What is diabetes-related ketoacidosis (DKA)?
Diabetes-related ketoacidosis (DKA) is a serious and life-threatening, but treatable, complication that affects people with diabetes and those who have undiagnosed diabetes.
Diabetes-related ketoacidosis occurs when your body doesn't have enough insulin (a hormone that's either produced by your pancreas or injected). Your body needs insulin to turn glucose, your body’s go-to source of fuel, into energy. If there’s no insulin or not enough insulin, your body starts breaking down fat for energy instead. As fat is broken down, ketones are released into the bloodstream.
For a person with diabetes, a high amount of ketones causes their blood to become acidic (the blood pH is too low). This creates an emergency medical situation that requires immediate attention and treatment.
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Who does diabetes-related ketoacidosis (DKA) affect?
Diabetes-related ketoacidosis can develop in people of any age who have diabetes or undiagnosed diabetes.
- Individuals who have undiagnosed Type 1 diabetes: For some people, diabetes-related ketoacidosis (DKA) is how they find out that they have Type 1 diabetes. Type 1 diabetes (also known as diabetes mellitus or insulin-dependent diabetes and formerly known as juvenile diabetes) is a chronic autoimmune disease in which your immune system attacks the insulin-producing beta cells in your pancreas. Oftentimes people are in DKA when they're first diagnosed with Type 1 diabetes because they no longer have enough insulin in their body to use glucose for energy. Type 1 diabetes typically develops during childhood or adolescence but can also develop in adulthood. You can develop Type 1 diabetes even if you don’t have a family history of diabetes. Approximately 20% to 40% of DKA cases are from people who are newly diagnosed with Type 1 diabetes.
- Individuals who have Type 1 diabetes: People who have been diagnosed with Type 1 diabetes can develop DKA at any point throughout their life if their body does not get as much insulin as it needs.
- Individuals who have Type 2 diabetes: Although it’s not as common, people with Type 2 diabetes who have ketosis-prone diabetes can develop diabetes-related ketoacidosis (DKA).
What's the difference between diabetes-related ketoacidosis (DKA) and hyperglycemia (high blood sugar)?
Hyperglycemia (high blood sugar) and diabetes-related ketoacidosis both happen when your body doesn't have enough insulin or isn't using the insulin it has properly.
The difference is that DKA is an acute complication, meaning it has a severe and sudden onset. While very high blood sugar (above 250 mg/dL) is almost always a contributing factor to DKA, other conditions need to be present to have DKA, including ketones in your blood and/or urine. You can have high blood sugar without having ketones in your blood and/or urine.
Untreated high blood sugar can lead to DKA. This is why it’s important to treat high blood sugar with insulin as soon as possible.
Although it’s not as common, you can be in DKA even if your blood sugar is lower than 250 mg/dL. This is known as euglycemic diabetes-related ketoacidosis (euDKA).
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What's the difference between diabetes-related ketoacidosis (DKA) and ketosis?
Even though they sound alike, diabetes-related ketoacidosis and ketosis are two different things.
Ketosis occurs when you have ketones in your blood and/or urine but not enough to turn your blood acidic. It usually happens if you are eating a low-carbohydrate diet, if you’re fasting or if you’ve drunk too much alcohol. Ketosis isn't harmful.
Diabetes-related ketoacidosis (DKA) affects people with diabetes and people with undiagnosed diabetes. It happens when your blood turns acidic because there are too many ketones in your blood due to a lack of insulin. Diabetes-related ketoacidosis is life-threatening and requires immediate treatment.
