{"id":10886,"date":"2026-09-01T15:21:44","date_gmt":"2026-09-01T19:21:44","guid":{"rendered":"https:\/\/type1support.ca\/?p=10886"},"modified":"2026-09-01T15:21:45","modified_gmt":"2026-09-01T19:21:45","slug":"diabetic-ketoacidosis-understanding-it-to-better-protect-yourself","status":"publish","type":"post","link":"https:\/\/type1support.ca\/en\/diabetic-ketoacidosis-understanding-it-to-better-protect-yourself\/","title":{"rendered":"Diabetic Ketoacidosis: Understanding It to Better Protect Yourself"},"content":{"rendered":"\n

You can live with type 1 diabetes (T1D) for several years without fully understanding what diabetic ketoacidosis (DKA) is or being particularly aware of its risks. We often hear more about the risk of severe hypoglycemia<\/a>, but DKA is just as important to understand, particularly so that you can recognize the warning signs and know how to respond quickly.<\/p>\n\n\n\n

Even when you put a lot of effort into managing your T1D, you can never completely eliminate the risk. An illness<\/a>, an infection, a missed insulin dose, or a problem with an insulin pump<\/a> are examples of situations that can lead to DKA.<\/p>\n\n\n\n

Understanding DKA, knowing what to watch for, and developing the right habits can help you act quickly when a potentially serious situation arises. Learn more below.<\/strong><\/p>\n\n\n\n

What are ketones, and what is diabetic ketoacidosis?<\/h2>\n\n\n\n

When there is not enough insulin, glucose remains in the bloodstream instead of entering cells to provide them with energy. The body then looks for another source of energy and begins using its fat stores. The breakdown of fat produces substances called ketone bodies, or ketones.<\/p>\n\n\n\n

Producing some ketones is not necessarily dangerous. For example, ketones can appear when you eat very little, are unable to eat because of illness, are fasting, or are following a ketogenic diet. A person living with T1D can therefore have ketones without being in DKA.<\/p>\n\n\n\n

What becomes dangerous is when ketones build up in the blood because there is not enough insulin. This causes the blood to become more acidic: this is diabetic ketoacidosis. Ketone levels therefore need to be interpreted in context: a high ketone level on its own does not necessarily mean that DKA is present.<\/p>\n\n\n\n

In other words, the presence of ketones does not necessarily mean that a person is experiencing DKA. It is primarily the accumulation of ketones in the context of insufficient insulin that can lead to ketoacidosis.<\/p>\n\n\n\n

Diabetic ketoacidosis is a potentially serious condition that requires prompt medical attention.<\/strong> If left untreated, it can cause significant dehydration, changes in level of consciousness, and other complications, and may require hospitalization. Some people experience DKA at the time of their T1D diagnosis, sometimes during their first hospitalization.<\/p>\n\n\n\n

The risk of DKA can also vary depending on how insulin is administered. With injections, two types of insulin are generally used: long-acting and rapid-acting insulin. If a dose of rapid-acting insulin is missed<\/a> (e.g., at mealtime), there is still some long-acting insulin in the body. With an insulin pump, only rapid-acting insulin is used. If the pump stops delivering insulin (e.g., because of a problem with the infusion system), the body can quickly become short of insulin and ketone levels can rise rapidly.<\/p>\n\n\n\n

Ketones and blood glucose: What you need to know<\/h2>\n\n\n\n

DKA is often associated with very high blood glucose levels, and this is indeed common. However, normal blood glucose does not completely rule out DKA. This can happen, for example, during pregnancy or with certain medications, such as SGLT2 inhibitors (e.g., Invokana, Forxiga, Jardiance, and Steglatro).<\/p>\n\n\n\n

Blood glucose and ketone levels should therefore be interpreted together, while also taking your symptoms and the circumstances into account. Symptoms of DKA, such as nausea, vomiting, or abdominal pain, can sometimes resemble those of gastroenteritis. If you are sick or experiencing unusual symptoms, it may therefore be important to check your ketones even if your blood glucose is not very high, particularly if you use an insulin pump.<\/strong><\/p>\n\n\n\n

This is also why you should not wait until your blood glucose is very high before checking for ketones if you are feeling unwell.<\/p>\n\n\n\n

What signs should you watch for?<\/h2>\n\n\n\n

Certain signs may indicate that DKA is developing:<\/p>\n\n\n\n