DKA Warning Signs: What to Watch For and When to Act

When your body can’t use sugar for energy, it starts burning fat instead—and that’s when diabetic ketoacidosis, a dangerous condition where the blood becomes too acidic from excess ketones. Also known as DKA, it’s not a slow-developing issue—it can turn life-threatening in hours. This isn’t just for people with type 1 diabetes. Anyone with insulin deficiency, whether diagnosed or undiagnosed, can slip into DKA if blood sugar spikes and stays high. It’s not rare. It’s not theoretical. It’s happening right now to people who didn’t recognize the signs until it was too late.

The first red flag is usually high blood sugar, levels above 250 mg/dL that don’t come down even with extra insulin. But sugar alone isn’t the whole story. You’ll also notice ketones, toxic byproducts of fat breakdown that flood the bloodstream when insulin is missing. These show up in urine or blood tests, but you don’t need a kit to spot them—your breath starts smelling like nail polish remover or rotten apples. That’s not a coincidence. That’s your body screaming for help. Alongside that, you’ll feel unusually thirsty, urinate nonstop, and get tired fast—even if you’ve slept well. Nausea, vomiting, and stomach pain often follow, and people mistake it for the flu. But if you have diabetes and these symptoms hit together, it’s not a stomach bug. It’s DKA.

What makes this dangerous isn’t just the symptoms—it’s how fast things can collapse. You might feel fine one hour and be in the ER the next. Kids, older adults, and people who skip insulin doses—even just once—are at higher risk. Stress, infection, or a new illness can trigger it. Even if you’re on insulin, if your pump fails or your injection site gets blocked, DKA can sneak up. There’s no time to wait and see. If you see three or more of these signs—high sugar, ketones, fruity breath, nausea, extreme thirst, or confusion—you need to act now. Call your doctor. Go to urgent care. Don’t wait for a hospital to open. Every hour counts.

Below, you’ll find real stories and science-backed insights from people who’ve been there—what they missed, what saved them, and how to protect yourself before the next crisis hits.