What are symptoms of diabetic ketoacidosis (DKA)?

Diabetic ketoacidosis (DKA) often gives plenty of warning before it happens, but it can also occur with little warning. If you regularly check your blood glucose several times during the day, you won’t miss the most important warning signs: high blood glucose and ketones in your urine. Test your urine for ketones whenever your blood glucose is over 300 mg/dl or you feel ill. Signs of DKA include the following:
  • High blood glucose above 240 mg/dl and not falling
  • Classic signs of hyperglycemia: intense thirst, dry mouth, need to urinate frequently
  • Lack of appetite or pains in your stomach
  • Vomiting or nausea
  • Blurry vision
  • Fever or warm, dry, or flushed skin
  • Difficulty breathing
  • Feeling of weakness
  • Sleepiness
  • A fruity odor on your breath
If you have high blood glucose, ketones, and dehydration, you can have a serious condition called diabetic ketoacidosis (DKA). With severe DKA you might have to go to the hospital or clinic for intravenous fluids and insulin. DKA can become a medical emergency. Besides high blood glucose and ketones, DKA can come with these symptoms:
  • chills, fever
  • deep, labored breathing -- called "Kussmaul respirations"
  • Sweet, fruity-smelling breath
  • Dehydration (dry mouth, dry eyes, little or no urination, dark circles under the eyes)
  • Tenderness or pain in your stomach area
  • Confusion, slowness, or drowsiness
Call your doctor or diabetes educator if you have vomiting or the symptoms above along with blood glucose over 300 mg/dL and ketones. Your doctor can decide whether you should treat it at home -- or whether you need to go to a hospital.