From the Guidelines
Diabetic ketoacidosis (DKA) symptoms include nausea, vomiting, Kussmaul respirations, dehydration, and altered mental status, as a result of absolute or relative insulin deficiency leading to fat breakdown and acidosis 1. These symptoms can lead to severe morbidity and mortality if not promptly treated.
- The symptoms of DKA can be categorized into several key areas, including:
- Gastrointestinal symptoms: nausea, vomiting
- Respiratory symptoms: Kussmaul respirations
- Cardiovascular symptoms: dehydration
- Neurological symptoms: altered mental status
- It is essential to recognize these symptoms early, as DKA can progress rapidly and lead to life-threatening complications, such as cerebral edema and cardiac arrhythmias 1.
- The management of DKA requires prompt treatment with insulin, fluids, and electrolyte replacement to prevent serious complications and improve patient outcomes.
- Prompt medical attention is crucial for patients experiencing DKA symptoms, as timely intervention can significantly reduce the risk of morbidity and mortality 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. 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.
DKA symptoms include:
- Drowsy feeling
- Flushed face
- Thirst
- Loss of appetite
- Fruity odor on the breath
- Polydipsia
- Polyuria
- Fatigue
- Dry skin
- Abdominal pain
- Nausea and vomiting
- Compensatory tachypnea These symptoms can occur over a period of hours or days 2, 2.
From the Research
DKA Symptoms
The symptoms of Diabetic Ketoacidosis (DKA) 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
- Hyperglycemia (blood glucose greater than 250 mg/dL), although recent guidelines have de-emphasized this due to the increasing incidence of euglycemic DKA 3
- Metabolic acidosis (pH less than 7.3, serum bicarbonate less than 18 mEq/L, anion gap greater than 10 mEq/L) 3, 4
- Elevated serum or urine ketones 3, 4
Common Presentations
DKA can present in various ways, including:
- As the initial presentation of diabetes, especially in young children 3
- In patients with type 1 and type 2 diabetes resulting from an absolute or relative insulin deficiency 3
- Precipitated by factors such as infection, which is a common precipitating factor 5
Diagnosis and Treatment
Diagnosis of DKA involves evaluating the patient's symptoms, laboratory results, and medical history 3, 4, 6, 7, 5 Treatment involves: