Last Modified: 12:47pm 26/03/2021

Causes of Diabetic Keto Acidosis

DKA occurs when there is not enough insulin present in the body. Without enough insulin, glucose builds up in the blood, causing high blood glucose levels. Since the body is unable to use glucose without insulin for energy, it breaks down fat instead. This can occur for several reasons:

  • Infection, injury, or serious illness
  • A lack of insulin in the body due to missed injections, spoiled insulin, poor absorption
  • Severe dehydration
  • Combination of these things
  • Blood glucose levels rise in response to stressor (e.g sepsis, new diagnosis type 1 diabetes, missed insulin, blocked cannula in an insulin pump user, insulin dose not increased with steroid based therapy, pregnancy, trauma, alcohol excess)

NOTE: euglycaemic DKA has also been reported in patients with type 2 diabetes who are treated with SGLT2 inhibitors (‘flozins’) and in pregnancy

Diagnostic criteria, ALL 3 of:

  • Blood glucose > 11mmol/L
  • HCO3 <15 mmol/L &/or venous pH <7.3
  • Ketonaemia > 3mmol/L or ketonuria (> ++ on urine ketostix)

(Joint British Diabetes Societies 2010)