From the Guidelines
Diabetic ketoacidosis (DKA) is a medical emergency characterized by symptoms such as nausea, vomiting, Kussmaul respirations, dehydration, and altered mental status, which develop due to insulin deficiency and fat breakdown, leading to metabolic acidosis 1.
Symptoms of DKA
The symptoms of DKA can vary in severity and may include:
- Nausea and vomiting
- Kussmaul respirations (rapid breathing)
- Dehydration
- Altered mental status
- Fruity-scented breath (from ketones)
- High blood glucose levels (typically above 250 mg/dL)
- Electrolyte imbalances, particularly potassium
- Increasing mental status changes that can lead to coma
- Physical examination may reveal dry mucous membranes, reduced skin turgor, tachycardia, and hypotension in severe cases.
Importance of Immediate Treatment
DKA is a life-threatening condition that requires immediate treatment with insulin, fluids, and electrolyte replacement to prevent complications such as:
- Dehydration
- Electrolyte imbalances
- Metabolic acidosis
- Coma
- Death The most recent and highest quality study 1 emphasizes the importance of individualized treatment based on careful clinical and laboratory assessment, and the use of continuous intravenous insulin in critically ill patients.
Key Takeaways
- DKA is a medical emergency that requires immediate attention
- Symptoms of DKA include nausea, vomiting, Kussmaul respirations, dehydration, and altered mental status
- Treatment goals include restoration of circulatory volume, resolution of hyperglycemia, and correction of electrolyte imbalance and acidosis
- Continuous intravenous insulin is the standard of care in critically ill patients with DKA 1.
From the FDA Drug Label
Hyperglycemia (too much glucose in the blood) may develop if your body has too little insulin ... In patients with type 1 or insulin-dependent diabetes, prolonged hyperglycemia can result in DKA (a life-threatening emergency) 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
From the Research
Symptoms of Diabetic Ketoacidosis (DKA)
The symptoms of DKA are nonspecific and can include:
- Fatigue 3
- Polydipsia (increased thirst) 3, 4, 5
- Polyuria (increased urine production) 3, 4, 5
- Weakness 3
- Weight loss 3, 4
- Nausea 3, 4, 6, 5, 7
- Vomiting 3, 4, 6, 5, 7
- Abdominal pain 3, 4, 6, 5, 7
- Tachycardia (increased heart rate) 3, 6, 5
- Tachypnea (rapid breathing) 3, 6
- Shortness of breath 5
- Confusion 5
- Headache 5
- General weakness 5
- Fatigue 5
- Dehydration 7
- Kussmaul breathing (deep and rapid breathing) 6, 7
Precipitating Factors
DKA can be precipitated by various factors, including: