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Symptoms
By Mayo Clinic staffDiabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. You may notice:
- Excessive thirst
- Frequent urination
- Nausea and vomiting
- Abdominal pain
- Loss of appetite
- 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
- High ketone level in your urine
When to see a doctor
Signs and symptoms of diabetic ketoacidosis may mimic those of the flu, so it can be tricky to know whether you have a viral infection or a more serious health problem. 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 excess ketones in your urine and can't reach your doctor for advice
- You have multiple signs and symptoms of diabetic ketoacidosis — excessive thirst or urination, nausea and vomiting, abdominal pain, loss of appetite, shortness of breath, fruity-scented breath, confusion
Remember, untreated diabetic ketoacidosis can be fatal.
- 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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