Diabetic ketoacidosis (DKA)
There are several factors that can cause diabetic ketoacidosis (DKA). The most common are:
- illness or underlying infection, such as a urinary tract infection (UTI), gastroenteritis, flu or pneumonia
- missed insulin injections
- previously undiagnosed diabetes (usually Type 1 diabetes)
- stroke or heart attack
- binge drinking alcohol
- drug use
If you develop DKA there is a relative lack of insulin or it can’t be used properly as the body is unwell. Instead of using glucose for energy, the body starts to break down other tissues and releases ketones and acids into the blood, which makes the body more unwell – this is an emergency and requires urgent treatment.
If you have Type 1 diabetes and you feel unwell, you may take a test for ketones and get a positive result. You will need to treat this urgently with sick day rules.
If ketones develop and you are vomiting or becoming more unwell, you need to seek medical assistance immediately and you may be urgently admitted to the hospital.
Find out below what may happen if you develop DKA and you’re admitted to the hospital:
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Staff will administer insulin to you through a drip and into a vein. Your glucose levels, ketone levels, potassium and fluid levels will all be closely monitored. This treatment will continue until the ketones have cleared, you are able to eat and drink again, and your glucose levels settle down.
Once things settle down, you will be able to go back to your usual insulin regimen but with some extra support from the diabetes team.
You and the medical staff will need to reflect on why ketoacidosis developed in the first place and discuss how you will try to prevent it from happening again.
You may also be given additional treatment, such as antibiotics for an infection, and it is important you complete the course of treatment.
For more advice on ketones, illness and what to do if you’re unwell, go to the Sick day rules section.
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Had a couple of these episodes
throughtout my 63 years of being type 1 diabetic I have had very few DKA episodes – much less than 10. Up until I had a Whipple operation, since then the way I process food has altered completely and from day to day. Even though I try to keep a close eye on my sugar levels its very hard now to get them under control. Since the Whipple i have had 2 episodes of DKA – reasons unclear. One when I was under the care of hospital staff on the wards. So I do find it a lot harder to control. But will try the methods described as I have never been told of these methods to decrease DKA’s.