Diabetes, if not properly managed, can have nasty consequences, including vision loss, amputations, heart disease and stroke or kidney failure.
Diabetic ketoacidosis, or DKA, is another one of those consequences, according to Dr. Linda Hermiller, an endocrinologist and diabetes expert at St. Elizabeth’s Regional Diabetes Center in Covington.
Diabetes causes blood sugar levels to climb too high because the body either can’t make insulin in order to break down the sugar from food to fuel cell activity (Type 1 diabetes) or because the body can’t properly utilize the insulin it does have (Type 2). Over time, excessively high blood sugar levels lead to a host of complications.
What is DKA?
DKA occurs when the body starts breaking down stored fat for fuel because it can’t utilize insulin to break down sugar. When fat is metabolized, it produces chemicals called ketones that build up in the blood, and those ketones cause the blood to become acidic.
High ketone levels are an indication that diabetes isn’t being properly managed. They’re also extremely dangerous. DKA, if not recognized and treated quickly, can be fatal, according to Dr. Hermiller.
“DKA is an acute metabolic emergency that more commonly happens in patients with Type 1 diabetes, but in unique situations may occur in those with Type 2,” Dr. Hermiller said.
Common causes of DKA
In many cases, people develop DKA after a stomach bug or other illness; sometimes it occurs when people aren’t taking their insulin as directed, or they aren’t taking enough insulin, she said. Blood sugar levels rise sharply, and the body begins producing ketones.
The best way to prevent DKA is good diabetes management, including checking blood sugar frequently. Guidelines call for checking for ketones in the urine (you can purchase special test strips for this) if your blood sugar is at 240 or higher. If the test results show ketone levels are elevated, call your doctor. If levels are high enough, you might need to be hospitalized.
Symptoms of DKA
Early symptoms include:
- Extreme thirst or a very dry mouth
- Frequent urination
- High blood sugar
- High ketone levels shown on a urine test
Later symptoms include:
- Tiredness or fatigue
- Nausea, vomiting or abdominal pain
- Dry or flushed skin
- Confusion
- Difficulty breathing
- A fruity odor to the breath
Who’s at risk for DKA?
Three kinds of patients are at a higher risk for developing DKA:
- Patients who are not getting enough insulin
- Patients who are not getting enough food, which is common when someone has a bug and doesn’t feel like eating
- Patients with low blood sugar
“Preventing DKA is about taking insulin every day as prescribed, checking blood sugars often, particularly in setting of illness, and if sugars get above a certain level, patients are instructed to check urine for ketones at home,” Dr. Hermiller said. “If mild, we can often try to address the issue and prevent a trip to the hospital.
