Diabetic ketoacidosis

Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones.

Diabetic ketoacidosis develops when your body is unable to produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as an alternate fuel. This process produces a buildup of toxic acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.

If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care.

Symptoms Causes Risk factors Complications Prevention

Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice:

  • Excessive thirst
  • Frequent urination
  • Nausea and vomiting
  • Abdominal pain
  • Weakness or fatigue
  • Shortness of breath
  • Fruity-scented breath
  • Confusion

More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include:

  • High blood sugar level (hyperglycemia)
  • High ketone levels in your urine

When to see a doctor

If you feel ill or stressed, or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit.

Contact your doctor immediately if:

  • You're vomiting and unable to tolerate any food or liquid
  • Your blood sugar level is higher than your target range and doesn't respond to home treatment
  • Your urine ketone level is moderate or high

Seek emergency care if:

  • Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 millimoles per liter (mmol/L)
  • You have ketones in your urine and can't reach your doctor for advice
  • You have multiple signs and symptoms of diabetic ketoacidosis — excessive thirst or frequent urination, nausea and vomiting, abdominal pain, shortness of breath, fruity-scented breath, confusion

Remember, untreated diabetic ketoacidosis can be fatal.

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