What is diabetic ketoacidosis?

Diabetic Ketoacidosis, is an illness you certainly do not want. Ketoacidosis in itself can affect anyone, but Diabetic Ketoacidosis or DKA is a complication commonly experienced by people with Diabetes Type 1.

Type 1 Diabetes

Diabetes is a condition which occurs when the pancreas is unable to make insulin or, when the body is unable to use the insulin effectively. With Type 1 Diabetes, the pancreas stops making insulin so the person must inject insulin on a daily basis to survive. Type 1 Diabetes is an autoimmune disease. Most people who get this type of diabetes will get the disease in their early childhood but it can occur at any time in a persons life.

Type 2 Diabetes

Type 2 Diabetes is normally when the pancreas is still making insulin but for some reason, the body cannot effectively use it. In some cases, the disease can be managed through healthy eating, exercise and weight loss. However, Type 2 sufferers may also need to take a form of tablet or even insulin to manage their blood glucose levels.

Gestational Diabetes

Whilst pregnant, women may develop Gestational Diabetes which needs close monitoring and treatment. However, once the baby is born, the symptoms should go away although the woman has a more increased likelihood of developing Type 1 or 2 Diabetes later on in life.

Diabeteic Ketoacidosis can affect any of the above but usually occurs in those with Type 1 Diabetes. If for any reason, the blood glucose levels are significantly raised over a period of time, the is ill or has an infection, he or she can develop DKA. If Type 1 Diabetics are on pump therapy and for some reason, their insulin supply is stopped, even for a few hours, they can also develop DKA very quickly. DKA can be life threatening so it is very important to know the cause and symptoms and to seek immediate treatment if suspected in yourself or anyone else.

The cause of DKA is an excessive amount of a chemical called Ketones in the body. Ketones occur naturally in the body and is a by product of muscles burning fat. However, large amounts of Ketones in the blood can be toxic. It can cause us to rapidly lose weight, upset the chemical balance of our blood and can be fatal.

In Diabetics, there are a variety of reasons for developing Diabetic
Ketoacidosis. The most common cause is not having enough insulin in our bodies. For most Diabetics who develop the disease later on in life, the only way they have been diagnosed was due to developing DKA. The pancreas had for some reason stopped making insulin which meant that the body could not access the glucose in the blood for energy so the body starts to break down body fat in order to find energy. This breaking down of body fat creates Ketones and as mentioned above, too many Ketones upsets the bloods' chemical balance hence the onset of DKA.

For those who already have Diabetes, they may have caught an infection, have another type of illness, or for some reason, have not been taking enough or any insulin and again, the cycle mentioned above starts, and they develop DKA.

On the flip side, again due to illness or for another reason, a Diabetic may not be able to eat, so again, needing to find a source of energy, the body starts breaking down body fat.

Women with Type 1 Diabetes are at significant risk of developing Ketones when they are pregnant due to the rapid changes in the body during pregnancy which in turn means the amount of food and insulin required will also change.

Symptoms of DKA are nausea, vomiting, abdominal pain, extreme thirst, increased urination, fruity smelling breath or breath which smells like nail varnish remover, rapid breathing, increased heart rate, increased tiredness and lethargy and finally coma.

If the Diabetic often monitors their blood levels, he or she should know that if their Glucose levels are consistently high, they need to check their Ketone levels, either with a urine strip or through a blood testing kit. Should their ketone levels be 1.5 mmol/l or higher, they most likely have Ketoacidosis and need to seek medical help immediately.

Treatment is usually a stay in hospital, involves re-hydrating the body and correcting insulin and glucose levels in the blood. Extremely severe cases will find themselves in ICU. The good news though, is once re-hydrated, all symptoms of DKA will disappear and with future careful monitoring and a "Sick Day Action Plan" one should hopefully never get Diabetic
Ketoacidosis again.

I am writing this article from experience s well as having read the "NDSS Information Pack", Abbott Diabetes Care, "Feeling Sick? What to do Information for people with Type 1 Diabetes" booklet, and Reality Check's, "A Starter Kit...".

I was diagnosed with Type 1 Diabetes in January 2008, aged 32. Through mismanagement of the disease and missing insulin shots, I was diagnosed with borderline DKA in August which resulted in a four day hospital stay. Since then, I have come to terms with Diabetes and am much better at controlling my blood levels but it is a daily struggle.