Diabetic ketoacidosis

A physical exam and blood tests can help diagnose diabetic ketoacidosis. Sometimes, other tests may be needed to find what caused diabetic ketoacidosis.

Blood tests

Blood tests used in the diagnosis of diabetic ketoacidosis measure:

• Blood sugar level. If there isn't enough insulin in the body to allow sugar to enter cells, the blood sugar level rises. This is called hyperglycemia. As the body breaks down fat and protein for energy, the blood sugar level keeps rising.
• Ketone level. When the body breaks down fat and protein for energy, it makes acids called ketones that go into the blood.
• Blood acidity. A blood ketone level that's too high causes the blood to become acidic. This can change how organs work throughout the body.

Other tests

Tests can help find health issues that might have led to diabetic ketoacidosis. These tests also may be used to check for other health concerns. The tests might include:

• Blood electrolyte tests.
• Urinalysis.
• Chest X-ray.
• A recording of the electrical activity of the heart, also known as an electrocardiogram.

If you're diagnosed with diabetic ketoacidosis, you might be treated in the emergency room or admitted to the hospital. Treatment most often involves:

• Fluids. Fluids replace those lost by urinating a lot. They also lower blood sugar. You can get fluids by mouth or through a vein. When given through a vein, they're called IV fluids.
• Electrolyte replacement. Electrolytes are minerals in the blood, such as sodium, potassium and chloride, that carry an electric charge. Many organs and tissues need electrolytes to work as they should. Too little insulin can lower the level of several electrolytes in the blood. You get IV electrolytes to help keep the heart, muscles and nerve cells working well.
• Insulin therapy. Insulin reverses diabetic ketoacidosis. You get insulin, fluids and electrolytes most often through a vein. You may be able to return to your regular insulin therapy when your blood sugar level falls to about 200 mg/dL (11.1 mmol/L) and your blood no longer has too much acid.

Diabetic ketoacidosis is life-threatening. If you get mild symptoms, contact your healthcare professional right away.

Call 911 or your local emergency number if:

• You can't reach your health professional.
• Your symptoms are getting worse.
• Your symptoms are already bad.

A healthcare professional who sees you for possible diabetic ketoacidosis needs answers to the following questions as fast as possible.

Questions about symptoms

• What are your symptoms?
• When did your symptoms start? Are they getting worse?
• Have you been diagnosed with diabetes?
• Have you recently checked your blood sugar level?
• Have you recently checked your ketone level?
• Have you lost your appetite?
• Can you keep fluids down?
• Are you having trouble breathing?
• Do you have chest pain?

Questions about possible causes

• Have you had a recent illness or infection?
• Have you had stress recently?
• Have you recently used alcohol or illegal drugs?
• Have you been following your diabetes treatment plan?
• How well were you managing your diabetes just before these symptoms started?