What is Diabetic Acidosis?

Diabetic acidosis, also known as diabetic ketoacidosis (DKA), is a complication of diabetes that occurs when the body cannot use glucose produced by the blood because insulin is lacking. Insulin, a naturally occurring hormone, is responsible for making glucose available to cells for energy. When glucose is unavailable, those cells instead burn fat for energy. While burning fat may sound good, it can cause problems when the byproducts of fat metabolism start building up in the body, particularly the blood and urine.

At high levels, those byproducts, which are known as ketones, become harmful. Ketoacidosis results; this leads to a decreased blood pH level known as acidosis, which is more harmful. Diabetic acidosis is a serious condition that primarily occurs in people with type 1 diabetes mellitus, often as the first indication of the disease. It also can occur in people with type 2 diabetes, though that is rare.

The most common causes of diabetic acidosis are a missed dose of insulin or an underlying infection or illness, such as a urinary tract infection. Other triggers include stress, trauma, surgery, heart attack, stroke, and alcohol or drug abuse. Ketoacidosis risk is believed to be increased in people under the age of 19.

Ketoacidosis is usually treated under medical supervision, often in a hospital, though hospitalization may not be required if caught soon enough. Treatment includes insulin administration, fluid replacement, electrolyte balancing, and treatment of any infections or illness that may have triggered the problem. With proper treatment, recovery is almost always successful, though a continued lack of treatment can be detrimental.

Diabetic acidosis symptoms develop quickly, often within 24 hours, and include excessive thirst, frequent urination, abdominal pain, nausea and vomiting, loss of appetite, shortness of breath, fruity-scented breath, weakness, fatigue, and confusion. Blood tests that confirm a high blood sugar level and a low blood pH level, and urine tests that confirm high ketone levels are used to diagnose ketoacidosis. These tests are valuable, because diabetic acidosis symptoms can mimic the flu and, thus, lead to a delay in proper treatment.

To prevent medical emergencies that may result from diabetic acidosis, including coma, it is important for diabetics to monitor their blood sugar and insulin levels and keep them under control. Ketone levels can also be checked with the use of an at-home urine test. It is essential that a diabetic work at prevention, pay attention to symptoms, and act quickly when signs of diabetic acidosis appear.