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Symptoms

By Mayo Clinic staff

Controlling Your Diabetes

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Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice:

  • Excessive thirst
  • Frequent urination
  • Nausea and vomiting
  • Abdominal pain
  • Weakness or fatigue
  • Shortness of breath
  • Fruity-scented breath
  • Confusion

More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include:

  • High blood sugar level (hyperglycemia)
  • High ketone levels in your urine

When to see a doctor
If you feel ill or stressed, or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit.

Contact your doctor immediately if:

  • You're vomiting and unable to tolerate any food or liquid
  • Your blood sugar level is higher than your target range and doesn't respond to home treatment
  • Your urine ketone level is moderate or high

Seek emergency care if:

  • Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 millimoles per liter (mmol/L)
  • You have ketones in your urine and can't reach your doctor for advice
  • You have multiple signs and symptoms of diabetic ketoacidosis — excessive thirst or frequent urination, nausea and vomiting, abdominal pain, shortness of breath, fruity-scented breath, confusion

Remember, untreated diabetic ketoacidosis can be fatal.

References
  1. Ketoacidosis (DKA). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html. Accessed July 3, 2012.
  2. Ferri FF. Ferri's Clinical Advisor 2013: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-08373-7..C2010-0-68318-0&isbn=978-0-323-08373-7&uniqId=343834918-3#4-u1.0-B978-0-323-08373-7..C2010-0-68318-0--TOP. Accessed July 3, 2012.
  3. Kitabchi A, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32:1335.
  4. Siafarikas A, et al. Type 1 diabetes in children: Emergency management. Australian Family Physician. 2010;39:290.
  5. Usher-Smith JA, et al. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: A systematic review. British Medical Journal. 2011;343:d4092.
  6. Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9141196. Accessed July 3, 2012.
  7. McPhee SJ, et al. Current Medical Diagnosis & Treatment 2012. 51st ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=15524. Accessed July 3, 2012.
  8. Checking for ketones. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-for-ketones.html. Accessed July 3, 2012.
  9. Castro MR (expert opinion). Mayo Clinic, Rochester, Minn. July 6, 2012.
DS00674 Oct. 23, 2012

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