What is Diabetic Ketoacidosis?

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  • Written By: D. Jeffress
  • Edited By: Jenn Walker
  • Last Modified Date: 15 October 2019
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Diabetic ketoacidosis is a potentially fatal health condition that can affect people with type one diabetes. It occurs when insulin levels are too low for body cells to properly metabolize glucose. Without energy from glucose, cells begin to break down fat deposits instead. Byproducts of fat breakdown called ketones are released into the bloodstream, which can be toxic in high enough levels. A diabetic person who experiences shortness of breath, drowsiness, mental confusion, and other symptoms of diabetic ketoacidosis should seek hospital care right away to reduce the risk of coma or death.

Insulin hormones help cells absorb and metabolize sugars from the bloodstream. Since people with type one diabetes are insulin deficient, their bodies cannot use glucose sugars as an energy source. Cellular energy must be derived from fat and muscle tissue, which leads to the production of ketones and other fatty acids. The risk of diabetic ketoacidosis is greatest when a person is very ill, under high stress, or misses a regular dose of insulin.

Symptoms of diabetic ketoacidosis tend to come on very quickly when insulin levels drop. Over the course of one or two days, a person can become dehydrated, fatigued, and nauseous. Abdominal pain, confusion, and dizziness are common as well. If the condition goes untreated, an individual's breathing can become very rapid and shallow. Diabetic coma can result when breathing problems become severe because the brain does not receive enough oxygen.


It is important for people who know they are at risk of diabetic ketoacidosis to recognize symptoms as soon as they begin. At a doctor's office or hospital, blood and urine tests can confirm the presence of excess ketones, unmetabolized glucose, and low insulin. A doctor may also take chest x-rays and perform blood pressure tests to gauge the severity of symptoms and make the best treatment decisions.

When diabetic ketoacidosis is discovered before serious complications occur, it can usually be reversed with a dose of insulin and increased fluid intake. Body systems usually return to normal in a few hours without lasting damage. If severe dehydration and breathing problems have already begun, hospitalization is necessary to provide a patient with intravenous fluids, medications, and oxygen therapy. Once the patient is stable, he or she is usually admitted into a hospital room so doctors can monitor symptoms for several days. Frequent follow-up visits with a doctor are important to make sure the condition is kept under control.


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Post 3

@burcidi-- Yea, diabetic ketoacidosis, or acidosis (same thing) can happen due to different reasons. It can happen due to pregnancy, drug use, disease or a heart attack. Type 2 diabetics are definitely not immune to it.

If someone with type 2 diabetes doesn't take their medication on time, they have the risk of developing acidosis just like a type 1 diabetic does. Type 2 diabetic ketoacidosis treatment is also exactly the same as type 1.

I have read that African Americans and Latinos are more likely to have type 2 diabetic ketoacidosis than other ethnic groups in the US. I'm not sure why but it must have to do with genetic factors.

Post 2

@fify-- As far as I know it mainly has to do with insulin levels but obviously insulin and glucose levels are related to one another.

But the root of the problem is just that there isn't enough insulin and what is meant by that is a severe deficiency. So the body has almost no insulin to break down glucose. This causes more and more glucose to build up in the bloodstream and then the body starts using fat and muscle for energy.

By the way, my aunt had diabetic ketoacidosis and its complications several years ago and she is a type 2 diabetic. So, ketoacidosis can happen to type 2 diabetics too, it's just less common.

Post 1

Does how much carbohydrates a diabetic consumes increase or lower their chances of experiencing ketoacidosis?

I guess what I'm trying to understand is whether the amount of insulin is important or the ratio of insulin to blood glucose. For example, if I have a low amount of insulin, but also low amounts of glucose in my blood, what are the chances of developing diabetes ketoacidosis?

Does the body automatically start breaking down fats when insulin levels fall below a certain amount or does it only happen when the insulin is not enough to metabolize the amount of glucose in our blood stream at that time?

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