Diabetic Ketoacidosis (DKA) is a diabetes emergency requiring urgent medical attention and treatment. It tends to occur more in patients with Type 1 Diabetes mellitus (or patients who have an absolute insulin deficiency). It is commonly triggered by missed insulin doses, infection, a medical event such as a heart attack or stroke, or medications such as steroids
that may be prescribed for other conditions. In DKA, patients may be lethargic, dehydrated, breathless, or even drowsy and without urgent treatment, can be fatal.
The key tips for a patient with diabetes to avoid DKA are:
Follow up with your regular endocrinologist to maintain good glycaemic control with an HbA1c around 7%
Do not miss your insulin dosing, especially your basal insulin
If you fall ill, check your blood glucose regularly 5-6 times in a day to ensure it stays within a reasonable range and check blood ketones periodically (expect your blood glucose to run slightly higher than usual due to higher stress hormones during an acute illness)
Stay well hydrated (if you're vomiting and can't keep any fluids down, see a doctor)
Try to eat regular meals (if solid food is difficult, consider fluids like smoothies or milkshakes to ensure some caloric intake but watch your glucose levels)
Be prepared to make changes to your diabetes medications (if you aren't sure what to do - get in touch with your usual diabetes nurse educator to get advice on how to make adjustments or see your local GP to get advice)
If your blood sugar is persistently <4mmol/L or >20mmol/L or your blood ketones are positive, go to the emergency department or an acute care centre for urgent medical attention.
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