WHAT YOU NEED TO KNOW:

What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening condition caused by dangerously high blood sugar levels. Your blood sugar levels become high because your body does not have enough insulin. Insulin helps move sugar out of the blood so it can be used for energy. The lack of insulin forces your body to use fat instead of sugar for energy. As fats are broken down, they leave chemicals called ketones that build up in your blood. Ketones are dangerous at high levels.

What increases my risk for DKA?

• Not enough insulin
  
  
• Poorly controlled diabetes
  
  
• Infection or other illness
  
  
• Heart attack, stroke, trauma, or surgery
  
  
• Certain medicines such as steroids or blood pressure medicines
  
  
• Illegal drugs such as cocaine
  
  
• Emotional stress
  
  
• Pregnancy

What are the signs and symptoms of DKA?

• More thirst and more frequent urination than usual
  
  
• Abdominal pain, nausea, and vomiting
  
  
• Blurry vision
  
  
• Dry mouth, eyes, and skin, or your face is red and warm
  
  
• Fast, deep breathing, and a faster heartbeat than normal for you
  
  
• Weak, tired, and confused
  
  
• Fruity, sweet breath
  
  
• Mood changes and irritability

How is DKA diagnosed? Your healthcare provider will ask about your symptoms and how you manage your diabetes. He will also look for signs of dehydration. Your blood and urine may be tested to check your blood sugar and ketone levels. These and other tests will show if you are dehydrated. You may also need an EKG to check your heart rhythm. You may need more tests to find out what triggered your DKA.

How is DKA treated? DKA can be life-threatening. You must get immediate medical attention. The goal of treatment is to replace lost body fluids, and to bring your blood sugar level back to normal. You may need any of the following:

• IV liquids help treat dehydration. Electrolytes may be added to the fluids to replace what has been lost from your body.
  
  
• Insulin decreases the amount of sugar in your blood. You may need to take insulin until your blood sugar level becomes normal.
  
  
• Glucose may be needed if your blood sugar level begins to decrease. This is to prevent your blood sugar level from dropping too quickly while you are getting insulin.
  
  
• Potassium may be given if your blood levels of potassium are low. This can happen when large amounts of insulin are given.

How can I help prevent DKA? The best way to prevent DKA is to control your diabetes. Ask your healthcare provider for more information on how to manage your diabetes. The following may help decrease your risk for DKA:

• Monitor your blood sugar levels closely if you have an infection, are stressed, or experience trauma. Check your blood sugar levels often. You may need to check at least 3 times each day. If your blood sugar level is too high, give yourself insulin as directed by your healthcare provider. Your healthcare provider can show you how to use a blood glucose monitor to check your levels.
  
  
• Manage your sick days. When you are sick, you may not eat as much as you normally would. You may need to change the amount of insulin you give yourself. You may need to check your blood sugar level more often than usual. Make a plan with your healthcare provider about how to manage your diabetes when you are sick.
  
  
• Check your ketones as directed. Follow your healthcare provider's instructions about when you should check your blood or urine for ketones. Your healthcare provider may give you a machine to check your blood ketones. Urine ketones can be checked with sticks you dip in your urine. Do not exercise if you have ketones in your urine or blood.
  
  
• Know how to treat DKA symptoms at home. If you have signs of DKA, drink more liquids that do not contain sugar, such as water. Take your insulin as directed by your healthcare provider and go to the nearest emergency room.

Call 911 for any of the following:

• You have a seizure.
  
  
• You begin to breathe fast, or are short of breath.
  
  
• You become weak and confused.

When should I seek immediate care?

• You have fruity, sweet breath.
  
  
• You have severe, new stomach pain and are vomiting.
  
  
• You are more drowsy than usual.

When should I contact my healthcare provider?

• Your blood sugar level is lower or higher than your healthcare provider says it should be.
  
  
• You have ketones in your blood or urine.
  
  
• You have a fever or chills.
  
  
• You are more thirsty than usual.
  
  
• You are urinating more often than usual.
  
  
• You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.