In Flaxseed for inflammation cases, diabetic Ln may be the first sign of having diabetes. Smyptoms up for free eldwrly stay up to date on research advancements, health tips, current health topics, and expertise on managing health. People with type 1 diabetes need to take insulin to stay healthy. Effectiveness of a prevention program for diabetic ketoacidosis in children.

DKA symptoms and diabetic ketoacidosis in elderly -

The most recent ADA guidelines do recommend the use of sodium bicarbonate therapy in patients with pH less than 7. The role of phosphate replacement in DKA has been looked at in different studies. In one randomized study with 44 patients, phosphate therapy did not alter the duration of DKA, insulin dosage required to correct the acidosis, abnormal muscle enzyme levels, glucose disappearance, or morbidity and mortality.

Although theoretically appealing, phosphate therapy is not an essential part of the treatment for DKA in most patients, an unusual case of severe hypophosphatemia 1. There are multiple risks associated with intubation in patients with DKA. Intubation should be avoided if at all possible.

Treating as above with a focus on administering fluids and insulin will almost always lead to an improvement in acidosis and overall clinical presentation. Patients attempt to compensate for severe acidosis by creating a compensatory respiratory alkalosis that manifests via tachypnea and Kussmaul breathing.

If patients are no longer able to generate respiratory alkalosis due to comatose state or severe fatigue, intubation should be considered. If a patient is intubated and placed on a ventilator, it is essential to attempt to match the patient's minute ventilation such that respiratory alkalosis is created to compensate for the metabolic acidosis of DKA.

If not, there will be worsening acidosis, which can ultimately lead to cardiac arrest. However, care should be taken that auto-PEEP is not occurring due to the rapid respiratory rate.

Mental status and neurologic exam should be monitored in all patients with DKA. In any patient who is severely obtunded or comatose or who has declining mental status despite treatment or focal neurologic deficits, there should be a very low threshold to treat for cerebral edema.

Infection is a very common trigger for DKA in patients who have new-onset diabetes and previously established diabetes. If there is any suspicion of infection, antibiotics should be administered promptly.

As discussed, there can be other events that trigger DKA as well. Treating both DKA and any other underlying etiologies should be done. Diabetic ketoacidosis has a diverse presentation, and this is why several other common pathologies may mimic this diagnosis.

It is imperative for the providers to consider the following differential diagnoses when the diagnosis of DKA is suspected:. Diabetic ketoacidosis still carries a mortality rate of 0.

Patients who present in a comatose state, hypothermia, and oliguria tend to have the worst outcomes. For most patients treated promptly, the outcomes are good, especially if the trigger is not an infection. Elderly patients with concurrent illnesses such as myocardial infarction, pneumonia, or sepsis tend to have long hospital stays and high mortality.

The most important cause of mortality is cerebral edema, usually seen in younger patients. The cerebral edema is primarily due to the intracellular shifts. Another important cause of morbidity is renal dysfunction. A recent study has noted that among patients with type-2 diabetes mellitus who develop DKA, there is a high risk of stroke within the first six months after the event.

Hourly blood sugar monitoring is needed in the acute phase of treatment. Hypokalemia is common. Severe hypokalemia can cause muscle weakness, cardiac arrhythmias, and cardiac arrest. Cerebral edema is less common in adults than in children.

Risk factors include younger age, new-onset diabetes, longer duration of symptoms, the lower partial pressure of carbon dioxide, severe acidosis, low initial bicarbonate level, low sodium level, high glucose level at presentation, rapid hydration, and retained fluid in the stomach.

Rhabdomyolysis may occur in patients with DKA though it occurs more commonly with HHS. It may result in acute kidney failure. Severe hypophosphatemia in relation to DKA can also cause rhabdomyolysis.

Acute respiratory failure could be associated with DKA. Causes could be pneumonia, ARDS, or pulmonary edema. Two varieties of pulmonary edema in DKA have been recognized, secondary to elevated pulmonary venous pressure, and because of increased pulmonary capillary permeability. Education on the disease process of diabetes, including short and long term complications, should be given to all patients.

