Diagnosis & symptoms of diabetic ketoacidosis

Diabetic ketoacidosis, also known as DKA, is a serious condition that happens when blood sugar is very high and acidic substances called ketones build up to dangerous levels in the body. This disease is a serious complication of type 1 diabetes (less common in type 2) and could be life-threatening.


DKA occurs when the body does not have enough insulin to process high levels of sugar in the blood. When less insulin is produced, glucose starts to build up in the blood and the body is unable to convert it to energy. In order to seek usable energy, the body breaks down stored fat and turns into fuel called ketones. Excessive ketones in the body lead to blood becoming acidic, causing diabetic ketoacidosis.


Symptoms of DKA can appear quickly and may be the first warning sign that one has diabetes, which include:

  • Frequent urination
  • Extreme thirst or dehydration
  • High levels of ketones in urine
    Flushed face
  • Confusion or disorientation
  • Rapid breathing or hyperventilation
    Dry mouth and skin
  • Fruity smelling breath
  • Flu-like symptoms (fatigue, nausea or vomiting, abdominal pain)


Some symptoms are more severe than others and require immediate emergency attention, including frequent vomiting of more than two hours, shortness of breath, belly pain, and feeling woozy.


When the symptoms (not severe) appear, one can test for ketones in the body through urine samples; can use a urine test strip to check the level of blood sugar first (should not be over 250 mg/dl) and then measure the ketones. Doctors also can perform few physical exams to diagnose DKA, including:

  • Blood work to assess metabolic function
  • Arterial blood gas, where blood is drawn from an artery to check its acidity
  • Blood pressure
  • Urinalysis
  • Chest X-ray to look for infections such as pneumonia


Diabetes is a long term disease and will need to be managed with care. At Regency Specialist Hospital, our Diabetes Care Unit is equipped with specialists and supporting healthcare professionals who are ready to help you improve your health condition.

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