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What is Diabetic Ketoacidosis?

When your body does not have enough sugar to use for energy, it begins to break down fat and produces blood acids called ketones.

What is diabetic ketoacidosis?

Diabetic ketoacidosis or DKA, occurs when ketones build up in the body because there isn’t enough insulin. This may be caused by elevated sugar levels, absence of enough insulin/diabetes medications, illness, and infection. Although DKA is more common in people with type 1 diabetes than people with type 2 diabetes, it can still occur and be a complication of both types of diabetes.1

What are symptoms of DKA?

Symptoms can vary by individual, but common symptoms are similar to signs of high blood sugar and may include:1

  • Increased thirst
  • Frequent urination
  • Nausea, vomiting, or abdominal pain
  • Weakness or fatigue
  • Fruity scented breath
  • Shortness of breath

When should you test for ketones?

If you are experiencing any of the symptoms listed above and/or:1

  • If blood glucose levels are greater than 240 mg/dl
  • If you are experiencing an illness such as: cold, flu, or unexplained nausea and vomiting

How do you test for ketones?

Testing for ketones can be done at home by testing either your blood or urine.

Blood ketones: can be tested using an at-home meter available for blood ketones, similar to how you would check using your glucometer. Prick your finger, and place a small amount of blood on the strip.1

Urine ketones: can be tested by urinating into a sterile cup and dipping your ketone strip into your urine. It will change color. Compare the urine stick to the color-coded chart on the container and package to determine what size ketones you have. This can range from negative (none), trace, small, moderate, or large.1

What do I do if I have ketones?

  1. You should discuss with your doctor or health care team what to do in the event you have ketones. If your ketone test is positive, you should contact your provider. You may be able to manage from home with additional insulin but could also require hospital treatment.
  2. Drink LOTS of water to help wash out ketones! Avoid consuming any carbohydrate beverages (juice, soda, sports drinks) that could further increase your blood sugars.
  3. Although exercise is usually very beneficial for people with diabetes, when you have ketones DO NOT exercise!
  4. Continue to monitor blood glucose levels every couple of hours.1

Who should check their ketones?

  • People with type 1 or type 2 diabetes
  • Pregnant women
  • People who take SGLT 2 inhibitors (Invokanna, Farxiga, Jardiance) may be at an increased risk of DKA1

*Discuss with your provider if you should be checking for ketones.

How do I get ketone strips?

They can be ordered to your pharmacy. In the event they are not covered by your insurance plan, they are available to be purchased over-the-counter online.

How do I store ketone strips?

They should be stored in a cool dry, place and in a sealed container. Similar to glucose strips, ketone strips do have an expiration date listed on the bottle and should be discarded after the expiration date. Ketone strips should be used between 3-6 months after opening them.

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