Advanced Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a dangerous condition characterized by a severe rise in blood sugar or hyperglycemia, depleted bodily fluids, shock, and in some cases unconsciousness. Coma and even death may occur if DKA is left untreated or if it becomes more severe due to excessive vomiting.

Symptoms of DKA

  • In the early stages of DKA, the affected individual appears flushed and breathes rapidly and deeply. This is called hyperventilation.
  • As the condition progresses, the skin may turn pale, cool and clammy, dehydration may begin to set in and the heart rate may become rapid and breathing shallow.
  • Nausea, vomiting and severe abdominal cramps.
  • Blurred vision
  • Fruity or pungent smelling breath due to the presence of acetone and ketones in the breath.


Although DKA can occur in patients with type 2 diabetes, it mainly develops in people with type 1 diabetes who need to take insulin for their condition. If individuals do not receive insulin, they will develop DKA.

If there is a shortage of insulin, the body fails to use glucose in the blood for energy and instead fats are broken down in the liver. When these fats are broken down, acidic compounds called ketones are produced as a by-product. These ketones build up in the body and eventually cause ketoacidosis. Aside from missed or inadequate doses of insulin, another common cause of DKA is infection or illness as this can raise the level of hormones that counteract the effects of insulin. In addition, the dehydration caused by major injury or surgery can raise levels of these hormones.

Diagnosis and treatment

Blood tests are performed to check the sugar levels and blood pH, which is classified as acidic if it is below the usual 7.3. Unlike non-ketotic hyperosmolar coma, in DKA the blood and urine levels of ketones are high and the blood osmolarilty is low.

Treatment involves rehydrating the patient with isotonic fluids and replacing lost electrolytes with supplements such as potassium, magnesium and phosphates. Insulin is administered intravenously to reduce blood levels of glucose and reverse ketoacidosis.

Further Reading

Last Updated: Feb 26, 2019

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.


Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Mandal, Ananya. (2019, February 26). Advanced Diabetic Ketoacidosis. News-Medical. Retrieved on October 07, 2022 from

  • MLA

    Mandal, Ananya. "Advanced Diabetic Ketoacidosis". News-Medical. 07 October 2022. <>.

  • Chicago

    Mandal, Ananya. "Advanced Diabetic Ketoacidosis". News-Medical. (accessed October 07, 2022).

  • Harvard

    Mandal, Ananya. 2019. Advanced Diabetic Ketoacidosis. News-Medical, viewed 07 October 2022,


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment
You might also like...
Researchers uncover a key process involved in diabetes-related vision loss