(Diabetic Coma; DKA)
by Alexandra Howson, PhD
Diabetic ketoacidosis (DKA) is a high level of ketones in the body. DKA is a serious condition that can lead to coma or death if it is not promptly treated.
Glucose is the main source of fuel for the body. Diabetes makes it hard for the body to use glucose. The body starts to breakdown fat for energy instead. Ketones are released with the breakdown of fat. The more fat is used, the higher ketone levels will be.
DKA is most often caused by uncontrolled type 1 diabetes. Type 2 diabetes can also lead to DKA but it is less common cause.
Things that may increase your risk of DKA are:
DKA may cause:
Symptoms that show emergency care is needed include:
The doctor will ask about symptoms and past health. A physical exam will be done. Blood and urine tests will be done.
An electrocardiogram (EKG) may also be done. It will show any problems with your heart's electrical activity.
DKA is treated with insulin, fluids, and minerals. Care may need to take place in a hospital. Close monitoring, exams, and blood tests will be needed.
Insulin may be given by IV or injections. The insulin will let the body use glucose for fuel again. Fat will not be needed for fuel, new ketones will not be made. The body will then be able to get rid of the extra ketones.
You and your doctor will make a plan to manage your diabetes. These steps will also reduce the chance of DKA. Steps may include:
American Diabetes Association
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Diabetes Association
Public Health Agency of Canada
Diabetic ketoacidosis (DKA) in adults. EBSCO DynaMed website. Available at: https://www.dyname... . Updated August 23, 2017. Accessed March 13, 2020.
Diabetic ketoacidosis. Family Doctor website. Available at: https://familydoctor.org/condition/diabetic-ketoacidosis/. Updated June 2017. Accessed March 13, 2020.
Westerberg D. Diabetic ketoacidosis: Evaluation and treatment. Am Fam Physician. 2013;87(5):337-346.
Wolfsdorf J, et al. ISPAD Clinical Practice Consensus Guidelines 2014. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2014 Sep;15 Suppl 20:154-79.
Last reviewed March 2020 by EBSCO Medical Review Board Monica Zangwill, MD, MPH
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