Diabetic Ketoacidosis: Causes, Signs, and What You Need to Know

When your body doesn’t have enough insulin, it can’t use sugar for energy, so it starts burning fat instead. That process produces diabetic ketoacidosis, a life-threatening condition caused by high levels of ketones and blood sugar in people with diabetes. Also known as DKA, it’s not just a spike in blood sugar—it’s a metabolic crisis that needs urgent care. This isn’t something that happens slowly. It can develop in hours, especially if you’re sick, missed insulin doses, or just starting insulin therapy.

Ketones, acidic substances produced when the body breaks down fat for fuel build up in your blood and urine when insulin is low. That’s why people with type 1 diabetes are most at risk—they make little to no insulin. But type 2 diabetes patients can get it too, especially under stress, infection, or when taking certain medications like SGLT2 inhibitors. High blood sugar, dehydration, and nausea often go hand-in-hand with DKA. You might notice fruity-smelling breath, extreme thirst, frequent urination, confusion, or trouble breathing. These aren’t normal side effects. They’re warning signs.

Insulin deficiency, the core trigger behind diabetic ketoacidosis can come from missed injections, pump failure, or even undiagnosed diabetes. Many people don’t realize they have type 1 until they end up in the ER with DKA. Others think a little high blood sugar isn’t a big deal—until they start feeling worse. The truth is, DKA doesn’t wait. It doesn’t care if you’re busy, tired, or scared. It just keeps getting worse.

What you’ll find here isn’t just theory. These posts cover real-world situations: how to test for ketones at home, what to do when your blood sugar won’t come down, why some medications raise your risk, and how to avoid the most common mistakes that lead to hospital visits. You’ll see how people manage DKA triggers, what doctors look for in emergency cases, and how to talk to your care team about prevention. This isn’t about fear—it’s about knowing what to watch for, when to act, and how to stay in control.