What is Diabetic Ketoacidosis?

Remember, I’m not a doctor, medical professional, nor a long time diabetic. This explanation comes from internet research and personal experience. If you’re reading this post and think you’re going into diabetic ketoacidosis, call your doctor or go to the emergency room!

What Does it Mean to go DKA?

DKA is the abbreviation for diabetic ketoacidosis, though you’ve probably figured this out by now. When you’re going into DKA, your body is producing high levels of something called ‘ketones’ and your body can’t produce enough insulin.

Due to the lack of insulin, your body starts breaking down fat for fuel (hence the rapid weight loss) and then the ketones build up in your bloodstream. This really isn’t a good thing for diabetics.

Who Can Go into Ketoacidosis?

Diabetics (usually T1, T2 is a lot rarer) can obviously go into ketoacidosis. However, ketoacidosis can actually occur in non-diabetics as well.

Starvation, alcoholism or an overactive thyroid can also land someone in ketoacidosis. Now, when I say starvation, I don’t mean someone on a reasonable caloric deficit trying to get to a normal body weight. Drinking in moderation also isn’t going to make you go into ketoacidosis (whiskey drinkers unite!). I’ve no experience with thyroid problems so I’ll take the internet’s word on the overactive thyroid. If you’re worried, talk to your doctor.

What are the symptoms of DKA?

I’ve read about DKA symptoms coming on pretty quickly, especially when sick. For me, I didn’t go full DKA but I did have a lot of these symptoms looking back at December 2018.

  • High blood sugar (hyperglycemia)
  • Big ketones
  • Incredible thirst
  • Lots of peeing
  • Nausea
  • Vomiting
  • Stomach pain
  • Weakness
  • Tired all the time
  • Rapid breathing
  • Trouble breathing
  • Keto breath
  • Keto pee
  • Confusion
  • Passing out
  • Coma

So from this list, I had high blood sugar, probably had ketones in my urine, was really thirsty, tons of peeing, was more tired than normal, and I had keto pee. For me both keto breath and keto pee smells like finger nail polish remover (acetone).

Also, since I was drinking and peeing excessively, I also had really bad charlie horses at night. So I was popping magnesium tablets, potassium, and salting my food quite a bit. Also, since I was in the states, I was drinking Gatorade quite a bit.

A note.. diabetic ketoacidosis is NOT dietary ketosis. As long as common sense is exercised, you’re going to be fine on a keto diet. Of course, once again (and to cover my ass), you can always talk to your medical professional(s) about going on this diet if you’re interested.

How to Treat Diabetic Ketoacidosis?

First, it’s probably time to make a trip to the hospital. If in the US, it’s probably going to be a trip to the Emergency Room or Urgent Care Clinic. In the Netherlands, I’d call my huisart (GP) if the symptoms came on during the day. She would then give me instructions.

If it were after office hours, there’s a special number that we call to see if the situation warrants coming to the emergency room. If the DKA were coming on slowly, I’d probably call to see if they want me to wait and monitor or to come in right away. If I was vomiting and/or having problems breathing my husband would probably be throwing me in the car and taking me to the ER straight away.

If I were passing out or having problems staying away, chances are 112 would be called and I’d be taking an ambulance ride.

Now, my bout of ketoacidosis was NOT critical. It was coming on very slowly and I don’t think I was ever in danger, though more than likely if I hadn’t been drinking enough water or taking my electrolytes we’d have been hoping our dutch insurance covered a trip to a USA emergency room.

If I ever make it into an ER due to DKA, they will run tests, hook me up to fluids to help with electrolytes and hydration, then inject large amounts of insulin to counteract the ketones in my blood.

I’ve read about diabetics being kept at the hospital after a bout of DKA, especially if it was due to infection.

Wrapping Up Diabetic Ketoacidosis

At the end of the day, whenever a diabetic starts getting sick, there’s a chance of DKA due to dehydration. We’ve all been there at some point, not drinking enough because we feel like crap or it hurts our throat. Well, as a diabetic, we really need to be mindful.

So drink water, pay attention when you start feeling off and if you’re ever concerned, please call your doctor!

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