Diabetic Ketoacidosis (DKA): How to Care for Your Child

Diabetic ketoacidosis (DKA) can make your child very ill. Symptoms of DKA include tiredness; increased peeing; thirst; belly pain; nausea or vomiting; fruity-smelling breath; rapid, deep breathing; severe dehydration; confusion; and unconsciousness. Diabetic ketoacidosis can be life-threatening if it's not treated right away.

In the hospital, your child received insulin, IV fluids, and electrolytes (salts and minerals) to treat and correct the chemical imbalances caused by diabetic ketoacidosis. To prevent future episodes, your child must continue with the diabetes management plan provided by the health care team. 

• Check blood glucose levels (also called blood sugar levels) several times a day and, as instructed by the diabetes team, adjust insulin doses based on the readings.

• Make sure an adult watches when your child checks blood sugar levels or injects insulin.

• Following your diabetes team's instructions, do blood sugar readings more often, and check your child's urine (pee) or blood for ketones when your child is sick or blood sugar levels are high.

Your child:

• often has high or low blood sugar levels

• has ketones in the urine or blood when it's tested as instructed by the diabetes team

• isn't eating or drinking as expected

• has nausea, vomiting, or diarrhea

Your child:

• has ketones in the urine and shows symptoms of diabetic ketoacidosis, such as nausea or vomiting; breath that smells fruity; peeing more than usual; confusion; extreme drowsiness; or fast, deep breathing

• loses consciousness

How does diabetic ketoacidosis happen? Diabetic ketoacidosis happens when there isn't enough insulin in the body. Glucose (sugar) is the body's main source of energy, but we need insulin to use it. If a person with diabetes doesn't have enough insulin in the blood, the body starts to use fat for energy instead. When fat is used for fuel, chemicals called ketones enter the blood and make it acidic (having too much acid). This can cause diabetic ketoacidosis.

Several things can make a child with diabetes more likely to develop DKA, such as skipping doses or taking too little insulin; or being under stress from infection, severe injury, or emotional distress.

What are the earliest signs of diabetic ketoacidosis? The earliest signs of diabetic ketoacidosis are:

• fatigue (extreme tiredness)

• being very thirsty or peeing a lot

• dry mouth and dehydration

The symptoms don't always happen all at once. They usually happen over hours.