What it is
It can be triggered by missed insulin doses, illness or infection. Some diabetes tablets (SGLT2 inhibitors) can also cause it, sometimes with only mildly raised blood sugar.
It is treated in hospital with fluids, insulin and salts. Following sick day rules, such as checking ketones when unwell and never stopping insulin, helps prevent it.
Common signs
- Feeling very thirsty and peeing a lot
- Feeling sick, being sick, or tummy pain
- Breath that smells fruity, like pear drops or nail varnish
- Fast, deep breathing
- Feeling very tired, drowsy or confused
How it is usually diagnosed
- Blood glucose and blood or urine ketone tests
- Blood tests for acid levels and salts
Records worth keeping
Keeping these together makes each appointment easier, especially when you see a new doctor:
- Hospital discharge summaries
- Ketone and blood sugar readings
- Your sick day rules and insulin plan
Questions to ask your doctor
- What triggered it, and how can I avoid it happening again?
- What are my sick day rules?
- When should I test for ketones?
When to get help right away
Call 112 or go to the nearest emergency department if you have:
- High blood sugar with high ketones, vomiting, fast breathing or drowsiness: go to an emergency department or call 112
This page is general information. It is not a diagnosis and does not replace a doctor who knows your history. Medfold keeps your records organised; it does not interpret them.