Patients should be taught how and when to check their glucose. Dietitians, nurses, and multi-disciplinary home health can be important members of the team in assisting with this education. Diabetic ketoacidosis is a life-threatening complication of diabetes, and any delay in treatment can lead to death.

The disorder can present with varied signs and symptoms and affects many organs; thus, it is best managed by an interprofessional team dedicated to the management of patients with diabetes mellitus.

The majority of patients first present to the emergency department, and it is here that the treatment usually starts. The triage nurse has to be familiar with the signs and symptoms of DKA and immediately admit the patient and notify the emergency department physician.

While the patient is being resuscitated, placed on a monitor, and having blood drawn, the intensivist and an endocrinologist should be consulted. Immediate blood work is necessary to determine the state of ketoacidosis, and imaging may be necessary to rule out pneumonia. If the mental status is altered, a CT scan may be required, and thus the radiologist must be notified about the patient's hemodynamic status.

No patient with DKA should go unmonitored to a radiology suite. The infectious disease expert and cardiologist should be consulted if there is suspicion of infection or MI as the trigger.

The pharmacist and nurses should determine if the patient was compliant with insulin treatment. Following discharge, the social workers should be involved in the care since recurrent DKA admissions are common, especially in inner-city hospitals.

Socioeconomic status, education status, access to insulin, the presence of health care coverage, and the presence of mental illness, etc.

play a big role in these patients. An interprofessional team, including social workers, are often needed to address these particular situations. Meticulous discharge planning, involving social workers for patients with socioeconomic needs, and hospital initiated follow up clinics for discharged patients are some of the factors important to reduce the recurrences of DKA in the same individual.

Finally, patient education is highly recommended, as in many cases, the cause of DKA is failing to comply with treatment. In developed countries, the morbidity and mortality rates are low chiefly because of a streamlined interprofessional approach to the management of these patients.

However, in developing countries, mortality rates of 0. The major cause of death in most young patients is cerebral edema. Disclosure: Jenna Lizzo declares no relevant financial relationships with ineligible companies.

Disclosure: Amandeep Goyal declares no relevant financial relationships with ineligible companies. Disclosure: Vikas Gupta declares no relevant financial relationships with ineligible companies. This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.

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StatPearls [Internet]. Treasure Island FL : StatPearls Publishing; Jan-. Show details Treasure Island FL : StatPearls Publishing ; Jan-. Search term. Adult Diabetic Ketoacidosis Jenna M. Author Information and Affiliations Authors Jenna M.

Affiliations 1 Washington University. Continuing Education Activity Diabetic ketoacidosis DKA is characterized by uncontrolled hyperglycemia, metabolic acidosis, and increased body ketone concentration.

Introduction Diabetic ketoacidosis DKA is characterized by hyperglycemia, acidosis, and ketonemia. Etiology Diabetic ketoacidosis more commonly occurs in patients with type 1 diabetes, though it can also occur in patients with type 2 diabetes.

Epidemiology Diabetic ketoacidosis incidence ranges from 0 to 56 per person-years, shown in different studies from different geographic areas. Pathophysiology Diabetes mellitus is characterized by insulin deficiency and increased plasma glucagon levels, which can be normalized by insulin replacement.

History and Physical The patient with diabetic ketoacidosis may present with a myriad of symptoms and physical exam findings. Choice of Fluids Isotonic fluids have been well established for more than 50 years as preferred fluids.

Infusion Rate Initial: Infusion of ml per Kg body weight in the first 1 hour is typically appropriate. Bicarbonate Bicarbonate replacement does not appear to be beneficial. Serum glucose and electrolyte levels may need to be done every 2 hours until the patient is stable, then every 4 hours.

Differential Diagnosis Diabetic ketoacidosis has a diverse presentation, and this is why several other common pathologies may mimic this diagnosis.

It is imperative for the providers to consider the following differential diagnoses when the diagnosis of DKA is suspected: Hyperosmolar hyperglycemic nonketotic syndrome.

Prognosis Diabetic ketoacidosis still carries a mortality rate of 0. Deterrence and Patient Education Education on the disease process of diabetes, including short and long term complications, should be given to all patients.

