Symptoms and Signs of Diabetic Ketoacidosis

Medical Author:
Medically Reviewed on 9/3/2021

Doctor's Notes on Diabetic Ketoacidosis Symptoms, Causes, Treatment, and Complications

Diabetic ketoacidosis (DKA) is a variation of diabetes characterized by a combination of ketosis and acidosis (accumulation of ketones and increased acidity in the blood). The signs and symptoms of diabetic ketoacidosis can include vomiting, excessive thirst, abdominal pain, dry skin, and confusion. Patients may also exhibit loss of appetite, increased heart rate, low blood pressure, increased breathing rate, weakness, and a fruity-like odor on the breath. If diabetic ketoacidosis is not treated and allowed to progress, it can cause death.

Common causes of diabetic ketoacidosis are dehydration, increasing blood sugar levels, infections, diarrhea, vomiting, and missed doses of insulin or inadequate insulin levels. Other associated causes are stress, heart attacks, stroke, trauma, alcohol abuse, drug abuse, and surgery. A few individuals have no identifiable cause.

What Are the Treatments for Diabetic Ketoacidosis?

Treatment of DKA is a medical emergency; call 911. The patient needs immediate treatment in a hospital setting (ICU preferred) to accomplish the following:

  • Restore fluids with IV fluids.
  • Gradually reduce hyperglycemia with insulin administration with close monitoring of glucose levels.
  • Restore electrolyte levels (especially potassium).
  • Gradually correct patient's acid-base balance.
  • Treat any underlying problems such as infection.

Treatment should begin with emergency and/or critical care specialists.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.