Diabetic Ketoacidosis

I thought it prudent to write a brief post to explain what Diabetic Ketoacidosis is, in the simplest terms, before launching into the next post in my Eating Disorder Series.

People often mistakenly associate it with the Ketogenic Diet. So we will head there first . . .

Ketoacidosis is not an elongated word related to a Ketogenic Diet


A ketogenic or ‘keto’ diet is where (among other things) carbohydrates are restricted in comparison to what most folk living in the Western World are eating. The Keto Diet is followed by many people, with and without diabetes, to help control their blood sugar levels and other conditions it lays claims to help with.

No doubt people follow it for other reasons also including weight-loss, energy levels, because they believe it is the diet we should have always followed…list goes on. I am not supportive or unsupportive of this diet, it is just another diet to me and one which I have tried and discounted for myself. I do not currently follow a Keto Diet. But if it works for someone great, go for it. Like all other diets though, please don’t mistake me for someone who wants to hear half-baked theories or be converted to your way of eating. If it works for you, be content in that and talk about something else!

Due to the low carbohydrate content of the Keto Diet, it provides better blood sugar control for some (but not all) people.

As with any diet—the full extent of the effects from following a Keto Diet are not yet known. There are many speculations and even combative arguments between followers and non-followers on this. But to my mind—until people have been following the same diet consistently for several generations and all other influencing factors can be reliably isolated, it’s all hot air or to use one of my favourite words—conjecture.

Theories about diets are nigh on impossible to prove unless all other factors remain the same over generations and when does that seem likely? Can you prove it was the diet or the person’s outlook on life which meant they lived to 100 years old? Can you prove their environment and stress levels weren't the influencing factor and not the low carb coffee they guzzled each morning? How is the study set up and what does it actually prove beyond doubt?

Often nothing at all.

The only real truth is: The Keto Diet seems to work for some people and not for others.

It is important to say—for people following a Ketogenic Diet, you are likely to experience some of the symptoms of ketoacidosis (see symptoms below) when transitioning. Your urine / blood strips will likely show ketones. But your blood sugar levels should never be high at the same time.

Please discuss the implications of a Keto Diet with your medical team before embarking on it and talk about what is safe for you. Also, check how to tell the difference between ketones and ketoacidosis.


The last word: If anyone tries to push you into any diet or drones on and on about how their diet is “the best diet on the face of the planet”, I’d consider it a cult and them a cult member. Even if it seems they have nothing to profit from your conversion to their way of thinking and eating. Even if it seems they are just defending their own beliefs or their diet will save the planet. Even if they seem as though they’re doing it solely for your health and benefit with no financial gain and only a vested interest in you. Question their motives and take care. And feel free to tell them in no uncertain terms—you do not wish to discuss food or diet culture with them again. For some of us, it is inherently dangerous.

Okay, so—what is Diabetic Ketoacidosis?


I can see where the confusion between a Keto Diet and Diabetic Ketoacidosis comes in. The root of the two words are similar.

But they are very different.

Diabetic Ketoacidosis can occur in people with type one diabetes when diabetes has not yet been diagnosed. Or it occurs when those of us with established type one diabetes do not take enough insulin. That’s it, in the simplest of terms.

Diabetic Ketoacidosis (DKA) means there is not enough insulin in the body.

Without enough insulin, the result is high blood sugar levels. Eventually, extremely high blood sugar levels, which if left untreated, can quickly become life-threatening. Yes, we can die from ketoacidosis in a matter of days or even hours.

DKA commonly occurs when those of us with T1D get ill, because our blood sugars will often naturally run higher at this time. We usually have to increase our insulin to match this, but the onset can be sudden and DKA can happen before we get the balance of insulin correct again.

This is why having some way to measure ketones is an essential part of every T1D’s kit. And you need to know what to do. Ask your medical team now if you don’t!


The Symptoms of Ketoacidosis

Early Signs of DKA include:

  • Extreme thirst

  • Urinating more frequently

  • High blood sugar levels

  • High ketone levels in the urine and / or blood

Later Signs include:

  • Lethargy, feeling weak or constantly sleepy

  • Dry / flushed skin

  • Nausea, vomiting, pains in the abdomen

  • Difficulty breathing

  • Fruit smelling breath

There we have it. It is important to react immediately (contact Emergency Services / your Medical Team and you must speak to someone right away - no waiting!) if you suspect DKA.

Do not wait. It is life-threatening. It can and does kill.

Contact your diabetes medical team if you are unsure about what to do if DKA happens—they should have given you education on this already. Having a plan of action in place in advance could save your life.