Diabetic Ketoacidosis – DKA
Answers to common questions about diabetic ketoacidosis – dka.
Questions on this page
What is diabetic ketoacidosis?
Diabetic ketoacidosis (DKA) is a serious complication of diabetes caused by severe insulin deficiency. The body starts producing large amounts of ketones, leading to metabolic acidosis.
DKA is a medical emergency.
Who can develop DKA?
DKA is particularly common in type 1 diabetes, but it can also occur in people with type 2 diabetes under certain circumstances.
What causes DKA?
Common triggers include:
- Missed or inadequate insulin
- Infection
- Severe illness
- Surgery
- Major physical stress
- New-onset diabetes
- Certain medications
- Severe dehydration
What are the symptoms of DKA?
Possible symptoms include:
- Excessive thirst
- Frequent urination
- Nausea and vomiting
- Abdominal pain
- Dehydration
- Weakness
- Rapid or deep breathing
- Fruity-smelling breath
- Drowsiness or confusion
Can DKA occur even if blood sugar is not extremely high?
Yes. Euglycaemic DKA can occur in some situations, including with certain diabetes medications such as SGLT2 inhibitors.
This is particularly important because a relatively modest glucose level does not completely exclude DKA.
What should I do if I suspect DKA?
Check blood glucose and ketones if available and seek urgent medical attention, particularly if there is vomiting, dehydration, breathing difficulty, persistent ketones or altered consciousness.
Should I stop insulin if I am not eating?
People with type 1 diabetes should generally not stop basal insulin simply because they are not eating. Illness requires an individualized sick-day plan.
Can DKA be prevented?
Often, the risk can be reduced through:
- Correct insulin administration
- Sick-day planning
- Ketone monitoring when appropriate
- Early treatment of infections
- Not stopping insulin without medical advice
- Knowing when to seek medical attention