This is a medical emergency situation which can cause death although prompt and proper treatment can lead to full recovery. The usual first symptoms:

• Very dry mouth
• Frequent urination
• High blood-glucose levels
• Constant tiredness
• Nausea, vomiting, or abdominal pain
• Fruity odor on breath, hyperventilation (gasping)
• Concentration Problems.

Causes of DKA
Diabetic ketoacidosis is a complication of diabetes mellitus, most often in Type 1. Without insulin production, glucose is not available as a fuel source for the body. So body fat is broken down instead and the byproducts of fat metabolism are called ketones. When fat is metabolized, ketones build up in the blood and accumulate also in the urine. Thereby, a condition called ketoacidosis develops when the blood becomes more acidic than body tissues. This acidic condition affects most of the enzymatic reactions taking place in the cells. Blood glucose levels rise (usually higher than 300 mg/dL) since the liver produces more glucose to combat the problem. (This is because cells cannot take up that glucose without insulin, which is deficient)People with type 2 diabetes usually develop ketoacidosis only under conditions of severe stress or due to improper diet and management of diabetes. Children with type 2 diabetes are also at high risk.

Treatment of DKA
Treatment of DKA requires emergency medical care and intensive monitoring to prevent life threatening complications, which include shock due to dehydration (loss of water), hypokalemia (loss of potassium), and cerebral oedema (swelling of the brain). This involves correction of dehydration, hyperglycemia, and electrolyte imbalances through initial dehydrations and low-dose insulin therapy. The goal of treatment is to correct the high blood glucose level by giving insulin, and to replace fluids loss because of excessive urination and vomiting. With proper medical attention, DKA is almost always successfully treated. (The DKA mortality rate is about 10%).

Prevention of DKA
Once type 1 diabetes has been diagnosed, preventive measures to avoid diabetic ketoacidosis include regular monitoring of blood glucose, more so, during periods of infection, stress trauma and other illnesses when glucose concentrations increase as a response to these situations. Ketone tests, usually by using urine test strips, are also important if glucose levels are found high (above 250 mg/dl). If you are sick, get yourself tested for sugar and if possible, ketones in urine 3 – 4 times a day and accordingly adjust insulin dosage.

DKA is uncommon in Type 2 diabetics but they have their own similar and equally dangerous problem called hyperosmotic diabetic coma.