A physical exam and blood tests can help diagnose diabetic ketoacidosis. In some cases, other tests may be needed to help find what caused the diabetic ketoacidosis.
Blood tests used in the diagnosis of diabetic ketoacidosis will measure:
- Blood sugar level. If there isn't enough insulin in the body to allow sugar to enter cells, the blood sugar level will rise. This is known as hyperglycemia. As the body breaks down fat and protein for energy, the blood sugar level will keep rising.
- Ketone level. When the body breaks down fat and protein for energy, acids known as ketones enter the bloodstream.
- Blood acidity. A too-high blood ketone level will cause the blood to become acidic. This can change how organs throughout the body work.
Tests that can help find health problems that might have contributed to diabetic ketoacidosis and check for complications might include:
- Blood electrolyte tests
- 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 usually involves:
- Fluids. Fluids replace those lost through too much urinating. They also thin out the blood sugar. Fluids can be given 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. Too little insulin can lower the level of several electrolytes in the blood. IV electrolytes are given to help keep the heart, muscles and nerve cells working as they should.
- Insulin therapy. Insulin reverses diabetic ketoacidosis. In addition to fluids and electrolytes, insulin is given, usually through a vein. A return to regular insulin therapy may be possible when the blood sugar level falls to about 200 mg/dL (11.1 mmol/L) and the blood is no longer acidic.
Preparing for your appointment
Diabetic ketoacidosis is life-threatening. If you develop mild symptoms, contact your health care provider immediately.
Call 911 or your local emergency number if:
- You can't reach your care provider
- Your symptoms are getting worse
- Your symptoms are already very bad
A health care provider who sees you for possible diabetic ketoacidosis needs answers to these questions as quickly as possible:
- What are your symptoms?
- When did your symptoms develop? 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?
- Have you had a recent illness or infection?
- Have you had recent stress or trauma?
- Have you recently used alcohol or recreational drugs?
- How closely have you been following your diabetes treatment plan?
- How well have you been managing your diabetes just before these symptoms started?
Oct 06, 2022
- DKA (ketoacidosis) and ketones. American Diabetes Association. https://diabetes.org/diabetes/dka-ketoacidosis-ketones. Accessed Sept. 17, 2022.
- Diabetic ketoacidosis (DKA). Merck Manual Professional Version. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetic-ketoacidosis-dka?query=Diabetic ketoacidosis (DKA). Accessed Sept. 17, 2022.
- Hirsch IB, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. https://www.uptodate.com/contents/search. Accessed Sept. 17, 2022.
- Hirsch IB, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. https://www.uptodate.com/contents/search. Accessed Sept. 17, 2022.
- Ferri FF. Diabetic ketoacidosis. In: Ferri's Clinical Advisor 2023. Elsevier; 2023. https://www.clinicalkey.com. Accessed Sept. 17, 2022.
- Evans K. Diabetic ketoacidosis: Update on management. Clinical Medicine. 2019; doi:10.7861/clinmed.2019-0284.