Ketoacidosis is the accumulation of ketone bodies (ketones) in the blood. This then causes the blood to become acidic.
Ketones are chemicals made by the body as a by-product when it breaks down fat to make energy. This can happen when there isn’t enough insulin in the body for it to break down sugars for energy, so it uses fat as a fuel instead.
Unfortunately, ketones are harmful and the body will immediately try to excrete them. This will be via the urine and also via the lungs, producing a typically fruity odour to the breath. Untreated, ketoacidosis can be fatal. Fortunately, treatment is available and is usually successful.
Diabetic ketoacidosis typically occurs when diabetes (especially type 1 diabetes) is present but has not yet been diagnosed, or in people with known diabetes who are not getting enough insulin to meet their needs. This can happen if the person:
Any form of stress to the body, particularly that produced by infection, can cause severe ketoacidosis even in mild cases of diabetes — even if you continue to take your insulin. This is because the hormones that your body produces in response to stress oppose the action of insulin, resulting in your body requiring more insulin than usual.
Symptoms may include:
Diabetic ketoacidosis occurs when a person fails to take their insulin regularly or in the correct dosage, or because their insulin requirements increase due to illness or infection and extra insulin is not administered. This can cause the person to lapse into a coma (called ketoacidotic coma or diabetic coma). This type of coma may take hours or days to develop. During this time the person will be thirsty and pass a lot of urine, they may be nauseous and vomit and have abdominal pain. If left untreated, the person could die.
Diabetic ketoacidosis should be treated in a hospital as a medical emergency. It should be remembered that a person with dangerous ketoacidosis who requires urgent treatment may still be conscious and not in a coma.
Diabetic ketoacidosis causes a loss of water, potassium and sodium in the urine, and treatment will be needed to replace these important elements. Glucose levels will also need to be monitored closely and insulin injections or an insulin infusion given to correct abnormal levels. Antibiotics may be required if an infection is present.
Last Reviewed: 14 September 2009