From the Guidelines
Diabetic Ketoacidosis (DKA) is a life-threatening condition that presents with symptoms such as nausea, vomiting, and a high level of ketones in the blood and urine, requiring immediate medical attention. The primary symptoms of DKA include:
- Nausea
- Vomiting
- Abdominal pain
- Weakness or fatigue
- Shortness of breath
- Fruity-scented breath
- Confusion These symptoms develop when the body, lacking insulin, breaks down fat for energy instead of glucose, producing ketones that acidify the blood 1. DKA can be caused by high blood glucose (hyperglycemia) that is left untreated over a period of days, and can be life-threatening if not treated promptly with insulin, fluids, and electrolyte replacement 1. It is essential to seek emergency care immediately if symptoms of DKA occur, as the condition can progress to decreased alertness and potentially coma if left untreated 1. Blood and urine tests will show elevated ketones and acidosis (low pH), confirming the diagnosis of DKA 1.
From the FDA Drug Label
Hyperglycemia, diabetic ketoacidosis, or hyperosmolar coma may develop if the patient takes less Humulin R U-100 than needed to control blood glucose levels ... Early signs of diabetic ketoacidosis include glycosuria and ketonuria. Polydipsia, polyuria, loss of appetite, fatigue, dry skin, abdominal pain, nausea and vomiting and compensatory tachypnea come on gradually, usually over a period of some hours or days, in conjunction with hyperglycemia and ketonemia.
The symptoms of Diabetic Ketoacidosis (DKA) include:
- Polydipsia (excessive thirst)
- Polyuria (frequent urination)
- Loss of appetite
- Fatigue
- Dry skin
- Abdominal pain
- Nausea and vomiting
- Compensatory tachypnea (rapid breathing)
- Glycosuria (glucose in the urine)
- Ketonuria (ketones in the urine) 2
From the Research
Symptoms of Diabetic Ketoacidosis (DKA)
The symptoms of DKA can be nonspecific and may include:
- Polyuria and polydipsia, which are the most common symptoms 3
- Nausea, vomiting, abdominal pain, weight loss, severe fatigue, dyspnea, and preceding febrile illness 3
- Fatigue, polydipsia, polyuria, weakness, weight loss, nausea, vomiting, and abdominal pain with tachycardia and tachypnea on exam 4
- Headache, non-bloody, non-bilious emesis, and epigastric abdominal pain 4
- Hyperglycemia, metabolic acidosis, and ketosis 5
- Coma, which occurs in less than 20% of DKA patients 5
Common Precipitating Causes
The common precipitating causes of DKA include:
- Infections, such as urinary tract infection and pneumonia 6
- Intercurrent illnesses, such as surgery, trauma, myocardial ischemia, and pancreatitis 6
- Psychological stress and non-compliance with insulin therapy 6
- Newly discovered diabetes and failure to start insulin therapy 5
Importance of Early Detection and Treatment
Early detection and treatment of DKA are crucial to prevent complications and reduce mortality rates 3, 5, 6. Hospital admission is necessary for vigorous intravenous fluid therapy, insulin therapy, electrolyte replacement, diagnosis and treatment of the underlying triggers, and routine monitoring of the patient's clinical and laboratory conditions to manage DKA properly 5.