Even if blood sugar levels are consistently in safe ranges, a spike to levels greater than 250 may signal a serious condition for adults and children with type 1 diabetes. Elaine Blackwood, Diabetes Management & Supplies diabetes educator, urges an increased understanding of diabetic ketoacidosis and what should be done when it is encountered.

Participants at a recent American Diabetes Association meeting were warned that, while stable in recent years, the number of U.S. children with diabetic ketoacidosis (one in three) signals a need for increased awareness and action.

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication. It is more common in adults and children with type 1 diabetes, but it can occur in those with type 2 diabetes under certain circumstances. DKA results from a shortage of insulin; in response the body switches to burning fatty acids and producing acidic ketone bodies that can cause dangerous complications.

“I try to encourage all my patients with type 1 diabetes to have ketone urine testing strips on hand in case their blood glucose goes over 250 (some physicians recommend 300),” Blackwood said. “I also encourage them to talk with their health care provider on treatment should the ketones show positive.”

DKA may be the first symptom of undiagnosed diabetes, but it may also occur in people with a long-standing diagnosis as a result of a variety of causes, such as intercurrent illness (one disease you get while battling another) or poor compliance with insulin therapy.

DKA Symptom

• Vomiting
• Dehydration
• Deep gasping breathing
• Confusion
• Coma (in rare, severe cases)

DKA is diagnosed with blood and urine tests; it is distinguished from other, rarer forms of ketoacidosis by the presence of high blood sugar levels. Treatment involves intravenous fluids to correct dehydration, insulin to suppress the production of ketone bodies, treatment for any underlying causes such as infections, and close observation to prevent and identify complications.

For more on diabetic ketoacidosis from the ADA conference, visit, Family Practice News: Ketoacidosis rates remain troubling in juvenile type 1 diabetes