• Diabetic ketoacidosis is also called “DKA.” It is a serious problem in people with diabetes  mellitus. DKA happens when your blood sugar gets very high and is not treated properly.
• Much of what you eat and drink is changed into sugar (glucose). Sugar gives you energy. Insulin makes your body use this sugar and helps keep your blood sugar normal. With diabetes mellitus, your body does not make enough insulin or your body does not respond normally to insulin. Without insulin, sugar builds up in the blood.
• With diabetes, sugar stays in your blood and is not changed into energy. Your body must now use fat for energy. When this happens, chemicals called ketones are left in your blood. Your blood sugar will keep getting higher if you do not get enough insulin. Ketones build up in your blood and cause body cells to be damaged. This makes you very sick and you can even die.

Causes: DKA can come on slowly or happen very quickly.
Some of the main causes are:

• Not getting enough insulin.
• Missing a dose of insulin.
• Illness, such as pneumonia.
• Infection, such as a urinary tract infection.
• New diagnosis of diabetes.
• Diabetes that is not being treated.
• Stress.
• Injury.

Signs and Symptoms:

• * Early signs and symptoms of DKA.
• ** Fast, deep breathing.
• ** High blood sugar.
• ** Vomiting (throwing up).
• ** Weakness.
• * Later signs and symptoms of DKA:
• ** Abdominal pain.
• ** Chest pain.
• ** Confusion.
• ** Dry mouth.
• ** Fruity-smelling breath.
• ** Fullness in abdomen (belly).
• ** Headache.
• ** Hungrier than usual.
• ** Nausea (upset stomach).
• ** Tiredness or sleepiness.
• ** Thirstier than usual.
• ** Urinating (going to the bathroom) more than usual.
• ** Weight loss.
• ** Coma (unable to be woke up from sleeping).

Care:

• DKA can be treated and controlled most of the time. But early treatment is very important. Call your caregiver when you see or feel any signs of DKA. Check your blood sugar and urine ketone levels as often as your caregiver tells you to. Check your blood sugar more often when you are sick. Ask your caregiver for the CareNotes(tm) handouts explaining how to do these tests if you don’t know.
• You may need to be put in the hospital for tests and treatment. You may need to have an EKG, blood tests, x-rays, and have an IV. The dose or type of medicine that you take for diabetes may have to be changed. Your diet may have to change, and your urine and blood checked often. Ask your caregiver for information about DKA to help you understand about the different tests and treatments.