Diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is a serious problem that can happen in people with diabetes if their body starts to run out of insulin.

When this happens, harmful substances called ketones build up in the body, which can be life-threatening if it's not found and treated quickly.

DKA mainly affects people with type 1 diabetes, but can sometimes affect people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if you get DKA.

Symptoms of diabetic ketoacidosis

Symptoms of DKA include:

You can get DKA if you have high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine. You can check your ketone levels using a home-testing kit.

Symptoms usually start over a 24-hour period, but they can happen faster.

Check your blood sugar and ketone levels

Check your blood sugar level if you have symptoms of DKA.

If your blood sugar level is 11mmol/L or above, and you have a blood or urine ketone testing kit, check your ketone level.

If you do a blood ketone test:

If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA and you should get medical help immediately.

When to get medical help

Go to your nearest A&E immediately if you think you have DKA, especially if you have a high level of ketones in your blood or urine.

DKA is an emergency and needs to be treated in hospital immediately.

Call your diabetes team or GP as soon as possible if you're not sure whether you need emergency help – for example:

If you cannot contact your care team or GP, call your local out-of-hours service or NHS 111 for advice.

Causes of diabetic ketoacidosis

DKA is caused by a lack of insulin in the body, which results in the body breaking down fat for energy. Ketones are released into the body as the fat is broken down.

If you have diabetes, certain things can make this more likely to happen, including:

Sometimes, there's no obvious trigger.

Preventing diabetic ketoacidosis

The following tips can help reduce your chances of getting DKA:

Contact your diabetes team or GP for advice if you find it hard to keep your blood sugar level down.

Treatments for diabetic ketoacidosis

DKA is usually treated in hospital.

Treatments for DKA include:

You'll also be closely monitored for any life-threatening problems that can happen, such as problems with your brain, kidneys or lungs.

You can leave hospital when you're well enough to eat and drink and tests show a safe level of ketones in your body. It's common to stay in hospital for around 2 days.

Before leaving hospital, ask to speak to a diabetes nurse about why you got DKA and what you can do to stop it happening again.

Page last reviewed: 1 May 2020
Next review due: 1 May 2023