Diabetic ketoacidosis (DKA) is a life-threatening blood chemical (electrolyte) imbalance that develops in a person with diabetes when the cells do not get the sugar (glucose) they need for energy. As a result, the body breaks down fat instead of glucose and produces and releases substances called ketones into the bloodstream.

People with type 1 diabetes and some people with type 2 diabetes are at risk for DKA if they do not take enough insulin, have a severe infection or other illness, or become severely dehydrated.

Symptoms of diabetic ketoacidosis include:

• Flushed, hot, dry skin.
• A strong, fruity breath odor (similar to nail polish remover or acetone).
• Restlessness, drowsiness or difficulty waking up. Young children may lack interest in their normal activities.
• Rapid, deep breathing.
• Loss of appetite, abdominal pain, and vomiting.
• Confusion.

Severe diabetic ketoacidosis can cause difficulty breathing, brain swelling (cerebral edema), coma, or death.

Treatment involves giving insulin and fluids through a vein and closely monitoring and replacing electrolytes.

Author:	Katy Magee, MA
Medical Review:	Patrice Burgess, MD - Family Medicine
Last Updated:	May 30, 2003