From the Guidelines
Diabetic ketoacidosis (DKA) symptoms include excessive thirst, frequent urination, nausea, vomiting, abdominal pain, weakness, fatigue, confusion, fruity-scented breath, and rapid breathing, and can range from mild hyperglycemia and acidosis to severe hyperglycemia, dehydration, and coma 1. These symptoms develop when the body cannot use glucose for energy due to insufficient insulin, causing it to break down fat for fuel instead, producing ketones that make the blood acidic. Some key points to consider in DKA diagnosis and treatment include:
- Individualization of treatment based on a careful clinical and laboratory assessment is needed 1
- Management goals include restoration of circulatory volume and tissue perfusion, resolution of hyperglycemia, and correction of electrolyte imbalance and acidosis 1
- Treatment typically involves insulin administration, fluid replacement, and electrolyte correction, with continuous intravenous insulin being the standard of care for critically ill and mentally obtunded patients 1
- The use of bicarbonate in patients with DKA is generally not recommended, as several studies have shown that it makes no difference in the resolution of acidosis or time to discharge 1 If you experience these symptoms, especially if you have diabetes, seek immediate medical attention as DKA is a medical emergency. DKA can be prevented by consistently taking prescribed insulin, monitoring blood glucose regularly, following your diabetes management plan, and seeking medical advice when blood glucose remains high or ketones are present in urine. It is essential to note that the presentation of DKA can vary considerably, and treatment should be tailored to the individual patient's needs, as stated in the most recent guidelines 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 2
From the Research
Symptoms of Diabetic Ketoacidosis (DKA)
The symptoms of DKA can be identified through various studies, including 3, 4, 5, 6, 7. The key symptoms include:
- Hyperglycemia (high blood glucose levels) 3, 4, 5, 7
- Metabolic acidosis (high anion gap acidosis) 3, 4, 5, 7
- Ketonuria (presence of ketones in the urine) 3, 4, 5, 7
- Polyuria (frequent urination) and polydipsia (excessive thirst) 7
- Nausea and vomiting 7
- Abdominal pain 7
- Weight loss 7
- Severe fatigue 7
- Dyspnea (shortness of breath) 7
- Preceding febrile illness (fever) 7
Diagnosis and Treatment
Diagnosis of DKA is confirmed when all three criteria are present: hyperglycemia, metabolic acidosis, and ketonuria 4. Treatment involves: