Diabetic Ketoacidosis; Serious Complication of Diabetes

Medicare Benefits Solutions
Apr 27, 2022

Getting diagnosed with diabetes can come with a steep learning curve. Education and research is an important step to help manage your condition. You can learn to monitor your blood sugar levels, create a nutrition plan and exercise routine to stay healthy and strong, and work with your team of medical providers to plan ahead.

Part of taking care of yourself includes being aware of potential diabetes complications like diabetic ketoacidosis – and how to recognize the symptoms.

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What is Diabetic Ketoacidosis?

Diabetes develops when your body loses its capacity to produce insulin or supply it in sufficient amounts to facilitate the transport of glucose from your blood to your cells. Glucose is a major energy source for your muscle and brain cells, with leftover glucose used for storage. High blood glucose (sugar) describes the accumulation of glucose in the blood when it can’t move into the cells.

The human body is designed to find a way to adapt when an internal process does not function properly. So if your muscle cells are deprived of energy, your body will break down fat to use for fuel. The problem is that acids then build up in your bloodstream. These blood acids, known as ketones, are toxic chemical compounds. People with high blood glucose (diabetes) and ketones in their blood or urine have a condition known as diabetic ketoacidosis (DKA).

If the warning signs are missed, and you do not undergo diabetic ketoacidosis treatment, you run the risk of going into a diabetic coma. Though more common in Type 1, this complication also occurs in patients with Type 2 and gestational diabetes.

What are the Warning Signs of Diabetic Ketoacidosis?

For people who don’t know they have diabetes, diabetic ketoacidosis symptoms may be the trigger that leads to testing and diagnosis. According to the Cleveland Clinic, “approximately 20% to 40% of DKA cases are from people who are newly diagnosed with Type 1 diabetes.”

Here are the symptoms you may experience:

• Frequent urination and excessive thirst
• Nausea, vomiting and abdominal pain
• Feeling unusually tired and weak
• Confusion and shortness of breath
• Fruity-scented breath
• Blood sugar levels over 250 mg/dL

How Do You Test for Diabetic Ketoacidosis?

In-home tests include urine ketone tests, blood ketone tests and blood glucose tests. If you are admitted into the hospital, the resident doctor may order an arterial blood gas, basic metabolic panel and osmolality blood test in addition to a blood glucose test and blood pressure check. Other tests may include blood electrolyte tests, urinalysis, electrocardiogram and chest X-ray.

What Causes Diabetes Ketoacidosis?

Be aware of the following events that may contribute to the development of diabetic ketoacidosis:

• Illness that activates an overproduction of cortisol, adrenaline and other hormones that make it harder for your body to properly use insulin
• Infection that demands more insulin from your body than usual, as in the case of pneumonia, and skin and urinary tract infections
• Interruption of or inefficient insulin treatment, or using an insulin pump that does not work properly
• Trauma, either emotional or physical, causing high production of cortisol, the stress hormone
• Being pregnant and having diabetes
• Pancreatitis (inflammation of the pancreas)
• Abuse of drugs or alcohol
• Heart attack or stroke (brain attack)
• Specific types of medications

How Do You Treat Diabetic Ketoacidosis?

Diabetic ketoacidosis is a serious condition; however, it is treatable. But you will need professional medical attention as soon as possible. If there’s a delay in connecting with your doctor, or your symptoms are severe or worsen, get to the emergency room. If you can’t drive, call 911.

It’s important to stay hydrated by drinking water, broth or sugar-free beverages. The treatment itself, a combination of fluids, electrolytes and insulin, can lead to further complications if your blood glucose or potassium levels fall too fast. However, left untreated, diabetic ketoacidosis can be fatal.

While you are hydrating, eat as usual, taking your insulin with meals, if applicable, but refrain from physical activity until your doctor says you can restart. Continue checking your blood sugar and ketones, and follow medical instructions on doses of insulin and other medication.

Recovering From Diabetic Ketoacidosis

Recovery can take anywhere from 24 hours to several days, depending on the severity of the condition. The Cleveland Clinic advises that full treatment is “when your blood sugar is less than 200 mg/dL and your blood pH is higher than 7.3.”

How Do You Prevent Diabetic Ketoacidosis?

A key factor in preventing complications associated with diabetes is awareness of your risk. Risk increases when you have a family history of diabetes or autoimmune disease, are inconsistent in taking your insulin as scheduled and do not monitor your blood sugar frequently.

Below are steps typically recommended to prevent complications. Your doctor may offer personalized suggestions.

• Integrate healthy eating and exercise into your day-to-day regimen.
• Follow your doctor’s instructions for taking medication and administering insulin.
• Closely monitor your blood sugar levels throughout the day using a glucometer or a continuous glucose monitor.
• Maintain your insulin pump, and perform operation checks to ensure accurate insulin dosages.
• Have an over-the-counter test kit handy to check your urine ketones. If ketone levels deviate from the normal range, alert your healthcare provider, or go to the emergency room.
• Work with your doctor to develop a treatment program that includes a contingency plan so that you are prepared with the necessary dosage modification in response to changes in blood glucose levels, food intake, activities and bouts of sickness.

And finally, continue seeing your healthcare provider to stay informed about how to manage your diabetes. Regular medical appointments are an important part of self-care to help you avoid any illnesses that could potentially precipitate diabetic ketoacidosis.