Introduction

Diabetic ketoacidosis is a potentially life-threatening complication of diabetes caused by a lack of insulin in the body.

Itoccurs when the body is unable to use blood sugar (glucose) because there isn't enough insulin. Instead, it breaks down fat as an alternative source of fuel. This causes a build-up of a potentially harmfulby-product called ketones.

It sometimes develops in people who were previously unaware they had diabetes. Children and young adults are most at risk.

It's important to seek medical advice quickly if you think that you or your childis experiencingthe condition, because serious complications of diabetic ketoacidosis can develop if it's not treated early on.

Warning signs to look out for

If you take insulin to control your diabetes, you should keep an eye out for signs and symptomsof diabetic ketoacidosis.

Early signs and symptoms can include:

• passing large amounts of urine
• feeling very Thirst
• feeling sick
• abdominal(tummy)pain
• tiredness
• shortness of breath
• an increase in your blood sugar and/or ketone levels self-testing kits are available to check these (see below)

You may become very dehydrated and ifthe condition isn't treated quickly, it can lead to vomiting, an increased breathing and heart rate, dizziness, drowsiness, a smell of pear drops or nail varnish on your breath, and loss ofconsciousness.

Before beingdischarged from hospital,a diabetes nurse will talk to you about why you developed diabetic ketoacidosis and help you come up with a planto prevent future episodes.

These hormones interfere with the effect of insulin, meaning that you need more insulin. It can also occur if you don't have enough insulin because you aren't following your recommended treatment plan correctly.

A simple finger prick blood test can be used to detect an increase in blood sugar before it becomes a serious problem. Kits can also check the level of ketones in urine. You should monitor your blood sugar and ketone levels closely if you have type 1 diabetes, particularly when you're ill,so you canspot anyincreases early on.

Generally speaking, a blood sugar reading of 11 mmol/l or more is a sign that you're at risk of diabetic ketoacidosis and should check your ketone level if you feel ill. A ketone level reading of 2+ or more on urine strips or 0.6 mmol/l or more in your blood is a sign that you need to take immediate action to correct your levels.

Adjusting yourinsulindose as advised by your diabetes care teamwill often correct your blood sugar and ketone levels, preventing diabetic ketoacidosis. Seek medical advice if your levels remain high after taking insulin or you develop the symptoms mentioned above.

and preventing diabetic ketoacidosis .