Diabetic ketoacidosis (DKA) is a life-threatening condition caused by a build-up of waste products called ketones in the blood. It occurs in people with diabetes mellitus when they have no, or very low levels of, insulin.
DKA mostly occurs in people with type 1 diabetes, but it can also occur in some people with type 2 diabetes and pregnant women with gestational diabetes.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
Glucose is an essential energy source for the body's cells. When food containing carbohydrates is eaten, it is broken down into glucose that travels around the body in the blood, to be absorbed by cells that use it for energy.
Insulin works to help glucose pass into cells. Without insulin, the cells cannot absorb glucose to use for energy. This leads to a series of changes in metabolism that can affect the whole body.
The liver attempts to compensate for the lack of energy in the cells by producing more glucose, leading to increased levels of glucose in the blood, also known as hyperglycaemia.
The body switches to burning its stores of fat instead of glucose to produce energy. This leads to a build-up of acidic waste products called ketones in the blood and urine. This is known as ketoacidosis, and it can cause heart rhythm abnormalities, breathing changes and abdominal pain.
The kidneys try to remove some of the excess glucose and ketones. However, this requires taking large amounts of fluid from the body, which leads to dehydration.
This can cause:
The pressure the blood places on the walls of the arteries, largely mirroring the contraction of the heart, and consisting of two readings. The higher reading is systolic blood pressure, when the heart contracts, and the lower is diastolic blood pressure, when the heart is relaxed.
A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
A pair of organs responsible primarily for regulating the water balance in the body and filtering the blood.
A large, internal organ of the body, located on the upper right-hand side of the abdomen. The liver has hundreds of distinct functions, including producing bile, regulating the body's metabolism and detoxifying the blood.
The sum of all chemical changes that take place within an organism to maintain growth and development and convert food into energy and building blocks.
A life-threatening condition in which the organs and other tissues do not receive adequate blood flow.
Relating to the abdomen, the middle portion of the trunk which contains organs such as the intestines, stomach and liver.
A water-soluble compound and major mineral that is essential for maintaining contractions of muscles, including the heart.
For people with type 1 diabetes, factors that can increase the risk of DKA include:
The risks are highest in the period just before diabetes is diagnosed. The symptoms of DKA may be the first sign of type 1 diabetes. Younger people - particularly in their teens - with type 1 diabetes tend to be at greater risk of developing DKA.
DKA is much less common in people with type 2 diabetes, but factors that can increase the risk include:
Pregnant women who have pre-existing diabetes or develop gestational diabetes during pregnancy can also be at risk of developing ketoacidosis.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
Inflammation of the pancreas.
An illness caused by inflammation throughout the body in response to an infection. It can be life-threatening if it leads to septic shock, a dramatic loss of blood pressure.
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
Relating to bacteria, which are microscopic organisms with DNA, but no definite nucleus. They are capable of causing many diseases in humans.
Relating to bacteria, which are microscopic organisms with DNA, but no definite nucleus.
Symptoms of DKA can develop over the course of hours. They can include:
DKA can rapidly cause severe dehydration.
People who self-test their own blood and urine may notice:
If you notice signs or symptoms of DKA, it is important to contact your doctor immediately or seek emergency treatment. This is the case even if there has not been a previous diagnosis of diabetes.
A state of exhaustion and weakness.
A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.
A sensation of sickness and unease, typically felt in the stomach, often accompanied by the urge to vomit. Nausea is a common symptom with many possible causes.
Relating to the abdomen, the middle portion of the trunk which contains organs such as the intestines, stomach and liver.
An acid that is produced by the body during the breakdown of fats for energy. It can be seen in patients with type 1 diabetes mellitus when the body cannot use sugar for energy and breaks down fat instead.
Your doctor may ask you about your symptoms, results of any self-testing of blood glucose and ketone levels and any factors that might have triggered DKA.
A physical examination can help to evaluate the severity of symptoms. In particular, your doctor may focus on checking for signs of dehydration.
Blood tests and urine tests are used to detect DKA by measuring the levels of glucose and ketones.
A hand-held portable glucose measuring device.
Other tests may be recommended to detect any underlying conditions that may have triggered the DKA and determine if you have any complications.
These can include:
Substances that form ions when dissolved in water. These include potassium and sodium minerals that are necessary for normal functioning of the body and all its cells.
A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
An organ located behind the stomach that secretes insulin and glucagon into the bloodstream and digestive enzymes into the intestines.
A water-soluble compound and major mineral that is essential for maintaining contractions of muscles, including the heart.
A test used to measure long-term levels of glucose in the blood, usually in patients with diabetes.
A test that measures a specific pancreatic enzyme, called amylase, usually in the blood or urine. It is commonly used as a marker for pancreatic disorders, such as pancreatitis (an inflamed pancreas).
An acid that is produced by the body during the breakdown of fats for energy. It can be seen in patients with type 1 diabetes mellitus when the body cannot use sugar for energy and breaks down fat instead.
A test that uses electrodes placed on the chest and limbs to record the electrical impulses causing the contractions of the heart.
DKA usually requires treatment in a hospital. Treatment aims to:
It is important that this treatment be monitored carefully to make sure that glucose and electrolyte levels are maintained at safe levels, or complications may develop.
Any underlying conditions that may have triggered DKA may also need treatment. If the DKA is a sign of undiagnosed diabetes, your doctor will develop a plan to help you manage your diabetes.
Substances that form ions when dissolved in water. These include potassium and sodium minerals that are necessary for normal functioning of the body and all its cells.
A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
Complications that can occur with treatment of DKA include:
If insulin causes blood glucose levels to drop too low, this can cause hypoglycaemia, a serious condition that can cause people to lose consciousness.
Replacement of fluids to treat dehydration can lead to potassium levels falling too low, known as hypokalaemia. As potassium is vital for the function of muscles, nerves and the heart, this can be dangerous.
If blood sugar levels change too quickly, it can lead to swelling in the brain (cerebral oedema), particularly in children. In turn, this swelling restricts the flow of oxygen-rich blood to the brain, which can result in the damage or death of brain cells.
Careful monitoring of blood glucose and electrolyte levels during treatment can help to prevent these complications.
Substances that form ions when dissolved in water. These include potassium and sodium minerals that are necessary for normal functioning of the body and all its cells.
A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
One or more fibres that transmit signals of sensation and motion between the brain or spinal cord and other parts of the body.
A water-soluble compound and major mineral that is essential for maintaining contractions of muscles, including the heart.
With prompt treatment, the prognosis of DKA is generally good. However, every year people still continue to die from diabetic ketoacidosis, often as a result of not seeking treatment early.
While DKA cannot always be prevented, by managing diabetes well, you can significantly reduce the risk of it occurring.
Steps you can take include:
A simple sugar found in many foods (such as fruit) that functions as a major energy source for the body.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
An acid that is produced by the body during the breakdown of fats for energy. It can be seen in patients with type 1 diabetes mellitus when the body cannot use sugar for energy and breaks down fat instead.