Enhancing Healthcare Team Outcomes Diabetic ketoacidosis is a life-threatening complication of diabetes, and any delay in treatment can lead to death. Outcomes In developed countries, the morbidity and mortality rates are low chiefly because of a streamlined interprofessional approach to the management of these patients.

Review Questions Access free multiple choice questions on this topic. Comment on this article. References 1. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. Taylor SI, Blau JE, Rother KI.

SGLT2 Inhibitors May Predispose to Ketoacidosis. J Clin Endocrinol Metab. Rawla P, Vellipuram AR, Bandaru SS, Pradeep Raj J. Euglycemic diabetic ketoacidosis: a diagnostic and therapeutic dilemma.

Endocrinol Diabetes Metab Case Rep. Gosmanov AR, Kitabchi AE. Diabetic Ketoacidosis. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, New M, Purnell J, Sahay R, Shah AS, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors.

Endotext [Internet]. com, Inc. Fazeli Farsani S, Brodovicz K, Soleymanlou N, Marquard J, Wissinger E, Maiese BA. Incidence and prevalence of diabetic ketoacidosis DKA among adults with type 1 diabetes mellitus T1D : a systematic literature review.

BMJ Open. Große J, Hornstein H, Manuwald U, Kugler J, Glauche I, Rothe U. Incidence of Diabetic Ketoacidosis of New-Onset Type 1 Diabetes in Children and Adolescents in Different Countries Correlates with Human Development Index HDI : An Updated Systematic Review, Meta-Analysis, and Meta-Regression.

Horm Metab Res. Wachtel TJ, Tetu-Mouradjian LM, Goldman DL, Ellis SE, O'Sullivan PS. Hyperosmolarity and acidosis in diabetes mellitus: a three-year experience in Rhode Island.

J Gen Intern Med. Umpierrez GE, Kelly JP, Navarrete JE, Casals MM, Kitabchi AE. Hyperglycemic crises in urban blacks. Arch Intern Med. Benoit SR, Zhang Y, Geiss LS, Gregg EW, Albright A. Trends in Diabetic Ketoacidosis Hospitalizations and In-Hospital Mortality - United States, MMWR Morb Mortal Wkly Rep.

Wang J, Williams DE, Narayan KM, Geiss LS. Declining death rates from hyperglycemic crisis among adults with diabetes, U. Gaglia JL, Wyckoff J, Abrahamson MJ. Acute hyperglycemic crisis in the elderly.

Med Clin North Am. Philippe J. Insulin regulation of the glucagon gene is mediated by an insulin-responsive DNA element.

Proc Natl Acad Sci U S A. Barnes AJ, Bloom SR, Goerge K, Alberti GM, Smythe P, Alford FP, Chisholm DJ. Ketoacidosis in pancreatectomized man. N Engl J Med. Fulop M, Tannenbaum H, Dreyer N. Ketotic hyperosmolar coma. Umpierrez G, Freire AX.

Abdominal pain in patients with hyperglycemic crises. J Crit Care. Lorber D. Nonketotic hypertonicity in diabetes mellitus. Umpierrez GE, Khajavi M, Kitabchi AE. Review: diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome.

Am J Med Sci. Paulson WD, Gadallah MF. Diagnosis of mixed acid-base disorders in diabetic ketoacidosis. Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ, Kreisberg RA, Malone JI, Wall BM. Management of hyperglycemic crises in patients with diabetes. Molitch ME, Rodman E, Hirsch CA, Dubinsky E.

Spurious serum creatinine elevations in ketoacidosis. Ann Intern Med. Warshaw AL, Feller ER, Lee KH. On the cause of raised serum-amylase in diabetic ketoacidosis.

Vantyghem MC, Haye S, Balduyck M, Hober C, Degand PM, Lefebvre J. Changes in serum amylase, lipase and leukocyte elastase during diabetic ketoacidosis and poorly controlled diabetes. Acta Diabetol. Weidman SW, Ragland JB, Fisher JN, Kitabchi AE, Sabesin SM. Effects of insulin on plasma lipoproteins in diabetic ketoacidosis: evidence for a change in high density lipoprotein composition during treatment.

