Causes
By Mayo Clinic staffSugar is a main source of energy for the cells that make up your muscles and other tissues. Normally, sugar enters your cells with the help of insulin. If you don't have enough insulin in your body, your body won't be able to use sugar for energy. This prompts the release of hormones that break down fat as an alternate fuel. In turn, this process produces toxic acids known as ketones. Excess ketones accumulate in the blood and eventually "spill over" into the urine.
Diabetic ketoacidosis is usually triggered by:
- An illness. An infection or other illness can cause your body to produce certain hormones, such as adrenaline. Unfortunately, these hormones work against insulin — sometimes triggering an episode of diabetic ketoacidosis. Pneumonia and urinary tract infections are common culprits.
- A problem with insulin therapy. Missed insulin treatments or inadequate insulin therapy can leave you with too little insulin in your system, triggering an episode of diabetic ketoacidosis.
Other possible triggers of diabetic ketoacidosis may include:
- Stress
- Physical or emotional trauma
- High fever
- Surgery
- Heart attack
- Stroke
- Alcohol or drug abuse
- Ketoacidosis (DKA). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html. Accessed March 31, 2010.
- Ferri FF. Diabetic ketoacidosis. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/192147260-3/0/2088/189.html#4-u1.0-B978-0-323-05609-0..00013-7--sc0070_3802. Accessed March 31, 2010.
- Eisenbarth GS, et al. Type 1 diabetes mellitus. In: Kronenberg HM, et al. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/192147260-3/0/1555/195.html?tocnode=54108733&fromURL=195.html#4-u1.0-B978-1-4160-2911-3..50033-9--cesec72_2996. Accessed March 31, 2010.
- Fogel N, et al. Management of diabetic ketoacidosis in the emergency department. Clinical Pediatric Emergency Medicine. 2009;10:246.
- Checking for ketones. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-for-ketones.html. Accessed March 31, 2010.
- If you have diabetes, know your blood sugar numbers! National Diabetes Education Program. http://www.ndep.nih.gov/media/KnowNumbers_Eng.pdf. Accessed March 31, 2010.
- Kitabchi A, et al. Clinical features and diagnosis of diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults. http://www.uptodate.com/home/index.html. Accessed March 31, 2010.
- Collazo-Clavell, ML (expert opinion). Mayo Clinic, Rochester, Minn. April 20, 2010.

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