When Diabetic Turns Dangerous: Understanding Diabetic Ketoacidosis

What is Diabetes?

Diabetes mellitus refers to a group of diseases that impact the way the body uses glucose as an energy source. The resulting effect is excess sugar in the blood, requiring insulin via either injection or a pump, to allow the sugar in the blood to enter the cells and be used for energy.

Type 1

Type 1 diabetes (T1D) is a autoimmune disease that results in the destruction of pancreatic beta cells, the cells that produce insulin, leading to an insulin deficiency. Individuals with T1D require lifelong external insulin replacement, without which can develop severely high blood sugar and eventually diabetic ketoacidosis which can be life threatening if not treated quickly enough. Diabetic management also involves nutritional education to avoid the opposite reaction, severely low blood sugar, which can result in unconsciousness in dire cases.

Type 2

Type 2 diabetes (T2D) is a chronic metabolic disorder that is characterized by persistent high blood sugar due to either impaired insulin secretion, or insulin resistance or a combination of the two. It is most common in adults above the age of 45 years old, and is frequently caused by low levels of activity, energy dense diets, and obesity.

Other Types

Diabetes may also occur during pregnancy in something known as gestational diabetes. This can be complicated by preeclampsia, a condition in which the expecting mother experiences both high blood pressure and signs of organ damage. Diabetes can also be caused by a single gene mutation known as monogenic diabetes. Something known as secondary diabetes may also be caused by other diseases that affect the pancreas or hormone imbalances.

What is Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) occurs when the body is lacking insulin to turn glucose into energy, and is often a result of undiagnosed T1D. Due to the inability for the body to use glucose that has been in taken as an energy source, the liver will begin to break down fats in the body instead, releasing ketones into the blood stream, resulting in the blood becoming acidic. DKA can be caused from a new TD1 diagnosis due to missed warning signs. It can also be caused by missing one or more doses of insulin, or using insulin that has expired. DKA can be fatal if not treated quickly enough, and it is important to recognize early warning signs.

Symptoms of DKA

Early detection signs of DKA may include:

• Frequent urination

• Extreme thirst

• Extreme hunger

• Headache

• Vomiting

• Weakness or fatigue

• Fruity smelling breath

• Confusion or disorientation

• Loss of consciousness

Often the symptoms of DKA begin slowly but develop rapidly, so it is important to see a healthcare professional as soon as you begin experiencing symptoms that may indicate DKA.

DKA Treatment

DKA often results in dehydration, so administration of IV fluids is necessary to restore hydration and flush ketones through the urine. An insulin IV may also be necessary, or a subcutaneous shot of insulin to restore blood glucose levels. In less common cases, treatment of the underlying cause of DKA may need to be addressed such as treatment of bacterial infection.

The most important way to treat DKA is through preventative measures:

• Consistently checking blood glucose levels

• Avoiding missed insulin doses

• Checking urine for ketone levels

• Seeing your provider and endocrinologist regularly

• Educating yourself on diabetic management

Resources

“Diabetes - Symptoms and Causes.” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444. Accessed 15 May 2025.

Goyal, Rajeev, et al. “Type 2 Diabetes.” StatPearls, StatPearls Publishing, 2025, http://www.ncbi.nlm.nih.gov/books/NBK513253/.

Lucier, Jessica, and Priyanka M. Mathias. “Type 1 Diabetes.” StatPearls, StatPearls Publishing, 2025, http://www.ncbi.nlm.nih.gov/books/NBK507713/.

“What Are the Signs of DKA?” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/21945-diabetic-ketoacidosis-dka. Accessed 22 May 2025.

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