Ketones in Gestational Diabetes

Very high amounts of ketones in the blood are the hallmark of diabetic ketoacidosis, which may affect anyone with type 1 and 2 diabetes. Possible medical emergency.

Ketoacidosis in People with Diabetes

Ketoacidosis (also known as DKA) is a life-threatening complication of type 1 diabetes and, to a much lesser extent, type 2 diabetes. Diabetic ketoacidosis (DKA) occurs when ketones, which are acidic chemicals, accumulate in harmful amounts due to excessive blood sugar.

The dangerous condition of ketoacidosis should not be confused with the normal metabolic state of ketosis. Ketosis may be induced by fasting or by eating a very low-carbohydrate diet (a ketogenic diet).

DKA occurs when the body lacks insulin to convert blood sugar into energy. When this happens, the liver begins converting fat into ketones for fuel. An unhealthy amount of ketones in the blood might be fatal.

Those with type 2 diabetes are less likely to have this complication since their insulin levels seldom get that low, although it does occur. Diabetic ketoacidosis (DKA) is a possible early indicator of type 1 diabetes since people with T1D can not produce insulin.

Diabetic Ketoacidosis Symptoms

Rapid onset of DKA symptoms is possible.

DKA's early warning signs might include the following −

  • urine output fluctuates often

  • insatiable hunger or thirst

  • Hyperglycemia, or high blood sugar.

  • Ketones in the urine at very high levels

In the latter stages of DKA, additional symptoms may emerge −

  • sickness and throwing up

  • Ache in the Stomach

  • confusion

  • breath that smells like fruit

  • pink cheeks

  • the state of being tired or weak

  • Rapid respiration

  • dry skin

  • syncope (or fainting) is a temporary loss of consciousness.

How do you Deal With Diabetic Ketoacidosis?

Normalizing blood sugar and insulin levels is an essential part of treating DKA.

DKA occurs when blood sugar levels rise too high and stay high for too long without treatment. If you have not been previously diagnosed with diabetes, your doctor will develop a diabetes management plan to prevent future episodes of DKA.

The danger of developing DKA is raised by infection. An antibiotic may also be prescribed when DKA is secondary to a disease or other condition.

Substitute for Lost Fluids

To assist your body in rehydrating, your doctor in the hospital will most likely provide intravenous (IV) fluids. If you're experiencing a DKA episode, you may be losing a lot of fluids, which may cause your blood volume to drop.

Replacing lost fluids aids in getting the blood pumping again. It's also helpful in treating dehydration, another factor that might raise blood sugar.

Replacement of Electrolytes

Low insulin levels may lead to abnormally low electrolyte levels in the body.

An adequate supply of electrolytes is essential for normal muscle and nerve function. IVs are also often used to provide electrolyte replacement therapy.

Injections of Insulin

You will likely get intravenous insulin until your blood sugar level is between 200 and 250 mg/dL. The emergency care team will also monitor additional blood test findings that show when insulin treatment is no longer necessary.

After ensuring that your blood sugar and other test results are within a healthy range, your doctor will work with you to reduce your risk of DKA in the future.

What Factors Lead to the Onset of Diabetic Ketoacidosis?

Diabetic ketoacidosis develops in the absence of sufficient insulin. Insulin is necessary for the body to use the glucose already in the blood. High blood sugar levels come from the accumulation of glucose in the blood because it cannot enter the cells in people with DKA.

As a result, body fat is converted into energy, bypassing the need for insulin. Ketones are a byproduct of the fat-burning process. An acidic blood pH results from an excess of ketones in the body. This condition is known as diabetic ketoacidosis.

Common triggers for DKA include −

  • Diabetes complications due to insulin neglect or insufficient injections

  • Infected or unwell

  • A clogged insulin pump, assuming you have one

Those with Diabetes are more Likely to get Ketoacidosis

Indicators of impending DKA include −

  • Affected by type 1 diabetes

  • Being younger since studies show 63% of DKA instances

  • Affect those who are younger than 51 years old

  • Physiologic shock, a potentially fatal state brought on by a lack of blood supply

  • Stress, either mental or emotional

  • Cardiological emergencies like heart attacks and strokes

  • A sudden sickness of the digestive tract, such as pancreatitis

  • Afflicted with a dependency on drugs or alcohol

  • Eating disorder

  • Hyperthyroidism and Cushing's syndrome are two examples of endocrine disorders.

  • Incisions made in the recent past

  • Pregnancy


The danger of developing DKA is heightened by several drugs. Some of them are −

medicines in the class of antipsychotics, including

  • Olanzapine (Zyprexa)

  • Clozapine (Clozaril)

  • Risperidone (Risperdal)

  • Thiazide diuretics

  • Corticosteroids

Diabetes Prone to Ketosis

In persons with type 2 diabetes, DKA is less prevalent, although it still occurs. The risk of developing diabetic ketoacidosis (DKA) is increased in those who are "ketosis-prone," such as those with type 2 diabetes. If you: Have type 2 diabetes, which often causes ketoacidosis

  • People of African descent (including African Americans, Afro-Caribbeans, and sub-Saharan Africans), Asians (including Chinese, Indians, and Japanese), and Hispanics

  • Those that are overweight or obese

  • Individuals in the midst of the lifespan

  • Males

Discussing your risk factors with your healthcare provider may help you get the best possible care.

Ketone Testing

The first stages in diagnosing DKA may include testing for ketones. Type 1 diabetics need to be prepared with a stock of ketone tests for use at home. These may check for ketones in either your urine or blood.

They are widely available in pharmacies and on the web.

Time of Testing

The American Diabetes Association recommends a ketone test.

  • When blood sugar levels are 240 or above,

  • if you feel unwell

  • For those who are experiencing DKA symptoms.

Get a urine or blood sample every 4 to 6 hours.

How to Examine

Ketones in the urine cause the test strip to change color. To use, urinate directly onto the strip or immerse it in a urine collection. The strip's indicator will flash a different hue. Verify the findings of the test strip against the chart.

Ketone blood tests are also readily accessible. In most cases, they are multi-functional monitors that can track glucose and ketones simultaneously.

A drop of blood is applied on a test strip, just as with blood glucose testing. You'll need to place a test strip into a monitor to check for ketones in your blood.

See your doctor or local pharmacy if you have questions about when and how to use your at-home ketone testing.

Updated on: 07-Apr-2023


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