How diabetic ketoacidosis occurs is a concern for many people with diabetes, especially those with type 1. Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication, but knowing what causes it and how to spot the signs can make all the difference.
How Diabetic Ketoacidosis Occurs
DKA happens when your body doesn’t have enough insulin to let glucose (sugar) into your cells for energy. Without insulin, your body starts breaking down fat for fuel. This process creates acids called ketones. When ketones build up in the blood, they make it acidic, which can be very dangerous.
DKA is most common in people with type 1 diabetes, but it can also happen in those with type 2 under stress, illness, or missed insulin doses.
Causes and Triggers
- Missed or not enough insulin doses
- Infection or illness (like the flu or a urinary tract infection)
- Physical or emotional stress
- Undiagnosed diabetes (especially in children or teens)
Sometimes, DKA is the first sign that someone has diabetes.
Warning Signs and Symptoms
Early symptoms can be easy to miss. Watch for:
- High blood sugar (often over 250 mg/dL)
- Frequent urination and extreme thirst
- Nausea, vomiting, or stomach pain
- Fatigue or weakness
- Rapid, deep breathing
- Fruity-smelling breath
- Confusion or trouble concentrating
If you notice these signs, seek medical help right away. DKA can develop quickly and become an emergency.
Risk Factors for Diabetic Ketoacidosis
- Type 1 diabetes
- Missed insulin injections
- Infections or illness
- Young age (children and teens at higher risk)
- New diabetes diagnosis
How to Prevent Diabetic Ketoacidosis
- Take insulin as prescribed
- Check your blood sugar regularly
- Test for ketones when you’re sick or your blood sugar is high
- Stay hydrated
- Have a sick-day plan with your healthcare team
Prevention is key. If you’re unsure about your symptoms or how to manage your diabetes, talk to your doctor or diabetes educator.
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