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Diabetic Ketoacidosis (DK) occurs when a person with diabetes becomes dehydrated during a state of relative insulin deficiency, associated with high blood levels of sugar and organic acids called ketones.  As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. DK is a serious condition that can lead to diabetic coma or even death if left untreated. DK is associated with significant disturbances of the body’s chemistry, which can resolve with proper therapy.

In Diabetic Ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). As the body produces stress response hormones unopposed by insulin due to the insulin deficiency, the body begins to consume its own muscle, fat and liver cells into glucose and fatty acids for use as fuel.  These hormones include glucagon, growth hormone and adrenaline.  These fatty acids are converted to ketones by a process called oxidation.

Ketones are acids that build up in the blood and appear in the urine when your body doesn’t have enough insulin. They are a warning sign that your diabetes is out of control or that you are getting sick. High levels of ketones can poison the body.

Ketoacidosis may happen to anyone with diabetes and individuals with Type I need to take extra precautionary measures.  But you can help prevent DK by learning the warning signs and checking your urine and blood regularly.

Ketoacidosis usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours. Early symptoms include the following:

  • Thirst or a very dry mouth
  • Frequent urination
  • High blood glucose (sugar) levels
  • High levels of ketones in the urine

Then, other symptoms appear:

  • Constantly feeling tired
  • Dry or flushed skin
  • Nausea, vomiting, or abdominal pain
    (Vomiting can be caused by many illnesses, not just ketoacidosis. If vomiting continues for more than 2 hours, contact your health care provider.)
  • A hard time breathing (short, deep breaths)
  • Fruity odor on breath
  • A hard time paying attention, or confusion

Ketoacidosis is dangerous and serious. If you have any of the above symptoms, contact your health care provider IMMEDIATELY, or go to the nearest emergency room of your local hospital.