When your body doesn’t have enough insulin, it can’t use sugar for energy—so it starts burning fat instead. That process creates toxic acids called ketones, acidic substances produced when the body breaks down fat for fuel in the absence of insulin. Too many ketones in your blood make it acidic, leading to a life-threatening condition called diabetic ketoacidosis, a dangerous complication of diabetes caused by severe insulin deficiency and high blood sugar. It’s most common in people with type 1 diabetes, an autoimmune condition where the body destroys insulin-producing cells, but it can also happen in type 2 diabetes under stress, illness, or missed insulin doses. This isn’t a slow-developing issue—it can turn deadly in hours if ignored.
Diabetic ketoacidosis doesn’t come out of nowhere. It usually follows a trigger: skipping insulin, getting sick with an infection, having a heart attack, or even severe dehydration. High blood sugar, elevated glucose levels that exceed the body’s ability to process it is the starting point. Your kidneys try to flush out the extra sugar through urine, which pulls water and electrolytes with it. That’s why people with DKA often feel extremely thirsty, urinate nonstop, and feel weak or confused. The ketones make your breath smell fruity—like nail polish remover. Nausea, vomiting, and abdominal pain are common too. Many mistake these for the flu. That’s dangerous. If you have diabetes and your blood sugar stays above 250 mg/dL for hours, check your ketones with a urine strip or blood meter. Don’t wait for vomiting to start.
What makes this worse is that people often delay care because they think, "I just missed one insulin shot," or "I’ll feel better tomorrow." But DKA doesn’t care about your excuses. It’s a medical emergency that needs IV fluids, insulin, and electrolyte correction—usually in a hospital. Left untreated, it leads to coma or death. Even after recovery, repeated episodes damage your kidneys, nerves, and heart. The good news? It’s preventable. Regular insulin use, checking blood sugar during illness, and knowing your ketone thresholds can stop it before it starts. Below, you’ll find real-world insights from people who’ve dealt with this—what worked, what didn’t, and how to avoid the mistakes that lead to hospital visits.
SGLT2 inhibitors help manage type 2 diabetes but carry a hidden risk: euglycemic diabetic ketoacidosis (euDKA), where ketones rise even with normal blood sugar. Learn the symptoms, who's at risk, and how to prevent this life-threatening complication.
Nov, 20 2025
3 Comments