May 28, 2021

Diabetic Ketoacidosis | DKA Symptoms & Causes

Diabetic ketoacidosis is a complication of diabetes that can be life-threatening, most common in people with type 1 diabetes mellitus, though people with type 2 diabetes can also develop DKA. Learn more about symptoms, causes and more.

Share This Story

Hyperglycemia in Diabetes | Symptoms, Causes & Treatment

Home / Living with Diabetes / Diabetic Ketoacidosis | DKA Symptoms & Causes

Diabetic Ketoacidosis Overview 

DKA develops when your body does not have enough insulin to allow blood glucose to enter the cells to be utilized for energy. Your liver instead to compensate, starts to break down fat for energy and this leads to the production of ketones. DKA  involves the buildup of acidic ketones in a person’s bloodstream, which can result in coma or death if left untreated. 

It can be comforting to assume diabetic ketoacidosis won’t affect you, but that may not be the case. According to CDC statistics, the rate of American hospitalizations related to DKA increased by a total of 54.9% between 2009 and 2014 – so it’s more crucial than ever for people who have diabetes to learn what symptoms are associated with this complication. 

In this article, we’ll give you an overview of what causes diabetic ketoacidosis and what symptoms you should keep an eye out for.

Causes Of DKA 

Like other complications of diabetesdiabetic ketoacidosis is a result of high blood sugar and low insulin levels in a person’s system. Cells use insulin to access the glucose they need to function; when they can’t use glucose, they are forced to find another fuel source, in this case ketones.  

There’s just one problem: ketones are toxic and acidic, and when they build up in a person’s bloodstream, their blood will become acidic too. This is why this condition is known as diabetic ketoacidosis, and it can have major repercussions if it’s not taken care of quickly. 

Factors which can lead to the development of DKA include: 

  • Not using enough insulin 
  • Missing an insulin dose 
  • Insulin pump clogs 
  • Infection 
  • Sickness 
  • Heart attack or stroke 
  • Physical injury 
  • Alcohol or drug use 
  • Certain medicines such as diuretics or corticosteroids 

DKA Symptoms 

Fortunately for those worried about developing diabetic ketoacidosis, the complication has a number of telltale symptoms to look out for. Some of these symptoms are: 

  • High blood glucose levels/ketone levels in urine 
  • Breath that smells “fruity 
  • Frequent urination (early symptom) 
  • Rapid breathing 
  • Dry skin/mouth, being very thirsty 
  • Pain in the abdomen 
  • Nausea, vomiting 
  • Flushed face 
  • Headache 
  • Muscle aches and stiffness  

No matter what type of diabetes you have, if you suspect you are dealing with diabetic ketoacidosis, it is extremely important to take this seriously. 

Common DKA Complications 

dka-diabetic-ketoacidosisInterestingly enough, the majority of common diabetic ketoacidosis complications are related to treatment methods for the condition. We’ll explain these treatments later, but here are some complications to be aware of if you’re receiving medical attention for DKA: 

  • Hypoglycemia, or low blood sugar. When you receive insulin after experiencing DKA, your blood glucose level can drop quickly – too quickly, in some cases. 
  • Hypokalemia, or low potassium levels. Fluid treatments and insulin can lower the amount of potassium in your system, which may cause problems related to body parts such as nerves, muscles, and the heart. (Because of this, potassium and other electrolytes are often given to patients along with other treatments.) 
  • Cerebral edema, or swelling of the brain. As a result of your blood glucose level changing rapidly, your brain may start to swell. This is seen more often in children, particularly if they have just been diagnosed with diabetes recently. 

Although these complications can be problematic, they are much better than the alternative. If it is not dealt with, DKA can cause people to lose consciousness and eventually die. 

Prevention Of DKA

Unlike type 1 diabetes, there are many different steps people can take to avoid developing diabetic ketoacidosis. Many of these steps involve making a serious effort to keep diabetes under control. 

A key part of this involves regularly testing your blood glucose level (at least three or four times a day) to make sure it stays in your target range. If it is out of balance, adjust your insulin accordingly. Eating a healthy diet and getting exercise play an important role in preventing DKA, as well.

When you have reason to believe you may have diabetic ketoacidosis – or even if you’re just experiencing illness or stress – it’s a good idea to test your urine for the presence of ketones. Testing kits are available for purchase over the counter. If you have a high or moderate ketone level, seek emergency assistance or contact your healthcare team.

DKA Treatment Methods 

If you are dealing with diabetic ketoacidosis, you will likely need to go to the hospital for treatment. Here are some of the treatment methods used in response to DKA: 

Fluid Replacement 

One important treatment for DKA is fluid replacement – either orally or through an IV. This can help alleviate dehydration, since this condition can make blood glucose levels even worse. 


While you’re experiencing DKA, you’ll be given insulin until your blood glucose level goes under 240 mg/dL. Once that level is reached, your doctor will talk to you about avoiding diabetic ketoacidosis going forward. 

Replacement Of Electrolytes 

Since low insulin levels can be associated with low levels of electrolytes (including, but not limited to, potassium), you may also receive electrolyte replacement from an IV. 

Any underlying illness that may have led to DKA may be treated with antibiotics for the infection. 


The risk of diabetic ketoacidosis is one you can’t afford to ignore – but it’s not something you should lose sleep about, either. By taking some common-sense steps and being aware of possible symptoms of this complication, you can significantly lower your DKA risk. 

Because one of the best ways to avoid DKA is keeping a watchful eye on your blood glucose levels and adjusting insulin levels accordingly, it pays to make this process as easy as possible. US MED’s selection of blood glucose meterscontinuous glucose monitoring systems, and insulin pumps can go a long way in this regard! 

Shirley DeLeon Certified Diabetes Care & Education Specialist

Medical Review by Shirley DeLeon, Certified Diabetes Care and Education Specialist

Latest Recipes

Read Next:


5 Steps for Managing Diabetes | Type 1 and Type 2

We’ll walk you through five steps to help you manage your diabetes so you can live a life ...

Prediabetes: Key Risk Factors and Effective Lifestyle Changes

If you’re at risk for type 2 diabetes, you may develop a condition known as “prediabetes” first. Here’s ...

Comparing the Best Insulin Pumps: Features, Pros, and Cons for Managing Diabetes

What is the Best Insulin Pump for Your Diabetic Needs? Diabetes is a serious condition, and more people ...