Recognising DKA Early
Reviewed by CDE Mehandi Sharma · Updated
DKA does not appear all at once. It builds in a sequence, and recognising the early part is what prevents the late part.
It begins with heavy thirst and passing urine frequently. On their own these are just high blood sugar, and easy to dismiss.
If it continues untreated, the more specific signs develop, and they can come on quickly:
- Fast or deep breathing.
- Dry skin and a dry mouth.
- A flushed face.
- Breath that smells sweet or fruity.
- Headache, and aching muscles.
- Nausea, vomiting and stomach pain.
- Tiredness, then drowsiness and confusion.
Two of these deserve emphasis. Vomiting and stomach pain in someone with Type 1 are very often mistaken for a stomach infection, and that misreading costs time. And the fruity breath is distinctive enough that a family member may notice it before the person does.
The rule of thumb: high blood sugar plus vomiting in Type 1 is an emergency until proven otherwise. Check ketones rather than assuming it is a stomach bug.
In a child, drowsiness and unusually heavy breathing are the signs that mean go now, not wait and see.