DKA and sepsis: what to know

Diabetic ketoacidosis happens when there is too little effective insulin, causing the body to break down fat and build up acidic ketones. It can cause marked thirst, frequent urination, nausea, vomiting, abdominal pain, dehydration, deep breathing, fruity-smelling breath and drowsiness. It can occur in people with diabetes and may sometimes be the first sign of diabetes.

Sepsis is a dangerous response to an infection that can impair organs and circulation. Pneumonia, Cellulitis and a Urinary Tract Infection can be possible starting infections. Fever or chills, feeling generally unwell, weakness, fast breathing, confusion, mottled skin or very little urine are concerning signs. DKA and sepsis can occur together, particularly when infection raises stress on the body.

If DKA or sepsis is possible, seek emergency care rather than waiting for symptoms to settle. If you have diabetes, follow your sick-day plan, check glucose and ketones if you have been instructed how to do so, and continue prescribed insulin unless a clinician tells you otherwise. Do not exercise when ketones or severe illness are present, and take medication lists with you.

Call emergency services for repeated vomiting, deep or difficult breathing, severe abdominal pain, confusion, unusual sleepiness, collapse, blue or mottled skin, inability to drink, or rapidly worsening fever and weakness. A person who is hard to wake, breathing abnormally or producing very little urine needs immediate help.

What is my sick-day plan, including when to check glucose or ketones? Which infection symptoms should prompt emergency care? How should insulin, fluids and usual medicines be managed while I am unwell?