Diabetic Ketoacidosis: Causes, Risks, and What You Need to Know

When your body doesn’t have enough insulin, it can’t use sugar for energy—so it starts burning fat instead. This process produces ketones, acidic substances that build up in the blood when the body breaks down fat too quickly. Too many ketones make your blood too acidic, leading to a life-threatening condition called diabetic ketoacidosis, a dangerous complication of diabetes marked by high blood sugar, ketone buildup, and dehydration. It’s not just a number on a glucose meter—it’s a full-body crisis that needs fast action.

Most people who develop diabetic ketoacidosis have type 1 diabetes, but it can also happen in type 2, especially under stress, illness, or if insulin is skipped. Common triggers include missed insulin doses, infections like pneumonia or UTIs, heart attacks, or even severe emotional stress. You might notice extreme thirst, frequent urination, nausea, vomiting, abdominal pain, or breath that smells fruity—like nail polish remover. These aren’t just side effects; they’re warning signs your body is running out of fuel and drowning in acid. If you’re on insulin and your blood sugar stays above 250 mg/dL for hours, check your ketones with a simple urine or blood test. Waiting too long can lead to coma or death.

Diabetic ketoacidosis doesn’t happen in a vacuum. It’s tied directly to how your body handles insulin deficiency, the lack of insulin that prevents glucose from entering cells, forcing the body into fat-burning mode. That’s why it often shows up when diabetes medications aren’t working right—like when diabetes medication side effects, such as nausea or reduced appetite from metformin or SGLT2 inhibitors, lead to skipping doses or poor intake. It’s also linked to hyperglycemia, chronically high blood sugar that, if left unchecked, pushes the body into ketosis. This isn’t theoretical. Real people end up in the ER because they thought a high reading was "just a bad day," or they skipped insulin because they were sick and didn’t eat.

Knowing the signs saves lives. If you’re diabetic and feel off—especially with vomiting or confusion—don’t wait. Test your ketones. Call your doctor. Go to urgent care. The treatment is straightforward: fluids, electrolytes, and insulin. But only if you act fast. Most of the posts here focus on how medications affect your body, from kidney stress to brain fog. Diabetic ketoacidosis sits at the intersection of all of them. It’s the result of a system breaking down—medication, diet, stress, monitoring—all failing at once. You won’t find a magic fix in a pill. What you will find are real stories, practical advice, and clear explanations on how to prevent this from ever happening to you—or someone you care about.