DKA is a medical emergency. Call your local emergency services immediately if you think you may be experiencing DKA. If left untreated, DKA can lead to a coma or death.

If you use insulin , make sure you discuss the risk of DKA with your healthcare team and have a plan in place. Call your doctor if moderate or high levels of ketones are present. Always seek medical help if you suspect you are progressing to DKA.

People with type 2 diabetes are usually at lower risk of DKA. But the risk can increase when your body is under strain due to injury, infection, or surgery. Get help by calling local emergency services or having someone take you to the nearest emergency room.

The treatment for DKA usually involves a combination of approaches to normalize blood sugar and insulin levels. Infection can increase the risk of DKA. If your DKA is a result of an infection or illness, your doctor will treat that as well, usually with antibiotics.

At the hospital, your physician will likely give you intravenous IV fluids to help your body rehydrate. During a DKA event, you usually lose a lot of fluids, which can reduce the amount of blood flowing through your body. Fluid replacement helps restore typical blood flow.

It also helps treat dehydration , which can cause even higher blood sugar levels. Electrolytes are electrically charged minerals that help your body, including the heart and nerves, function properly.

Electrolyte replacement is also commonly done through an IV. The emergency care team will also monitor several other blood test results that indicate when insulin therapy is no longer needed.

When your blood sugar and other test readings are within an acceptable range, your doctor will work with you to help you avoid DKA in the future. DKA occurs when insulin levels are low. Our bodies need insulin to use the available glucose in the blood.

Turning fat into energy produces ketones. When too many ketones build up, your blood becomes acidic. This is diabetic ketoacidosis. Although DKA is less common in people who have type 2 diabetes, it does occur. A diagnosis of ketosis-prone diabetes is more likely for:.

Testing for ketones is one of the first steps for diagnosing DKA. If you have type 1 diabetes, you should have a supply of home ketone tests. These test either your urine or your blood for the presence of ketones.

According to the American Diabetes Association , you should test for ketones:. Urine test strips change color to signal the presence of ketones in your urine. The indicator on the strip will change color.

Compare the test strip to the results chart. Blood ketone testers are also available. These are usually combination devices that can measure both glucose levels and ketone levels.

The test strip is inserted into a monitor device to test for the presence of ketones in your blood. A doctor will likely do a test to confirm the presence of ketones in your urine. They will usually also test your blood sugar level. Other tests your doctor may order include:. There are many ways to prevent DKA.

You can lower your risk of DKA with proper management of your diabetes:. Call your doctor if you detect moderate or high ketones in a home test.

Early detection is essential. DKA is serious, but it can be prevented. Follow your diabetes treatment plan and be proactive about your health. They can adjust your treatment plan or help you come up with solutions for better managing your diabetes. Read this article in Spanish. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

VIEW ALL HISTORY. In an effort to control blood sugar and weight, some people are turning to the ketogenic diet for managing type 2 diabetes. We'll show you how…. When levels get too high, you can develop DKA. DKA may happen to anyone with diabetes, though it is rare in people with type 2. Treatment for DKA usually takes place in the hospital.

But you can help prevent it by learning the warning signs and checking your urine and blood regularly. DKA usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours. Early symptoms include the following:.

DKA is dangerous and serious. You can detect ketones with a simple urine test using a test strip, similar to a blood testing strip.

Ask your health care provider when and how you should test for ketones. When you are ill when you have a cold or the flu, for example , check for ketones every four to six hours. If your health care provider has not told you what levels of ketones are dangerous, then call when you find moderate amounts after more than one test.

Often, your health care provider can tell you what to do over the phone. Do NOT exercise when your urine tests show ketones and your blood glucose is high.

High levels of ketones and high blood glucose levels can mean your diabetes is out of control. Check with your health care provider about how to handle this situation. Diabetes Complications. Know the warning signs of DKA and check urine for ketones, especially when you're sick.

What are the warning signs of DKA? Early symptoms include the following: Thirst or a very dry mouth Frequent urination High blood glucose blood sugar levels High levels of ketones in the urine Then, other symptoms appear: Constantly feeling tired Dry or flushed skin Nausea, vomiting, or abdominal pain.

Vomiting can be caused by many illnesses, not just ketoacidosis. If vomiting continues for more than two hours, contact your health care provider. Difficulty breathing Fruity odor on breath A hard time paying attention, or confusion.

