What are some characteristics of ketoacidosis

Diabetic ketoacidosis (Diabetic metabolic imbalance, DKA)

Diabetic ketoacidosis (hyperacidosis) is an acute, life-threatening condition that can occur especially in patients with type 1 diabetes mellitus.

When signs of high blood sugar appear, the patient will feel sick. Symptoms of hyperacidity can also occur: vomiting and rapid breathing (hyperventilation). Patients with diabetic ketoacidosis should be treated promptly. You will receive insulin, fluids and salts (e.g. sodium), among other things. Diabetic ketoacidosis can be avoided with proper management of type 1 diabetes.

Why do you get diabetic ketoacidosis?

A lack of insulin leads to acidification: the main function of this hormone is to lower blood sugar. However, insulin also reduces the burning of fatty substances in the body. If the body lacks insulin, blood sugar rises. When there is an extremely strong insulin deficiency, fat burning gets out of control and ketone is produced.

Both blood sugar and fat burning waste products (so-called ketone bodies) are excreted in the urine. This removes large amounts of water and salts from the body. In the blood, the ketone bodies lead to acidification of the organism. The body tries to break down the excess acid by breathing faster.

What are the symptoms?

Diabetic ketoacidosis is almost always associated with high blood sugar levels, which can be seen in the following symptoms:

  • thirst
  • Frequent urination
  • fatigue
  • Loss of appetite

In addition, there are symptoms of acidosis:

  • Deep breathing (Kussmaul's breathing)
  • Acetone odor in the air
  • Nausea, vomiting, abdominal pain
  • Changes in consciousness

Often, diabetic ketoacidosis occurs in connection with other diseases, mostly infectious diseases.
Diabetic ketoacidosis usually develops over the course of a few hours to a day.

How does the doctor make a diagnosis?

  • Measuring blood sugar
  • Measure the sugar and ketone bodies in the urine
  • Taking a blood sample from an artery (wrist) to measure the degree of acidity (pH value) and blood gases
  • Measuring salts in the blood (potassium, sodium)
  • At the same time, the doctor looks for signs of an infectious disease.

What can you do yourself?

  • The most important thing is to prevent diabetic ketoacidosis from developing. Correctly adjusted blood sugar reduces the risk of it developing.
  • In addition to regular checkups, you should also measure your blood sugar levels if you feel unwell.
  • You can also use measuring strips to determine ketone bodies in the urine. Note that these gauges expire quickly and out of date gauges can give inaccurate readings.

Very often ketoacidosis occurs with an infection with nausea and vomiting. The patient does not eat anything and thinks they need to inject less insulin. But with an acute illness and especially with infectious diseases with fever, more insulin almost always has to be injected.

Greater insulin requirement (due to the infection) with simultaneously reduced insulin intake (which the patient considers necessary due to the reduced food intake) quickly leads to the development of diabetic ketoacidosis.

This is why it is very important to measure your blood sugar frequently while you are ill.

Some people with diabetes believe that exercise regulates high blood sugar and ketone bodies in the urine. However, this is not the case. The reason for ketoacidosis is a lack of insulin and can therefore only be treated with insulin.

How is diabetic ketoacidosis treated?

Treatment includes:

  • Administration of insulin
  • Supply of liquid
  • Supply of salt (potassium, sodium)
  • In the case of infections: give antibiotics


If the symptoms are recognized in good time, diabetic ketoacidosis can be treated easily over the course of a few days. Problems rarely arise after treatment. In the event of inadequate or late treatment, however, diabetic ketoacidosis is life-threatening.

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Dr. J. Henriksen, Dr. O. Nielsen, Prof. Dr. H. Beck-Nielsen

Status of medical information:

ICD-10: E87.2