Diabetic Ketoacidosis

WHAT YOU SHOULD KNOW

Ketoacidosis (KEY-toe-ASS-ih-DOE-sis) is one of the many dangerous complications of diabetes. The problem develops when the body is unable to get enough energy from blood sugar and begins to use fat. As a byproduct of this process, chemicals called ketones flood the bloodstream. Together with excess sugar, the extra ketones can build up to dangerous, even life-threatening levels. This condition needs immediate care by your doctor.

Causes

The body needs insulin in order to process blood sugar efficiently and prevent excessive breakdown of fats; so diabetic ketoacidosis is often the result of a diabetic's failure to take enough insulin, or to take any insulin at all. The problem may also be triggered by infection, injury, and emotional stress. Often, doctors can find no immediate cause.

Signs/Symptoms

Early signs include excessive thirst, frequent urination, headache, nausea, and vomiting. The breath may begin to take on a fruity odor, and you may develop rapid deep breathing, sleepiness, and fatigue. Other symptoms include weight loss and a feeling of fullness or pain in the stomach.

Care

Call your doctor when you first notice early signs. You may need to be hospitalized for tests and treatment. If the condition is left untreated, it could lead to coma and death.

WHAT YOU SHOULD DO

• To keep from losing too much water from your body, drink 1 to 2 glasses of fluid (soda-can sized) every hour, or sip 1 tablespoon of liquid every 10 to 15 minutes.
  • If you can't eat, alternate between drinking fluids with sugar (soda, juices, flavored gelatin, or ice) and salty fluids (broth or bouillon).
  • If you can eat, follow your usual diet and drink sugar-free liquids (water or diet drinks).
• Be sure to take your usual daily dosage of insulin, even if you can't eat.
• Continue to monitor your blood or urine glucose every 3 to 4 hours around the clock. Set your alarm clock or have someone awaken you. If you are too sick, have someone do the test for you.
• Your doctor will tell you the safe range for your blood or urine glucose levels. If either measures higher than that level, you will need to test for ketones.
• Rest and avoid exercise.

Call Your Doctor If...

• You have ketones in your urine or your blood sugar is over the level your doctor considers safe. You may need extra insulin.
• You cannot keep any liquids down.
• You have been vomiting for more than 1 hour.
• You develop any of the more advanced symptoms of ketoacidosis (fruity breath, rapid breathing, extreme sleepiness).

Seek Care Immediately If...

• You have signs of dehydration:
  • Decreased urination.
  • Increased thirst.
  • Light-headed feeling.
• Your blood or urine glucose measurement remains higher than the level judged safe by your doctor even when you take 2 extra doses of insulin per 24 hours.