Diabetic ketoacidosis - Symptoms of diabetic ketoacidosis

The initial symptoms of diabetic ketoacidosis (DKA) develop when the body detects that ketones are being produced.

High blood glucose and ketone levels make you pass large amounts of urine. This will make you very thirsty and can lead to dehydration.

Ketones are acidic so as more are produced, the level of acid in your blood will rise. The combination of dehydration and high blood acid levels can trigger a range of additional symptoms such as:

  • feeling sick (nausea)
  • abdominal pain
  • loss of appetite
  • shortness of breath

Left untreated, more advanced symptoms will develop such as:

  • rapid heartbeat (tachycardia)
  • rapid breathing, where you breathe in more oxygen than your body actually needs (hyperventilation)
  • being sick, which can make dehydration even worse
  • low blood pressure (hypotension), which can make you feel dizzy and lightheaded
  • a noticeable smell of ketones on your breath, which is often described as smelling like pear drops or nail varnish remover (not everyone is able to smell ketones) 
  • mental confusion
  • unconsciousness (coma)

When to seek medical advice

If you think you're experiencing the initial symptoms of diabetic ketoacidosis, and self-testing shows high levels of ketones in your blood or urine, you should immediately contact your GP or diabetes nurse for advice.

If this is not possible, call your local out-of-hours service or NHS 111 for advice.

If you, or someone in your care, appears to be experiencing more advanced symptoms of diabetic ketoacidosis, go immediately to your nearest accident and emergency (A&E) department.

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