Talk to your health care provider or diabetes educator about how to make your insulin dosage work for you. Consider factors such as your blood sugar level, what you eat, how active you are, and whether you're ill. If your blood sugar level begins to rise, follow your diabetes treatment plan to return your blood sugar level to your target range.

Check your ketone level. When you're ill or stressed, test your urine for excess ketones with a urine ketones test kit. You can buy test kits at a drugstore.

If your ketone level is moderate or high, contact your health care provider right away or seek emergency care. If you have low levels of ketones, you may need to take more insulin. Be prepared to act quickly. If you think you have diabetic ketoacidosis because your blood sugar is high and you have too many ketones in your urine, seek emergency care.

By Mayo Clinic Staff. Oct 06, Show References. DKA ketoacidosis and ketones. American Diabetes Association.

Accessed Sept. Diabetic ketoacidosis DKA. Merck Manual Professional Version. Hirsch IB, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment.

Ferri FF. Diabetic ketoacidosis. In: Ferri's Clinical Advisor Elsevier; Evans K. Diabetic ketoacidosis: Update on management. Clinical Medicine. Associated Procedures.

Chest X-rays. Electrocardiogram ECG or EKG. Show the heart some love! Give Today. Help us advance cardiovascular medicine. Find a doctor. Explore careers. Sign up for free e-newsletters. About Mayo Clinic. About this Site. Contact Us. Health Information Policy. Media Requests.

News Network. Price Transparency. Medical Professionals. Diabetes is rare in children under 5 years, but it is serious. Here's how to spot symptoms of diabetes and manage the condition in young children.

Are you living with diabetes and planning to fast for Ramadan? Follow these practical tips and advice so you can enjoy a safe and healthy Ramadan. Very low or very high blood glucose levels are primary causes of diabetic coma occurring in people with diabetes.

There are 3 types of diabetic coma: diabetic ketoacidosis coma; hyperosmolar coma and hypoglycaemic coma. Diabetic coma is regarded as a medical emergency requiring immediate treatment.

Read more on Ausmed Education website. Reproduced with permission from The Royal Australian College of General Practitioners. End-of-life care for people with type 2 diabetes should not be viewed as a failure of care, but as a complement to usual diabetes care.

Read more on RACGP - The Royal Australian College of General Practitioners website. Insulin is a hormone that is produced by the pancreas. Insulin helps to control blood glucose levels and plays a role in controlling the levels of carbohydra.

Read more on Pathology Tests Explained website. Amylase is an enzyme made mainly by the pancreas. It is released from the pancreas into the digestive tract to help digest starch in our food. When we breathe, we take oxygen from the air into the body, and remove carbon dioxide CO2 , a waste gas produced by cells.

Most of the CO2 in the bloo. Measuring the pH. The majority, 70—80 per cent of phosphate exists in the bones, complexed with calcium as hydroxyapatite, and a small fraction, 1 per cent is in the blood m. Healthdirect Australia is not responsible for the content and advertising on the external website you are now entering.

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For more information, please visit the links below:. Philadelphia, PA: Elsevier; chap ElSayed NA, Aleppo G, Aroda VR, et al. Classification and diagnosis of diabetes: standards of care in diabetes Diabetes Care.

PMID: pubmed. Maloney GE, Glauser JM. Diabetes mellitus and disorders of glucose homeostasis. In: Walls RM, Hockberger RS, Gausche-Hill M, Erickson TB, Wilcox SR, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. Updated by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA.

Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A. Editorial team. Diabetic ketoacidosis. DKA happens when the signal from insulin in the body is so low that: Blood sugar glucose can't go into cells to be used as a fuel source.

The liver makes a large amount of glucose. Fat is broken down too rapidly for the body to process. Common symptoms of DKA can include: Decreased alertness Deep, rapid breathing Dehydration Dry skin and mouth Flushed face Frequent urination or thirst that lasts for a day or more Fruity-smelling breath Headache Muscle stiffness or aches Nausea and vomiting Stomach pain.

Exams and Tests. Ketone testing is usually done when DKA is suspected: Most often, urine testing is done first. If the urine is positive for ketones, most often a ketone called beta-hydroxybutyrate is measured in the blood.

This is the most common ketone measured. The other main ketone is acetoacetate. Other tests for ketoacidosis include: Arterial blood gas Basic metabolic panel , a group of blood tests that measure your sodium and potassium levels, kidney function, and other chemicals and functions, including the anion gap Blood glucose test Blood pressure measurement Osmolality blood test.

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