Diabetic ketoacidosis (DKA)
ডায়াবেটিক কিটোএসিডোসিস (DKA)
Common Symptoms
Emergency Warning Signs
Phone 999 if someone has become unconscious.
Checking your blood sugar and ketones
If you have any of the symptoms of DKA, check your blood sugar level straight away. Your care team may have given you instructions on how to measure and read your ketones.
As a guide for ketones in your blood:
- under 0.6 mmol/L is normal
- 0.6 to 1.5 mmol/L is slightly high, so test again in 2 hours
- 1.6 to 3 mmol/L means you're at risk of DKA and should speak to your diabetes care team for advice
- over 3 mmol/L is high and means you may have DKA, so call 999 or go to the hospital emergency department
If you use strips to test for ketones in your urine, a reading over 2+ is high. This means you may have DKA, so call 999 or go to the hospital emergency department.
Phone 999 or go to the hospital emergency department if you:
- have a high level of ketones, over 3 mmol/L in your blood or over 2+ in your urine
- don't know your ketone levels but have symptoms of DKA
- have symptoms of DKA and have never been diagnosed with diabetes
Don't drive yourself to the hospital. If you can't get someone to drive you, call 999.
Phone your care team or the 16263 health line if you have diabetes and your:
- blood glucose is high and your insulin treatment isn't bringing it down, even if your ketones are normal
- ketones are slightly high (0.6 to 1.5 mmol/L) and you feel unwell
- ketones are 1.6 to 3 mmol/L, even if you don't feel unwell
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
Diabetic ketoacidosis (DKA) is a life-threatening condition that can affect people who have diabetes.
Symptoms of diabetic ketoacidosis (DKA)
The symptoms of diabetic ketoacidosis (DKA) include:
- the smell of ketones on your breath (this may smell like pear drops or nail polish remover)
- deep breathing
- abdominal (stomach) pain
- nausea and vomiting
These can come along with the symptoms of high blood sugar, which are:
- peeing often
- thirst
- tiredness and lack of energy
- blurry vision
The symptoms usually develop over 24 hours, but they can come on more quickly, especially in children and during pregnancy.
DKA is most likely to affect people with type 1 diabetes. It most often happens when another illness means you can't eat or drink properly, or can't take your insulin. Occasionally it can happen in people with type 2 diabetes who need insulin.
It can also happen when someone first develops type 1 diabetes and hasn't been diagnosed yet. This is more likely in children.
If DKA is left untreated, it can lead to unconsciousness.
Read more: Type 1 diabetes · Type 2 diabetes
Call 999 if:
- someone has become unconscious
Checking your blood sugar and ketones
If you have any of the symptoms of diabetic ketoacidosis (DKA), check your blood sugar levels straight away. Your care team may have shown you how to measure your ketones and understand the result.
As a guide, these are the ketone levels in your blood:
- under 0.6mmol/L is normal
- 0.6 to 1.5mmol/L is slightly high, so test again in 2 hours
- 1.6 to 3mmol/L means you're at risk of DKA, and you should speak to your diabetes care team for advice
- over 3mmol/L is high and means you may have DKA, so you should call 999 or go to the hospital emergency department
If you test for ketones in your pee using strips, a result over 2+ is high. This means you may have DKA, and you should call 999 or go to the hospital emergency department.
Call for an ambulance or go to the hospital emergency department if you:
- have a high level of ketones, which means over 3mmol/L in your blood, or over 2+ in your urine
- do not know your ketone levels but have symptoms of DKA
- have symptoms of DKA and have not been diagnosed with diabetes
Don't drive yourself to the hospital emergency department. If you can't get someone to drive you there, call 999.
Call your doctor or care team if:
Call a doctor or the 16263 health line if you have diabetes and any of these apply:
- your blood glucose is high and your insulin treatment is not bringing it down, even if your ketones are normal
- your ketones are slightly high (0.6 to 1.5mmol/L) and you feel unwell
- your ketones are 1.6 to 3mmol/L, even if you do not feel unwell
What causes diabetic ketoacidosis?
Diabetic ketoacidosis (DKA) happens when there isn't enough insulin in your body. Without it, your body can't use carbohydrate for energy, so it starts breaking down fat and muscle to fuel itself. This releases harmful substances called ketones, and they build up in your blood.
DKA can happen in people with diabetes, particularly if you:
- are unwell
- have had surgery
- have not taken enough insulin
Treatment for diabetic ketoacidosis
If you have diabetic ketoacidosis (DKA), you may need to be treated in hospital. You may be given:
- insulin
- fluids
- nutrients
These will be given to you through a drip into your vein.
The hospital team will also watch you for complications, because DKA can sometimes affect your brain, heart or lungs.
You can go home once your ketones are at a safe level and:
- you can eat and drink normally
- you're able to take insulin
Your doctors and nurses will talk with you about what caused the DKA. They'll also give you advice on how to lower the chance of it happening again.
How to prevent diabetic ketoacidosis
If you have Type 1 diabetes, you can help prevent diabetic ketoacidosis (DKA) by checking your blood sugar levels regularly.
Follow the treatment plan you've agreed with your care team or doctor. If you feel confident adjusting your insulin doses, you should do that. If you don't, contact your healthcare team.
Your blood sugar can run higher than normal when you're unwell, and that puts you at more risk of DKA. So work with your healthcare team to put together a set of steps for what to do when you're ill.
More information and advice on diabetic ketoacidosis
You can also buy one from a pharmacy.
You can use:
- a ketone meter to test your blood
- some types of blood glucose monitor that also test for ketones
- strips to test your pee
If you're unwell, you'll still need insulin and food. If you can't have either, contact your doctor.