Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a life-threatening diabetes complication in which acids called ketones build up in the blood.
About diabetic ketoacidosis
Diabetic ketoacidosis (DKA) is a life-threatening diabetes complication in which acids called ketones build up in the blood.
What can cause it?
DKA develops when too little insulin causes ketone and acid buildup, often during infection, missed insulin, pump failure, new diabetes, or certain medicines.
It can progress to dehydration, electrolyte disturbance, brain swelling, coma, and death.
What a patient may notice
Symptoms vary from person to person. Possible signs may include:
- Extreme thirst and frequent urination
- Nausea, vomiting, abdominal pain, or fruity-smelling breath
- Deep rapid breathing, severe fatigue, or confusion
How clinicians find the cause
Emergency blood testing measures glucose, ketones, acid-base status, electrolytes, kidney function, and the trigger. Urine or blood ketone testing may identify risk early but does not replace evaluation.
Treatment and next steps
- 1
Hospital treatment uses IV fluids, insulin, frequent potassium and glucose checks, and treatment of the trigger.
- 2
Insulin is adjusted carefully because rapid electrolyte shifts are dangerous.
- 3
DKA cannot be safely treated at home.
Supporting recovery
- Follow the diabetes sick-day plan, continue basal insulin unless specifically directed otherwise, and check ketones when advised.
- Seek help early for vomiting, rising ketones, pump failure, or inability to keep fluids down.
What to expect
Most people recover from diabetic ketoacidosis when IV fluids, insulin, electrolyte replacement, and treatment of the trigger begin promptly. Delayed care increases the risk of severe illness. A diabetes sick-day plan, reliable access to insulin and supplies, and early ketone checks can help prevent another episode.
Possible complications
- Severe dehydration, low blood pressure, shock, or acute kidney injury
- Potassium and other electrolyte shifts that can cause dangerous heart rhythms
- Brain swelling, especially in children, as well as coma or death
When to Contact a Medical Professional
This condition can be life-threatening. Call 911 or go to the nearest emergency department. Do not delay care to visit urgent care.
Call 911 or go to the emergency department immediately. DKA requires hospital treatment.Get emergency help for severe trouble breathing, new chest pressure, fainting, seizure, sudden weakness on one side, uncontrolled bleeding, blue or gray lips, or a person who is difficult to wake.
Ways to lower risk
- Never ration insulin and maintain backup supplies and pump plans.
- Review sick-day rules and ketone testing with the diabetes team.
Trusted health information
This CHS patient-education page uses original wording and links to MedlinePlus for additional information.