Glucose, produced by the breakdown of carbohydrate, is the body’s primary source of fuel. When forced to burn fat for fuel instead, acids called ketones are generated. Excess ketone production causes the blood to become too acidic. As your body tries to rid itself of these toxic acids, it becomes severely dehydrated, which can lead to a life-threatening condition known as diabetic ketoacidosis, or DKA. Ketones develop in five stages.
Stages of Ketone Production
During stage one, blood sugars start to rise and you might experience excessive thirst, urination and decreased energy. As you reach the second stage, called ketosis, you will feel especially fatigued and achy. The third stage is called ketonuria, in which you will likely become nauseous in addition to the aforementioned symptoms. Stage four, DKA, is characterized by vomiting, confusion, deep and labored breathing, dizziness and fruity-smelling breath. A person in DKA must be hospitalized for treatment. If ketone production continues from this point, it can lead to coma and death.
Causes
The latter stages of ketone development usually occur in people who have Type 1 diabetes or are dependent on insulin to manage blood sugars. When glucose, or blood sugar, is unavailable or unable to be burned for energy, the body will break down fat, producing ketones. This could occur due to illness and infection, starvation or lack of carbohydrates in the diet, lack of insulin in the body or an insulin pump malfunction.
Testing
Testing for and detecting ketones at the earliest possible stage prevents the uncomfortable symptoms and the potentially dangerous side effects of ketone buildup. Check for ketones any time you experience an unexplained high blood sugar or are ill. The American Diabetes Association recommends testing for ketones every 4 to 6 hours when blood glucose is above 240 ml/dL. Urine and blood ketone testing kits are available for home use. If either test reads positive for ketones, initiate treatment for the elevated blood sugars, call your physician or go to the emergency room.
Treatment
Treatment for positive ketones involves hydration and the administration of insulin. Drinking water helps the body flush out excess glucose through urination. Insulin injections will bring blood sugars back into normal range. Each person’s insulin dose is individualized, so follow your prescribed insulin administration orders or contact your physician for more information. Everyone who uses insulin should have a way to test for ketones and an emergency plan. If you do not, contact your health care provider.
