Alexandra Howson, PhD
Diabetic ketoacidosis (DKA) occurs when a person’s blood sugar (glucose) is too high because there is not enough insulin. Instead, the body starts to burn fat for energy. Fat is broken down into acids, causing acid levels to build up in the blood. These acids appear in urine and blood as ketones. DKA is a serious condition that can lead to coma or death if it is not promptly treated.
DKA is most often caused by uncontrolled type 1 diabetes
type 2 diabetes.
Factors that may increase your risk of DKA:
DKA may cause:
Call for emergency medical services right away if you have:
Your doctor will ask about your symptoms and medical history. A physical exam will be done. A urine and/or blood test will be done to look for the presence of ketones.
DKA is treated with insulin and fluids. This may require treatment in an intensive care unit.
Insulin may be given by IV or injections. The insulin will immediately start reversing the cycle causing DKA. 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 to 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 DKA. Steps may include:
If your blood glucose is high and you have moderate amounts of ketones in your urine:
American Diabetes Association
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Diabetes Association
Public Health Agency of Canada
Diabetic ketoacidosis (DKA) in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 22, 2015. Accessed September 8, 2015.
Ketoacidosis (DKA). American Diabetes Association website. Available at:
http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html. Updated March 18, 2015. Accessed September 8, 2015.
Westerberg D. Diabetic ketoacidosis: Evaluation and treatment. Am Fam Physician. 2013;87(5):337-346.
Last reviewed September 2015 by Kim Carmichael, MD
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