What Is Diabetic Ketoacidosis (DKA)? Its Causes, Symptoms, Treatment, Prevention

With multitude of campaigns on obesity and extensive healthcare advertising, weight loss nowadays has become almost a chimera, especially for diabetics. With this seems to emerge new trends in diet habits like fasting, crash-diets, caveman dieting etc. However, these methods work only to worsen the body’s condition.

It mostly happens that persons with Diabetes Type I go extremely conscious about their weight. This occurs mainly because of the multiple doses of insulin that they have to intake during a day; that also add to their body’s weight. In order to fulfil their impetuous urges to look slim, many people tend to skip their insulin injections notwithstanding that the results can be fatal. You got that right, fatal. In this case, this leads to Diabetic Ketoacidosis.

Diabetic Ketoacidosis (DKA), as the name suggests is a condition caused by ketone formation in the blood due to extreme blood sugar levels. It can induce coma or even lead to death. It can be treated, and prevented too. For this, let’s first understand the causes underlying.

Diabetic Ketoacidosis

Table of Contents

Causes of DKA

The primary source of energy for body is glucose which is absorbed by the cells through a hormone called insulin released by pancreas. DKA occurs when for a prolonged time, your cells don’t receive the glucose they need. In that case, they start burning the fat stored in adipose tissue. When this fat reaches the liver, it is broken down into ketones. The more energy body needs, more the fat it burns and in turn, more ketones are formed. Over time, this high ketonic content makes the bloodstream too acidic, causing chemical disturbances in the entire physiological system. This can happen due to any of the following reasons:

1. Lack of Insulin

This happens when the body loses its ability to create more insulin. This is prevalent mainly in cases of Diabetes Type 1. As pointed above, skipping an insulin injection can be extremely dangerous.

2. Insulin Resistance

This occurs in people affected with Diabetes Type 2 when the cells start to resist insulin owing to an autoimmune system. Here also the body starts building ketones to release energy.

3. Fasting or Dieting

Many low-carbohydrate diets are meant to form ketones and thus, release excess fat. Persons who don’t have diabetes can try these diets, but with extreme care not to build up high ketonic content. And if a person is already diabetic, this approach is not a good idea. Missing a meal can land them in a serious comatic condition.

4. Stress

Stress is s big factor in giving rise to diabetes and building up of ketones.

Symptoms & Testing

If a person is diabetic, one should keep an attentive eye on the ongoings of the system. In case any warning sign appears, one should immediately consult one’s doctor. Here are a few symptoms that indicate possibility of DKA.

a. Dry mouth or extreme thirst.

b. Continuous vomiting for 2-3 hours with nausea or abdominal cramps.

c. Breath smells fruity like pear drops or nail polish remover (ketones smell like this).

d. Shortness of breath or heavy breathing.

e. Confusion or lack of concentration.

f. Frequent urge to urinate.

g. Feeling tired quite often.

Apart from monitoring any symptoms, it is generally recommended for diabetic persons to check their ketone levels regularly, at least twice a day. This can be tested with blood testing strips or urine strips which are easily available with any drugstore. Upon testing, if you experience any of these conditions, immediately seek a doctor’s help.

  • Blood glucose level exceeds 240mg/dL.
  • Urine test strip shows change in colour due to high level of ketones.
  • High level of ketones and vomiting for more than 2-3 hours.


Excessive ketone levels in blood are generally treated in hospital. If not treated immediately, they can fall for DKA with swelling in the brain muscle, unconsciousness, coma or even death. It may take several days, or weeks to treat DKA. Usually following procedures are employed for this.

1. Intravenous Fluids

This is to compensate the dehydration caused by frequent urination.

2. Insulin

Insulin is injected in the body either via IV or through pumps to make up the deficiency.

3. Electrolytic Dilution

This is required if the body experiences lack of an electrolyte like sodium, potassium or chloride which are essential for functioning of heart muscles. To treat, an electrolyte solution is seeped into the body.

For vomiting, nausea and other such symptoms, different medicines are prescribed by the doctors.


DKA when treated early is curable; however, prevention is always better than any treatment. Following changes can be adapted in the habit to prevent DKA.

1. Healthy Diet Pattern

Consult with your healthcare practitioner to suggest you a suitable diet. Follow healthy diet plans and take meals on time.

2. Don’t Skip Insulin

Persons diagnosed with Diabetes Type I mustn’t skip their insulin doses.

3. Testing Kits

Always keep ketone testing kits at home so that you don’t have to panic in case of emergency. It will also help you keep a track of your blood glucose levels.

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