Managing diabetes mellitus, a common disorder affecting the body's ability to digest glucose for energy, is often similar to walking a tightrope. Food, fluid and insulin must be available in correct proportions at the right times to avoid complications such as hypoglycemia, diabetic ketoacidosis, and insulin shock. Diabetic ketoacidosis is a condition that usually occurs in undiagnosed Type I diabetic patients — often as the first serious indication that they suffer from the disease — or in diagnosed patients who experience an illness causing dehydration or infection. Despite rising blood sugar levels, the body is unable to use this glucose for fuel and turns instead to body fat. The end product of burning fat, ketones, and the high blood glucose levels cause the symptoms of diabetic ketoacidosis such as fruity breath, an unsatisfied thirst, very frequent urination and weakness.
All the symptoms of diabetic ketoacidosis are related to the underlying physiology of the body attempting to burn too much of the wrong fuel for energy. The end byproducts of burning excessive fat are ketones, which lend a fruity odor to a diabetic's breath. The body cannot burn the increasing glucose in the blood for energy and thus begins to excrete it in the urine, causing dehydration. This dehydration causes the excessive thirst that cannot be satisfied as the body continues to produce urine as the means to decrease and excrete glucose. Unmet energy needs and the overall fluid imbalance cause weakness, fatigue and nausea.
Laboratory or clinical tests that indicate symptoms of diabetic ketoacidosis include high blood glucose levels and high urine ketone levels. Vital signs accompanying symptoms of diabetic ketoacidosis include a lower-than-normal blood pressure and an increased or rapid heart rate, both secondary to the body's overall dehydration. A shallow and rapid respiration rate may develop as symptoms worsen. Confusion, coma and death can result if this potentially deadly complication is not treated promptly.
The American Diabetic Association warns diabetics to be particularly careful about developing symptoms of diabetic ketoacidosis when they become sick with the flu, a cold or other type of infection. An illness that prevents a diabetic from eating proper meals can lead to this syndrome if his insulin dosage is not adjusted or skipped. Other types of illness, however, can make a diabetic's insulin needs greater than usual, so blood glucose levels must be monitored closely and symptoms of diabetic ketoacidosis assessed for regularly.