Diabetic Ketoacidosis - NHS

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Symptoms of diabetic ketoacidosis (DKA)

Symptoms of diabetic ketoacidosis (DKA) include:

  • feeling thirsty
  • needing to pee more often
  • stomach pain, feeling sick or being sick
  • diarrhoea
  • breathing more deeply than usual
  • breath that smells fruity (like pear drop sweets or nail polish remover)
  • feeling tired, sleepy or confused
  • blurred vision

The symptoms usually develop over 24 hours, but it can be faster.

DKA usually affects people with type 1 diabetes, but it can also happen in people with type 2 diabetes who need insulin.

It can happen when people first develop type 1 diabetes and have not yet been diagnosed, particularly children.

Checking your blood glucose and ketones

If you have diabetes and have any of the symptoms of DKA, check your blood glucose. If it's high, test for ketones if you can.

If you use a meter to test for ketones in your blood:

  • under 0.6mmol/L is normal
  • 0.6 to 1.5mmol/L is slightly high – test again in 2 hours
  • 1.6 to 3mmol/L means you're at risk of DKA and should speak to your diabetes care team for advice
  • over 3mmol/L is high and means you may have DKA and should call 999 or go to A&E

If you use strips to test for ketones in your pee, over 2+ is high. This means you may have DKA and should call 999 or go to A&E.

Important

These ketone levels are a guide. Normal blood ketone levels can be different for different people. Your diabetes care team will advise you on what levels to look for.

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