Diabetes-related Ketoacidosis

Our bodies must have energy to survive. Typically we burn glucose to make energy, but when glucose is not available, or when the body cannot burn glucose for any reason, fat is the back-up fuel. And ketones are a by-product of fat metabolism. So when we burn fat to get energy, our bodies make ketones, which are acid bodies that enter the blood stream.

Because our blood is neutral (not too acidic or too alkaline) when we are healthy and everything is working properly, ketones can really throw things out of whack. When our blood becomes too acidic, we can become very sick. Typical signs of ketoacidosis are fruity odor and deep, labored breathing.

When there is not enough insulin available for the body to break down glucose, fat metabolism and ketone production can occur. People who experience diabetes-related ketoacidosis may have nausea, vomiting, abdominal pain, and even loss of consciousness.

This can happen for many reasons; here are some examples:

  • exercising with a high blood glucose level and not enough insulin working (blood glucose will actually go higher and not lower)
  • not taking enough insulin either by accident or on purpose
  • running out of insulin (for instance, not ordering in time or being away from home and not bringing enough insulin)
  • running out of insulin in an insulin pump
  • having a bad infusion set/connection and not having insulin delivered by insulin pump
  • using insulin that has gone bad (exposed to extreme temperatures or expired)

Usually only people with type 1 diabetes are at risk for ketoacidosis; however, some people with type 2 diabetes can have it happen as well. Be sure to check with your health care provider to find out if you are at risk for ketoacidosis and how you can lower that risk.

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2 Responses to Diabetes-related Ketoacidosis

  1. Deirdre says:

    Are some people with type I more prone to developing ketoacidosis than others?

    • jane k says:

      This is a great question. In my experience the answer is yes, but what is not clear is whether this is due to physiological differences, or how people manage their diabetes, or other lifestyle factors. Researchers have found that many people with long-standing type 1 diabetes actually still produce insulin. In that case, they would most likely be less prone to ketosis.

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