Diabetic Ketoacidosis (DKA) is a dangerous and potentially life threatening complication of diabetes, with thousands of preventable cases each year. DKA most commonly happens in people with Type 1 Diabetes although it occasionally occurs in people with insulin-treated Type 2 Diabetes. DKA occurs when there is persistently high glucose and a severe lack of insulin.
Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period, with the first sign often being hyperglycemia.
Typical symptoms of diabetic ketoacidosis include:
Ketones are the by-product of fat metabolism. Ketones can provide the body with energy when glucose is not available. As you know, in order to derive energy from the carbohydrates in the foods that we eat, the body needs insulin.
Insulin is the key that unlocks the body’s cells in order to allow glucose to enter to provide energy. In the absence of sufficient insulin, glucose cannot enter the cells and the glucose levels build up in the blood. Without insulin, the body begins to metabolize fat and produces ketones.
Ketones can be very dangerous when the blood glucose level is high. If the blood glucose and ketones levels continue to rise, one can get very sick very quickly. The person begins to get dehydrated and acidotic, meaning that the body loses water and salts and the pH falls with a build up of acids, the ketones, developing DKA.
You may have heard about or learned how to check urine ketones. Urine ketones reflect what has happened in the recent past but not necessarily what is happening right now. Blood ketones give information about what the body is experiencing at this very moment – so that you get the best and most up-to-date information about what to do.
Urine ketones are checked by dipping a strip into urine, an inconvenient process in the current era of checking blood levels. And, you can only estimate the level of the urine ketones by looking at the strip’s colour after 30-60 seconds. The American Diabetes Association states that blood ketone testing is preferred over urine ketone testing as a more reliable method of diagnosing DKA. Blood ketones are checked the same way that you check your blood sugar, PLUS the meter gives you the exact ketone level in only 10 seconds.
It is easy to understand the importance of blood glucose monitoring but what about blood ketone monitoring? Blood glucose levels provide the road map to your diabetes management by helping determine the proper insulin dosage and by evaluating the effects of diet and exercise. Checking blood ketone levels reduces the risk of DKA. Checking ketone levels and reacting in a timely manner with extra insulin, fluids, and communication with the healthcare team can keep you healthy and avoid the need for emergency treatment.
Diabetic Ketoacidosis can result from any of the following:
Remember to check for blood ketones whenever you are sick and/or you have elevated blood glucose levels of 13.9 mmol/L or higher!
DKA usually develops over 24 hours but can develop faster particularly in young children. Hospital admission and treatment is essential to correct the life-threatening acidosis and involves closely monitored intravenous fluids, insulin and glucose.
With the portable GlucoMen® Areo 2K meter you can check blood ketones levels anywhere, at home, at school or at work.
Click here to find out more about GlucoMen Areo 2K
Click here to download the full DKA Information Brochure
Normal; consider re-checking blood ketone levels in 1-2 hours if blood glucose remains elevated, above 13.9 mmol/L
Indicates a need for extra insulin It is important to call or follow the rules provided by your diabetes healthcare team and continue to check your blood glucose and blood ketone levels in 1-2 hours
Indicates risk of diabetic ketoacidosis. Call your health care team!
In addition to the information on this page, you can download a recent article from Diabetes UK (Balance magazine) below:
Click here to download the Balance article on DKA.
“Reducing the risk of diabetic ketoacidosis (also known as DKA) emergency begins with education!”
¹ National Diabetes Audit 2011-2012 – Report 2
² National Diabetes Audit 2009-2010
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