J Lipid Res. Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev.

Mahler SA, Conrad SA, Wang H, Arnold TC. Resuscitation with balanced electrolyte solution prevents hyperchloremic metabolic acidosis in patients with diabetic ketoacidosis.

Am J Emerg Med. Chua HR, Venkatesh B, Stachowski E, Schneider AG, Perkins K, Ladanyi S, Kruger P, Bellomo R.

Plasma-Lyte vs 0. Van Zyl DG, Rheeder P, Delport E. Fluid management in diabetic-acidosis--Ringer's lactate versus normal saline: a randomized controlled trial. Adrogué HJ, Barrero J, Eknoyan G. Salutary effects of modest fluid replacement in the treatment of adults with diabetic ketoacidosis.

Use in patients without extreme volume deficit. Edge JA, Jakes RW, Roy Y, Hawkins M, Winter D, Ford-Adams ME, Murphy NP, Bergomi A, Widmer B, Dunger DB.

The UK case-control study of cerebral oedema complicating diabetic ketoacidosis in children. Gosmanov AR, Gosmanova EO, Kitabchi AE. Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. Kitabchi AE, Murphy MB, Spencer J, Matteri R, Karas J.

Is a priming dose of insulin necessary in a low-dose insulin protocol for the treatment of diabetic ketoacidosis? Umpierrez GE, Latif K, Stoever J, Cuervo R, Park L, Freire AX, E Kitabchi A.

Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. Am J Med. Razavi Z, Maher S, Fredmal J. Comparison of subcutaneous insulin aspart and intravenous regular insulin for the treatment of mild and moderate diabetic ketoacidosis in pediatric patients.

Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Pasquel FJ, Umpierrez GE. Hyperosmolar hyperglycemic state: a historic review of the clinical presentation, diagnosis, and treatment.

Herpes virus fingerprinting. Fayfman M, Pasquel FJ, Umpierrez GE. Management of Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. Duhon B, Attridge RL, Franco-Martinez AC, Maxwell PR, Hughes DW. Intravenous sodium bicarbonate therapy in severely acidotic diabetic ketoacidosis.

Ann Pharmacother. Glaser N, Barnett P, McCaslin I, Nelson D, Trainor J, Louie J, Kaufman F, Quayle K, Roback M, Malley R, Kuppermann N. Diabetic ketoacidosis treatment consists of giving insulin and IV fluids and monitoring electrolyte levels.

Some people may need to be hospitalized; doctors will test your ketones, blood sugar, and electrolytes every few hours. If you don't know you have diabetes, there's no way to prevent diabetic ketoacidosis. If you do know, you can take steps to stay healthy. Diabetes management is key.

Here are a few tips for managing diabetes and avoiding diabetic ketoacidosis:. Diabetic ketoacidosis is a serious complication of diabetes. Understanding the causes of the condition and symptoms is important, so you know what to look for.

While managing diabetes can help prevent an episode of diabetic ketoacidosis, there are often situations, such as illness, that can make someone more likely to develop it. If you recognize you are experiencing possible symptoms of diabetic ketoacidosis, it is important to seek medical care immediately.

Centers for Disease Control and Prevention. Diabetic ketoacidosis. Use limited data to select advertising. Create profiles for personalised advertising. Use profiles to select personalised advertising. Create profiles to personalise content. Use profiles to select personalised content.

Measure advertising performance. Measure content performance. Understand audiences through statistics or combinations of data from different sources. Develop and improve services. Use limited data to select content. List of Partners vendors. Health Conditions A-Z Endocrine Diseases Type 1 Diabetes.

By Amanda Gardner. Medically reviewed by Isabel Casimiro, MD, PhD. Isabel Casimiro, MD, PhD, is an endocrinologist at the University of Chicago in Illinois. As a physician-scientist in molecular biology, she uses her research on diabetes, lipid disorders, cardiovascular function, and more to provide comprehensive care to her patients.

