Diabetic Ketoacidosis: Causes, Risks, and What You Need to Know

When your body doesn’t have enough insulin, a hormone that helps cells absorb sugar from the blood, it can’t use glucose for energy. Instead, it starts burning fat — and that produces toxic acids called ketones, byproducts of fat breakdown that build up in the blood. This dangerous mix — high blood sugar, low insulin, and rising ketones — is called diabetic ketoacidosis, a life-threatening condition that mostly affects people with type 1 diabetes. It doesn’t happen slowly. It hits hard and fast, often after an illness, missed insulin doses, or undiagnosed diabetes.

People with type 1 diabetes, an autoimmune condition where the pancreas stops making insulin are at the highest risk. But it can also show up in type 2 diabetes during severe stress, infection, or if someone stops taking their meds. You won’t always see it coming. Some people think they’re just sick with the flu — fatigue, nausea, frequent urination. But if you start breathing fast and deep, smell fruity on your breath, or feel confused, it’s not just a cold. That’s your body screaming for help. Diabetic ketoacidosis is a medical emergency. Waiting even a few hours can turn a treatable problem into a hospital stay — or worse.

What makes this worse is that many people don’t know how to check for ketones. A simple urine strip or blood test can catch it before it escalates. If you’re sick, your blood sugar is over 240 mg/dL, or you’re vomiting, test for ketones. Don’t wait. Don’t assume it’ll pass. And if you’re newly diagnosed with diabetes and feel awful, don’t brush it off — get tested. The posts below cover what to do when insulin fails, how to avoid triggers like infections or missed doses, how to recognize early signs, and what your care team needs to know to keep you safe. You’ll find real advice on managing blood sugar during illness, spotting warning signs before it’s too late, and understanding how medications and lifestyle choices interact with your body’s chemistry. This isn’t theory. It’s survival.