Diabetic Ketoacidosis – All That You Need To Know About It (Part -1)


Diabetic ketoacidosis is life-threatening condition, one of the serious most complications of Diabetes Mellitus.

It occurs as result of insulin shortage. In absence of insulin, fatty acids breakdown is triggered which in turn leads to accumulation of ketone bodies (byproducts of fatty acids metabolism). The symptoms of Diabetic ketoacidosis occur as a result of ketone bodies accumulation.

Sometimes, many previously undiagnosed cases of diabetes are first diagnosed during an episode of diabetic ketoacidosis (DKA). Although DKA is more common in type 1 diabetes, it might ensue in type 2 patients too under some circumstances.

DKA is one of the medical emergencies and if not treated appropriately in time it might result in fatality. Hence, it’s important to know how to recognize the problem at home, and how it is treated. Also, you should know what factors can trigger it, so that you can avoid them in future.


  • Nausea and vomiting
  • Abdominal pain
  • Excessive thirst (polydipsia)
  • Excessive urination (polyuria)
  • Increased blood sugar levels (hyperglycemia)
  • Kussmaul respiration (deep and labored breathing with gasping)
  • Coffee ground vomiting (the color of vomit is deep red to coffee colored because of blood) in some patients. This occurs because of esophageal erosion.
  • In severe DKA patient may experience lethargy, confusion and stupor. If untreated it might even lead to coma.


  • Dehydration: There would be signs of dehydration present like reduced skin turgor and dry mouth.
  • Hypovolemia: In severe dehydration hypovolemia may occur. The signs to look for are tachycardia (elevation in heart rate) and falling of blood pressure.
  • Fruity odor: Because of ketone a ketotic/fruity smell is present.
  • Kussmaul respiration: Presented by an increase in respiratory rate.
  • Cerebral edema: It can occur in small children presenting as headache, loss of pupillary reflex, coma. Ultimately it would progress to death. It can be seen in young adults too, however, quite rare in adults.


A diabetic ketoacidosis is often triggered by another problem superimposed on diabetes. Very often undiagnosed cases of diabetes are first diagnosed during the episode DKA. Underlying problems may include:

  • Infections like influenza, pneumonia, gastroenteritis or urinary tract infections.
  • Insufficient levels of insulin administration. It may occur because of defective pen device, inaccurate method of administration or deliberately taking less insulin like in young individuals who think more insulin may lead to weight gain.
  • Pregnancy
  • Cocaine use
  • Cerebral stroke
  • Myocardial infarction/heart attack

Read the next article : Diabetic Ketoacidosis – Diagnosis & Management