Ketoacidosis is less common in people with Type 2 Diabetes because the insulin levels usually don’t drop so low, but it can occur.

DKA can sometimes be the first sign of Type 1 Diabetes because people with this disease are unable to produce their own insulin.

 

What Are The Symptoms

The most common symptoms can occur quite quickly and may include:

• dry skin and mouth
• abdominal pain
• decreased level of consciousness (drowsiness, confusion, unconsciousness)
• frequent urination
• fruity-smelling breath
• shortness of breath
• nausea and vomiting
• dehydration

When our grandson has high glucose over a prolonged period of time our daughter use test strips (like the ones pictured above) to test his urine for keytones. If his keytone levels are high our daughter contacts his doctor. The doctor then lets her know whether or not to take him to the hospital or how to treat him herself. We have been very lucky that we have not experienced Diabetic Ketoacidosis with our grandson. We keep a close eye on him and monitor his blood glucose frequently through both scanning his Continuous Glucose Monitor (CGM) and finger pokes.

What Causes Ketoacidosis

Diabetic Ketoacidosis occurs when blood glucose levels are very high and insulin levels are low. Our bodies need insulin to use the available glucose in the blood. In DKA, glucose can’t get into the cells, so it builds up, resulting in high blood sugar levels.

The body then starts breaking down fat into a usable fuel that doesn’t require insulin. That fuel is called ketones. Your blood becomes acidic once too many ketones build up. This is diabetic ketoacidosis.

The most common causes of DKA are:

• missing an insulin injection or not injecting enough insulin
• illness or infection
• a clog in one’s insulin pump (for people who are using one)

Who Is At Risk For Developing Ketoacidosis

DKA risk is higher if the person:

• has Type 1 Diabetes
• under age 19
• has had emotional or physical trauma
• is stressed
• has a high fever
• has had a heart attack or stroke
• smoke
• has a drug or alcohol addiction

Although DKA is rare with Type 2, it can happen. Some people with Type 2 Diabetes are considered “keytone prone” which puts them at higher risk. Some medications can increase the risk of DKA. Talk to your doctor about your risk factors.

What Are The Complications

People who develop ketoacidosis often have other underlying illnesses (besides Diabetes), significant complications or even death can occur. Kidney failure and cardiac arrest and death are some well-known complications.

The treatment that is often life-saving for Diabetic Ketoacidosis can lead to other complications. These complications can include low blood sugar (hypoglycemia), swelling of the brain, or low potassium.

How Is It Diagnosed

Diabetic Ketoacidosis is diagnosed with a combination of blood and urine tests, patient history, and physical exam.

A combination of elevated blood glucose level, ketones detected in the blood or urine, and lower than normal pH level of the blood usually establish the diagnosis. Other blood tests also are ordered to assess the patient’s overall status, for example, to check the patient’s electrolyte levels, in particular potassium.

Upon physical exam, the patient’s pulse rate is often elevated and the blood pressure lower than normal. It is possible that the patient is confused and dehydrated.

If your doctor thinks an infection is present, other tests might be ordered.

What Is The Treatment

Several aspects need to be treated simultaneously. These include normalizing the blood PH while slowly lowering the blood glucose levels, and adding fluids for dehydration while normalizing the electrolyte levels.

Any underlying infections or illnesses will also need to be treated.

How Can It Be Prevented

To prevent Diabetic Ketoacidosis from occurring it is important to :

• take all medications as prescribed by your primary caregiver
• learn to recognize the symptoms of high blood glucose (sugar)
• Don’t skip insulin doses
• test glucose levels often as recommended by your doctor
• see your doctor if you are developing an illness or your glucose levels are remaining higher than usual or ketones are present in the urine when tested

Conclusion

While Diabetic Ketoacidosis is a serious and life-threatening complication of Type 1 Diabetes the risk can be significantly reduced by properly managing diabetes. Taking all medications and following your doctor’s advice on diet and exercise will aid in lowering the risk. Be sure to tell your doctor if something isn’t working for you or if you’re having trouble. They can work with you to alter your treatment plan or help you come up with better solutions for managing your diabetes.

“I am not in any way a medical practitioner, please do not rely on the information on our website as an alternative to medical advice from your doctor or another healthcare provider. We only share our experiences.”

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