Signs and symptoms?

Know when you are at risk

Get to know when you may be at risk of DKA.

• When you are ill
  If you are ill with an infection or other acute illness the body burns up sugar faster and this triggers the ketosis process. The situation is made worse when the illness stops you from eating properly.
  
  People with type 1 diabetes are particularly at risk during illness. People with type 2 diabetes usually have enough insulin to cope with illness, but in exceptional cases they may also develop DKA if the stress of an acute illness or infection overwhelms their ability to produce insulin.
• When insulin levels are low
  If you have type 1 diabetes you are at risk if you have not taken your insulin for several hours, perhaps because you forgot an insulin injection or because your insulin pump wasn't working properly.
  
  Even a few hours without insulin may be enough time for ketosis to start. (Note: exercising when excess ketones are present will not lower your blood sugar. You need insulin first.)

Recognise the symptoms

Learn to spot the signs and symptoms of ketosis before it develops into DKA.

Because there is too little insulin, your blood sugar levels will usually be high. You will also be experiencing one or more of the following:

• Feeling thirsty all the time
• Urinating more frequently
• Having dry or flushed skin
• Feeling sick or being sick
• Feeling tired and/or confused
• Finding it hard to breath
• Pain in your stomach
• Breath that smells of pear drops

Some of these symptoms arise because as your ketone level rises, your blood becomes more acidic. Acidic blood, combined with dehydration, causes diabetic ketoacidosis (DKA).

React quickly

Prevent DKA arising and avoid an emergency hospital admission!

Don't wait for symptoms to appear. The best way to find out if your blood ketone level is above normal is to check it.

When you have diabetes, especially if you have type 1 diabetes, test your ketone levels when:

• You have flu or any other infection
• You are under severe stress, either emotionally or physically
• Your blood glucose levels are 16.7 mmol/L or above
• Your blood glucose levels are above 10.0 mmol/L and go on rising or you feel ill
• You have any of the symptoms of DKA
• Your doctor has recommended testing
• You are pregnant