Endocrinology and Diabetes
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) can quickly become a life-threatening emergency. Our team of specialists provides world-class care to treat DKA and help you avoid it.
Medically reviewed by Nicole Glaser, M.D. on Nov. 13, 2023.
Receive Exceptional Care for Diabetic Ketoacidosis
Our team delivers immediate, advanced treatment for diabetic ketoacidosis (DKA). We also provide diabetes support and education to help you prevent complications and feel your best. You can be confident you’re receiving exceptional care at UC Davis Health. U.S. News & World Report ranks our diabetes care among the top programs in the nation.
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What Is Diabetic Ketoacidosis?
Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 and type 2 diabetes. DKA occurs when you have low insulin levels for too long, or an illness that causes the body not to respond well to insulin.
When you don’t have enough insulin, your cells cannot use glucose for fuel. In response, your liver starts to break down fat for energy, which produces acids called ketones. The ketones build up in your blood and make it acidic, harming your vital organs like your brain and kidneys.
Diabetic Ketoacidosis Symptoms
Symptoms of DKA may not be obvious at first. They also tend to come on slowly, over several hours.
Don’t ignore signs of DKA, even in a person who does not have a diabetes diagnosis. Some people don’t find out they have diabetes until they seek care for symptoms of DKA.
Common Symptoms
In the early stages of DKA, you may notice:
- Abdominal (belly) pain
- Dry mouth
- Feeling very thirsty
- Headache
- Nausea
- Urinating more than usual
- Fruity-smelling breath
Emergency Symptoms
DKA can quickly become an emergency. If you notice these symptoms, call 911 or have someone drive you to the nearest emergency room:
- Confusion
- Fast breathing or shortness of breath
- Vomiting
- Weakness or tiredness (difficult to wake up or not as alert as normal)
Causes and Risk Factors of Diabetic Ketoacidosis
The cause of DKA is low insulin levels or an illness which causes the body to not respond as well to insulin. DKA usually develops over several hours to a day or more. People with type 1 diabetes are more likely to develop DKA, but it also affects people with type 2 diabetes.
Certain things can make DKA more likely to happen, including:
Illnesses and Infections
Being sick can make it harder to manage your blood sugar and insulin levels.
Missing an Insulin Dose
If you forget to take your insulin, especially long-acting “basal” insulin, or take the wrong dose, your insulin levels could drop. Some people also get DKA because their insulin pump is clogged.
Medications and Drug Use
Certain medicines, such as corticosteroids, can raise your risk of getting DKA. You can also develop DKA if you use alcohol or street drugs.
Trauma or Injuries
A heart attack, stroke or traumatic injury can make DKA more likely.
Diagnosis and Testing for Diabetic Ketoacidosis
Our specialists have the expertise and knowledge to diagnose and address DKA quickly. In many cases, people with DKA arrive in our Emergency Department, where they receive rapid testing and treatment.
To confirm a DKA diagnosis, our team performs blood tests to measure your:
- Blood gases (oxygen and carbon dioxide levels)
- Glucose levels
- Electrolyte balance
- Ketone levels
Diabetic Ketoacidosis Treatments
Our diabetes specialists help many people treat early-stage DKA at home. We guide you through what to eat and drink, how much insulin to take and when to test your glucose and ketone levels.
If your DKA is in a later stage or at-home treatment isn’t enough, you need emergency medical care. At UC Davis Health, you receive the highest quality treatment from a skilled team of experts. Your care may include:
IV fluids
Dehydration is a common part of DKA. Our team will provide IV fluids and electrolytes to help restore your hydration levels.
Insulin
Usually, insulin is the first treatment for DKA. We may provide insulin as an injection (shot) or through an intravenous (IV) line.
Monitoring
Our team provides ongoing monitoring of your glucose, blood gases, electrolyte levels and vital signs during your hospital stay.
Follow-Up Care
After your treatment, our diabetes care team provides ongoing care to help you meet your health goals. You receive detailed instructions and support to manage diabetes at home and prevent DKA.
Preventing Diabetic Ketoacidosis
In many cases, DKA is preventable. If you have diabetes, you can help prevent many episodes of DKA with:
Insulin Pump Care
If you have an insulin pump, make sure it is working correctly. Check the tube connection and look for kinks or blockages. Make sure your pump reservoir does not run out of insulin.
Glucose Testing
Check your blood sugar regularly. If your levels are higher than normal, contact your diabetes care team.
Ketone Testing
Use a ketone test kit if your glucose is 300 mg/dL or higher. If the test shows you are in ketosis, immediately contact your provider.
Know the Symptoms
Watch for possible signs of DKA, especially when you’re sick or have missed an insulin dose.
See Your Provider
See your diabetes care team regularly to ensure your treatment is working.
Take Your Medications
Take your insulin and other medications exactly as prescribed. If you have questions about your medicines, ask your provider or pharmacist.
“Diabetic Ketoacidosis,” Centers for Disease Control and Prevention (CDC), https://www.cdc.gov/diabetes/basics/diabetic-ketoacidosis.html
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