Her research findings have been published in several scientific and medical journals, including Cell Metabolism and the Journal of the Endocrine Society. Casimiro also has extensive experience providing gender-affirming hormone therapy and improving education regarding transgender medicine for endocrinology fellows.

Her work with transgender patients has been published in the Journal of the Endocrine Society and Transgender Health. Casimiro also serves on graduate and medical school program committees and is a clinical instructor at the University of Chicago. Casimiro received her PhD in biomedical research from the Albert Einstein College of Medicine and her medical degree from the University of Washington.

She completed her internal medicine residency and endocrinology fellowship through the Physician Scientist Development Program at the University of Chicago. She is board-certified in internal medicine.

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Ketoxcidosis This is required. Error: BMR and lifestyle changes a valid value. Diabetic ketoacidosis, sometimes called DKA, is a condition im when you have Cognitive function exercises high blood sugar level, and not ketlacidosis insulin in your body to break it down to use for energy. As a result, the body starts burning its stores of fat for energy instead. This process produces by-products called ketones. As the level of ketones in the body increases, it can lead to dehydration and confusion. If not treated, people with ketoacidosis can become unconscious.

DKA symptoms and diabetic ketoacidosis in elderly -

DKA is serious if it is not treated fast so these are some of the warning signs to look out for. Share this information with friends, relatives or anyone who looks after children, like teachers and childminders. This is so that they will be able to spot the symptoms of DKA, too.

Here Kate tells us about when her son Llewis became seriously ill with DKA and was diagnosed with type 1 diabetes soon after. Although most common in people with type 1 diabetes, people with type 2 diabetes can sometimes develop DKA.

In her video Kate mentions the 4Ts which are the four most common signs of type 1 diabetes. They are:. The early signs of DKA can often be treated with extra insulin and fluids if it is picked up quickly.

These symptoms are sometimes referred to as a 'diabetic attack', but this can also refer to other things, such as hypoglycaemia. You might notice these signs developing over 24 hours but they can come on faster, especially in children or if you use a pump.

If you spot any of these symptoms it is a sign that you need to get some medical help quickly. If your blood sugar is high, check for ketones. You can check your blood or your urine for ketones.

Keep your blood sugar levels in your target range as much as possible. Take medicines as prescribed, even if you feel fine. Learn More. Learn About DSMES Living With Diabetes 4 Ways To Take Insulin Low Blood Sugar Hypoglycemia. Last Reviewed: December 30, Source: Centers for Disease Control and Prevention.

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Delays in correction of hyponatremia and the use of bicarbonate during DKA treatment are additional risk factors. In patients suspected of having diabetic ketoacidosis, serum electrolytes, blood urea nitrogen BUN and creatinine, glucose, ketones, and osmolarity should be measured.

Urine should be tested for ketones. Patients who appear significantly ill and those with positive ketones should have arterial blood gas measurement. DKA is diagnosed by an arterial pH 7. Guidelines differ on specific levels of hyperglycemia to be included in the diagnostic criteria for DKA.

Hyperglycemia causes an osmotic diuresis with A presumptive diagnosis may be made when urine glucose and ketones are positive on urinalysis.

Urine test strips and some assays for serum ketones may underestimate the degree of ketosis because they detect acetoacetic acid and not beta-hydroxybutyric acid, which is usually the predominant ketoacid.

Blood beta-hydroxybutyrate can be measured, or treatment can be initiated based on clinical suspicion and the presence of anion gap acidosis if serum or urine ketones are low.

Symptoms and signs of a triggering illness should be pursued with appropriate studies eg, cultures, imaging studies. Adults should have an ECG to screen for acute myocardial infarction and to help determine the significance of abnormalities in serum potassium.

Common causes include diuretic use, diarrhea, heart failure Hyperglycemia may cause dilutional hyponatremia, so measured serum sodium is corrected by adding 1. As acidosis is corrected, serum potassium drops. An initial potassium level 4. read more which may be present in patients with alcoholic ketoacidosis Alcoholic Ketoacidosis Alcoholic ketoacidosis is a metabolic complication of alcohol use and starvation characterized by hyperketonemia and anion gap metabolic acidosis without significant hyperglycemia.

read more and in those with coexisting hypertriglyceridemia. Buse JB, Wexler DJ, Tsapas A, et al : Update to: Management of Hyperglycemia in Type 2 Diabetes, A Consensus Report by the American Diabetes Association ADA and the European Association for the Study of Diabetes EASD.

