(Diabetic Coma; DKA)
Diabetic ketoacidosis is a high level of ketones in the blood. Ketone is an acid that is made when fat is broken down for fuel. A certain level of ketones is normal but excessive levels can make you very sick.
Ketoacidosis is a serious condition that can lead to coma or death if not treated.
Glucose is the most common source of fuel for the body. A hormone called insulin helps the body use glucose. If insulin is low or missing, the body cannot use glucose for fuel. Fat is used as the main source of fuel in place of glucose. The increased use of fat creates a toxic level of ketones in the blood. Ketones that are high in the blood will also spill over into the urine.
This situation is most often cause by type 1 diabetes and sometimes type 2 diabetes.
Factors that may increase your risk of ketoacidosis include have diabetes (type 1 or 2) and:
Symptoms of ketoacidosis may include:
Call for emergency medical help or have someone take you to the nearest emergency room if you have:
Your doctor will ask about your symptoms and medical history. A physical exam will be done. A urine test will be done to look for the presence of ketones. Blood tests will also be done to:
Ketoacidosis is treated with insulin and fluids.
Insulin may be given by IV or injections. The insulin will immediately start reversing the cycle causing ketoacidosis. The insulin will let the body use glucose for fuel again. Fat will not be needed for fuel so new ketones will not be made. The body will then be able to get rid of the extra ketones.
Fluids and electrolytes will also be given through IV. Fluids will help flush the ketones from your body. Electrolytes will help your blood restore balance.
You and your doctor will make a plan to manage your diabetes. These steps will also reduce the chance of ketoacidosis. Steps may include:
If your blood glucose is high and you have moderate amounts of ketones in your urine:
American Diabetes Association
National Diabetes Information Clearinghouse
Canadian Diabetes Association
Team Diabetes Canada
Diabetic ketoacidosis. American Diabetes Association website. Available at: http://www.diabete.... Accessed June 13, 2013.
Diabetic ketoacidosis. American Family Physician Association website. Available at: http://www.aafp.org/afp/2005/0501/p1705.html. Updated May 1, 2005. Accessed June 13, 2013.
Diabetic ketoacidosis (DKA). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated January 12, 2013. Accessed June 13, 2013.
Last reviewed May 2013 by Kim Carmichael, MD