When does diabetic ketoacidosis occur?

Diabetic ketoacidosis

In my experience diabetic ketoacidosis is one of the lesser known complications of having diabetes. Diabetic ketoacidosis is a very serious condition that occurs when your body produces very high levels of acid in the blood called ketones.

You are at risk of diabetic ketoacidosis if you have type 1 diabetes. In rare cases it effects type 2 diabetics. It is a very serious complication that can lead to death. When I was first diagnosed with diabetes this was one of the very first symptoms that the doctors were concerned about and one of the first things that they checked for.

Diabetic ketoacidosis

What is diabetic ketoacidosis?

It is important to note that diabetic ketoacidosis can lead to both a loss of consciousness and eventually death.

Diabetic ketoacidosis occurs when your body is not producing enough insulin. It therefore affects type 1 diabetics in most cases. Insulin allows sugar/ glucose to be converted to energy for your muscles and tissues.  When your muscles and tissues are not getting enough energy your body uses fat as an alternative energy source for fuel. When the body uses fat or protein for fuel it produces acids in the bloodstream known as ketones.

When does diabetic ketoacidosis occur?

Diabetic ketoacidosis occurs for a number of reasons. The main ones include –

When you are sick. Any sort of infection or illness can see your body produce hormones that counter the effects of insulin. I have had this occur when I have had the flu and have found it very hard to control my blood sugar during the time. Thankfully I never experienced DKA but my doctor advised me to buy an over the counter urine ketones testing kit just in case.

Not managing your blood sugar levels adequately. If you constantly have high blood sugar levels for whatever reason you may experience diabetic ketoacidosis. This generally happens when your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 millimoles per liter (mmol/L)

Alcohol or drug abuse.  Cocaine is known to be a notorious causer of DKA.

Psychological or emotional upset or upheaval can be another reason. These upsets can see your blood sugar at elevated levels for prolonged periods.

The symptoms of diabetic ketoacidosis

In some cases, diabetic ketoacidosis may be the first sign that a person has diabetes. Diabetic ketoacidosis symptoms can often develop very quickly, sometimes inside 24 hours. As mentioned, these symptoms can be the first indication someone has of having diabetes. Symptoms may include –

  • Excessive and insatiable thirst levels
  • Frequent urination especially at night.
  • Vomiting. Unable to hold down solids or fluids
  • Abdominal pain
  • If you are short of breath
  • If your breath has a fruity scent to it
  • Weakness, extreme laziness or fatigue
  • Confusion

If you are sick or emotionally stressed you should check your blood sugar levels more often than usual. You can even buy an over the counter urine ketones testing kit if your blood sugar remains at elevated levels for prolonged periods.

See your doctor if you are vomiting and can not hold down any foods or liquids especially after being unable to control your blood sugar levels for a prolonged period. Obviously see your doctor if your urine shows high levels of ketones or if you show multiple signs of diabetic ketoacidosis listed above

Diabetic ketoacidosis treatment

Fluid replacement will be the first thing required possibly through a drip to rehydrate the body. This will rehydration process will include electrolytes as these vital minerals can be depleted in the body through excessive urination. Insulin therapy may also be required to get your blood sugar levels under control.


This is yet another reason to monitor and manage your blood sugar levels very closely. Manage them even more closely if you fall ill (physcially or psychologically) for whatever reason. It makes sense to own an over-the-counter ketones testing kit at home so that you can check your ketones at any time day or night.

please also see my blog post on diabetic seizure symptoms.

Have you ever suffered from diabetic ketoacidosis? I would love to hear from you if you have.


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  1. Crystal

    Great article! As a medical student, I learned about this condition a year or so ago. It was good revision for me. Those Ketones can also damage your kidney and your brain if they are elevated for long periods.

    Again i must say great article and Keep up the good work!


    1. Ben (Post author)

      Thanks Crystal. As a medical student you maybe interested in the medical breakthroughs page on this site. Please check out the blood sugar patch that may offer hope to diabetics worldwide very soon… http://healthybloodsugars.com/the-blood-sugar-patc… Thanks for reading.

  2. Rendall

    Hello Ben,
    Thanks for this and comprehensive article. In my country DKA is the most common condition for patient > 45 years old and usually this is the main complication of uncontrolled diabetes mellitus type-2. DKA always considered as a critical metabolic disorder and according to my last epidemiological studies in 2012, the DKA happens to 12% for female and 17% for male patient with type 2 DM. The prognosis of DKA is bad when it involved the targeted organs damage.

    1. Ben (Post author)

      Awesome feedback Rendall thanks for the figures. I am sure there will be many people interested in those numbers. I guess it outlines the dangers of having uncontrolled diabetes. I note that you only mention type 2 diabetes which is the most common type of diabetes. Are there any numbers for type 1 diabetics? Thanks again.


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