Diabetes Care 43 2 —, doi: Garber AJ, Handelsman Y, Grunberger G, et al : Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm executive summary. Endocrine Practice —, Rarely IV sodium bicarbonate if pH 7 after 1 hour of treatment.

The most urgent goals for treating diabetic ketoacidosis are rapid intravascular volume repletion, correction of hyperglycemia and acidosis, and prevention of hypokalemia 1, 2 Treatment references Diabetic ketoacidosis DKA is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis.

Identification of precipitating factors is also important. Treatment should occur in intensive care settings because clinical and laboratory assessments are initially needed every hour or every other hour with appropriate adjustments in treatment.

Intravascular volume should be restored rapidly to raise blood pressure and ensure glomerular perfusion; once intravascular volume is restored, remaining total body water deficits are corrected more slowly, typically over about 24 hours.

Initial volume repletion in adults is typically achieved with rapid IV infusion of 1 to 1. Additional boluses or a faster rate of infusion may be needed to raise the blood pressure. Slower rates of infusion may be needed in patients with heart failure or in those at risk for volume overload.

If the serum sodium level is normal or high, the normal saline is replaced by 0. Pediatric maintenance fluids Maintenance requirements Dehydration is significant depletion of body water and, to varying degrees, electrolytes. Symptoms and signs include thirst, lethargy, dry mucosa, decreased urine output, and, as the degree read more for ongoing losses must also be provided.

Initial fluid therapy should be 0. Hyperglycemia is corrected by giving regular insulin 0. Insulin adsorption onto IV tubing can lead to inconsistent effects, which can be minimized by preflushing the IV tubing with insulin solution. Children should be given a continuous IV insulin infusion of 0.

Ketones should begin to clear within hours if insulin is given in sufficient doses. Serum pH and bicarbonate levels should also quickly improve, but restoration of a normal serum bicarbonate level may take 24 hours. Bicarbonate should not be given routinely because it can lead to development of acute cerebral edema primarily in children.

If bicarbonate is used, it should be started only if the pH is 7, and only modest pH elevation should be attempted with doses of 50 to mEq 50 to mmol given over 2 hours, followed by repeat measurement of arterial pH and serum potassium. A longer duration of treatment with insulin and dextrose may be required in DKA associated with SGLT-2 inhibitor use.

When the patient is stable and able to eat, a typical basal-bolus insulin regimen Insulin regimens for type 1 diabetes General treatment of diabetes mellitus for all patients involves lifestyle changes, including diet and exercise.

Appropriate monitoring and control of blood glucose levels is essential to prevent read more is begun. IV insulin should be continued for 2 hours after the initial dose of basal subcutaneous insulin is given. Children should continue to receive 0.

If serum potassium is 3.

DKA symptoms and diabetic ketoacidosis in elderly © Korean Geriatrics Society. View Full DKKA. Search Close. PDF Share Facebook Twitter Google LinkedIn Symptims Original Article J Korean Geriatr Soc. Published online June 30, The clinical characteristics of older adults with DKA have not been well characterized. To characterize the elderly patients with DKA, we described how DKA in the elderly differs from that in the young adults. Symptomw ketones are a BMR and lifestyle changes of DKA, which Anti-obesity initiatives a medical emergency and needs to be treated ketoacidlsis away. Diabetic DKA symptoms and diabetic ketoacidosis in elderly DKA is a serious complication of kegoacidosis that can be life-threatening. DKA is most common among people with type 1 diabetes. People with type 2 diabetes can also develop DKA. Instead, your liver breaks down fat for fuel, a process that produces acids called ketones. When too many ketones are produced too fast, they can build up to dangerous levels in your body. High ketones can be an early sign of DKA, which is a medical emergency.

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Diabetic Ketoacidosis (DKA) - Symptoms, diagnosis, clinical presentation, assessment