Diabetic ketoacidosis (DKA) occurs when ketone levels rise too quickly, which makes the blood more acidic. When this happens, a person can experience life threatening complications.

DKA can affect people with type 1 or type 2 diabetes. However, it is much more common in people with type 1 diabetes.

When a person has DKA, they have very little insulin, which reduces the amount of sugar that cells can absorb. When cells do not have enough sugar, the liver breaks down fat as an alternative energy source and produces ketones.

To prevent DKA from developing, people should check their blood sugar levels regularly, drink plenty of fluids, and ensure they are taking enough insulin.

Read on to learn more about DKA in type 2 diabetes, including the causes, treatment options, and how to reduce the risk.

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DKA occurs when insulin drops to a dangerous level. This can happen for many reasons, including missing an insulin shot or not eating and drinking as much as usual, which can happen when a person is ill and loses appetite and thirst.

Insulin helps sugar enter body cells. When there is not enough of it, the cells in the liver start breaking down fat as a source of energy. The process of breaking down fat releases ketones, increasing the acidity of blood.

DKA is a life threatening condition, and if a person does not receive treatment in time, they could experience:

A person should test their ketone levels every 4–6 hours when their blood sugar is 240 milligrams per deciliter or more.

Ketone tests are available over the counter and can measure ketones in blood or urine.

Learn more about diabetic ketoacidosis here.

While both people with type 1 or type 2 diabetes are at risk of DKA, the condition tends to be more life threatening in people with type 2 diabetes.

Authors of a 2017 study observed that stroke and heart attack were common triggers of DKA in people with type 2 diabetes.

The study also found that DKA had a higher mortality rate in people with type 2 rather than type 1 diabetes.

The signs and symptoms of DKA change over time, with some presenting sooner than others.

Early signs of DKA include excessive thirst and frequent urination.

Among the symptoms of DKA that occur later are:

DKA develops due to high blood sugar and low insulin levels. However, there are several triggers that can create this imbalance.

The two main triggers are sickness and missing insulin shots. When a person is sick, they may not eat and drink as much as usual, which can result in climbing blood sugar levels and a decrease in insulin.

Other triggers of DKA include:

When someone has DKA, they will receive treatment in the emergency room.

To reverse the effects of DKA, a doctor will use several medications.

Treatment will usually begin with a doctor administering fluids to dilute the sugar in the blood and replace fluids lost through urination.

The fluids doctors administer will be either saline or isotonic. Isotonic fluids contain essential electrolytes, such as potassium and magnesium, that are crucial for nerve function and other biological processes.

If an individual receives a saline solution first, a doctor will continue treatment with an isotonic solution.

A person will then receive insulin intravenously, meaning through a needle into a vein, to stabilize their blood sugar and insulin levels.

If an illness or infection triggered DKA, the person may also need antibiotics to ensure DKA does not recur.

One of the most effective ways to reduce the risk of DKA is through education. When people understand the risks of missing insulin shots and the importance of blood glucose testing, they are less likely to experience DKA.

People who can deliver this education include nutritionists, nurses, and other diabetes specialists.

A person should also consult a doctor about whether they need to adjust their insulin dose, especially if they are changing their diet or activity levels.

Additionally, individuals should follow “sick day rules” so that they know how to manage their blood sugar in times of illness.

Actions a person can take to reduce the risk of developing DKA include:

  • checking their blood sugar often
  • keeping their blood sugar levels in range as much as possible
  • staying mindful of how illness can affect their blood sugar levels
  • following their medication prescription schedule

Common causes of DKA in type 2 diabetes are similar to those of DKA in type 1 diabetes and include infection and missing insulin shots.

However, people with type 2 diabetes tend to be older when they experience DKA, and have a higher body mass index.

DKA is also more life threatening in people with type 2 diabetes, but this phenomenon could also be due to the fact that this population is older when they experience DKA.

After receiving insulin treatments, people with type 2 diabetes usually discontinue insulin and control their symptoms with oral hypoglycemic medication and a diabetes-friendly diet.

During treatment, however, they may need more insulin to reverse DKA than people with type 1 diabetes.

DKA is a serious condition that occurs when the liver begins to break down fat for energy and releases ketones. This happens when sugar cannot enter cells due to a lack of insulin.

The two main causes of DKA are illness or infection and missing insulin shots.

Ketones make blood more acidic, and this can lead to several serious complications, including fluid in the lungs and brain swelling.

DKA is more life threatening in people with type 2 rather than type 1 diabetes, but this could be because they are usually older when they develop DKA than people with type 1 diabetes.

Measuring blood sugar regularly and taking insulin shots on time are two of the most effective methods to reduce the risk of DKA.