What are the symptoms of Diabetic Ketoacidosis (DKA)?

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Last updated: February 19, 2025View editorial policy

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From the Guidelines

Diabetic ketoacidosis (DKA) symptoms include nausea, vomiting, abdominal pain, malaise, and nonspecific symptoms. If you suspect DKA, seek immediate medical attention 1.

Common Symptoms of DKA

  • Nausea and vomiting
  • Abdominal pain
  • Malaise
  • Euglycemic diabetic ketoacidosis may occur with normal or mildly elevated plasma glucose concentration (<200 mg/dL) 1
  • High level of ketones in the blood and urine 1

Risk Factors and Prevention

Factors that can trigger DKA include intercurrent illness, reduced food and fluid intake, reduced insulin doses, and alcohol consumption 1. Individuals at risk for DKA should measure urine or blood ketones in the presence of symptoms and potential precipitating factors, particularly if glucose levels exceed 200 mg/dL (11.1 mmol/L) 1.

Treatment and Management

Treatment typically involves administering intravenous fluids and insulin, usually regular insulin, at a dose of 0.1 units per kilogram per hour 1. Potassium supplements, like potassium chloride, may also be given to prevent hypokalemia. Close monitoring of blood glucose, electrolyte levels, and urine output is crucial. In severe cases, patients may require intensive care unit (ICU) admission. It is essential to work with a healthcare provider to manage DKA and prevent complications 1.

From the FDA Drug Label

The first symptoms of DKA usually come on gradually, over a period of hours or days, and include a drowsy feeling, flushed face, thirst, loss of appetite, and fruity odor on the breath. With DKA, blood and urine tests show large amounts of glucose and ketones. Heavy breathing and a rapid pulse are more severe symptoms If uncorrected, prolonged hyperglycemia or DKA can lead to nausea, vomiting, stomach pain, dehydration, loss of consciousness, or death.

The symptoms of Diabetic Ketoacidosis (DKA) include:

  • A drowsy feeling
  • Flushed face
  • Thirst
  • Loss of appetite
  • Fruity odor on the breath
  • Heavy breathing
  • Rapid pulse
  • Nausea
  • Vomiting
  • Stomach pain
  • Dehydration
  • Loss of consciousness
  • Death 2 2

From the Research

Symptoms of Diabetic Ketoacidosis (DKA)

The symptoms of DKA are nonspecific and can include:

  • Fatigue 3
  • Polydipsia (increased thirst) 3, 4
  • Polyuria (increased urine production) 3, 4, 5
  • Weakness 3
  • Weight loss 3, 4
  • Nausea 3, 6, 4, 5, 7
  • Vomiting 3, 6, 4, 5, 7
  • Abdominal pain 3, 4, 5, 7
  • Tachycardia (increased heart rate) 3, 6
  • Tachypnea (rapid breathing) 3, 6
  • Shortness of breath 4, 5
  • Confusion 5
  • Headache 5
  • General weakness 5
  • Fatigue 5
  • Increased heart rate 5

Precipitating Factors

DKA can be precipitated by various factors, including:

  • Infections 7
  • Non-compliance to treatment 7
  • Pneumonia 7
  • Urinary tract infection 7
  • Excessive alcohol use 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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