What are the symptoms of Diabetic Ketoacidosis (DKA)?

From the Guidelines

Diabetic ketoacidosis (DKA) presents with several characteristic symptoms, including excessive thirst, frequent urination, dehydration, nausea, vomiting, abdominal pain, weakness, fatigue, confusion, and fruity-smelling breath, as a result of severe insulin deficiency, as noted in the most recent study 1. The symptoms of DKA can vary in severity and may include:

• Excessive thirst (polydipsia)
• Frequent urination (polyuria)
• Dehydration
• Nausea
• Vomiting
• Abdominal pain
• Weakness
• Fatigue
• Confusion
• Fruity-smelling breath (due to acetone) Patients may also experience rapid, deep breathing (Kussmaul respirations), which is the body's attempt to eliminate excess acid through the lungs. Physical examination may reveal dry mucous membranes, reduced skin turgor, and signs of volume depletion such as tachycardia and hypotension. Laboratory findings typically show elevated blood glucose (usually >250 mg/dL), presence of ketones in blood and urine, metabolic acidosis with low bicarbonate levels, and an elevated anion gap. DKA develops when insulin deficiency leads to increased breakdown of fat for energy, producing ketone bodies that accumulate and cause acidosis, as explained in 1. This condition most commonly occurs in type 1 diabetes but can also affect those with type 2 diabetes during severe stress or illness. DKA is a medical emergency requiring immediate treatment with insulin, fluids, and electrolyte replacement to prevent potentially life-threatening complications, as emphasized in the recent study 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. 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. 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:

• Mild to moderate symptoms:
  • Drowsy feeling
  • Flushed face
  • Thirst
  • Loss of appetite
  • Fruity odor on the breath
  • Polydipsia
  • Polyuria
  • Fatigue
  • Dry skin
• Severe symptoms:
  • 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 include:

• Nausea and vomiting
• Increased thirst and urine production
• Hyperglycemia
• Abdominal pain
• Shortness of breath
• Confusion
• Headache
• General weakness
• Fatigue
• Increased heart rate 3

Diagnosis of DKA

A diagnosis of DKA is confirmed when all of the three criteria are present:

• 'D', either elevated blood glucose levels or a family history of diabetes mellitus
• 'K', the presence of high urinary or blood ketoacids
• 'A', a high anion gap metabolic acidosis 4

Complications of DKA

If left untreated, DKA can lead to more serious complications, including:

• Circulatory collapse
• Decreased blood potassium levels
• Infection
• Cerebral edema 3