Diabetic Ketoacidosis (DKA) Risk Assessment

Diabetic Ketoacidosis (DKA) is a life-threatening complication primarily occurring in Type 1 Diabetes. It is caused by an absolute shortage of insulin. Without insulin, cells starve for energy and the body begins rapidly breaking down fat, producing toxic acids called ketones. This tool helps assess the urgency of symptoms.

MEDICAL DISCLAIMER: This is an educational tool, not a diagnostic device. If you are experiencing severe symptoms (vomiting, confusion, difficulty breathing), go to the Emergency Room immediately.

Blood Ketone Level (mmol/L) - if tested Leave blank if you only have urine strips or haven't tested.

Current Symptoms (Check all that apply)

Blood sugar consistently > 250 mg/dL for several hours

Nausea or Vomiting

Abdominal Pain

Fruity-smelling breath

Rapid, deep breathing (Kussmaul respirations)

Confusion or extreme lethargy

Understanding Ketones

Ketones can be measured via urine strips or blood meters. Blood ketone meters are significantly more accurate because they measure Beta-hydroxybutyrate in real-time, whereas urine strips measure acetoacetate and reflect what happened in the body hours ago.

Below 0.6 mmol/L: Normal / Negative
0.6 - 1.5 mmol/L: Trace / Small. Drink water, take correction insulin.
1.6 - 3.0 mmol/L: Moderate / Large. High risk of DKA. Contact doctor.
> 3.0 mmol/L: Danger / Medical Emergency.

Common Mistakes

Assuming insulin pumps always work: The #1 cause of DKA in patients on Insulin Pumps is a bent cannula or failed infusion site. Because pumps only deliver rapid-acting insulin, if the site fails, the patient has zero insulin in their body and will enter DKA within hours. Always correct stubborn highs with an injection via syringe/pen.
Stopping insulin when sick: When ill (flu, COVID), blood sugars naturally rise due to stress hormones. Patients often eat less and mistakenly stop taking insulin to avoid lows, inadvertently triggering DKA. Sick day management usually requires more insulin, not less.

Frequently Asked Questions (FAQ)

Is dietary ketosis (from a Keto diet) the same as DKA?: No. Nutritional ketosis produces low levels of ketones (usually 0.5 - 3.0 mmol/L) with normal blood sugar and normal blood pH. DKA involves massive ketone production, high blood sugar, and a dangerous drop in blood pH (acidosis).