Diabetic Ketoacidosis: Causes, Risks, and What You Need to Know

When your body can’t use sugar for energy because of not enough insulin, it starts burning fat instead—and that’s when diabetic ketoacidosis, a dangerous buildup of acids called ketones in the blood can happen. It’s most common in people with type 1 diabetes, but it can also strike those with type 2, especially if they’re sick, stressed, or skipping insulin. This isn’t just high blood sugar—it’s a metabolic crisis that needs fast action.

Diabetic ketoacidosis doesn’t come out of nowhere. It usually follows insulin resistance, a condition where cells stop responding properly to insulin, or a sudden drop in insulin levels. Think missed doses, a broken insulin pump, or an infection like pneumonia or a urinary tract infection. These events push blood sugar into the hyperglycemia, dangerously high blood glucose levels range, and your body starts producing ketones as a backup fuel. The problem? Ketones make your blood acidic, which can mess with your heart, kidneys, and brain. If you’re feeling unusually thirsty, peeing a lot, nauseous, or breathing fast with a fruity smell on your breath, don’t wait—this is your body screaming for help.

What makes this even trickier is how it connects to the medicines people use every day. Some diabetes medications, like SGLT2 inhibitors, while great for lowering blood sugar, can increase ketone production even when glucose isn’t sky-high. That’s why doctors now warn patients on these drugs to watch for symptoms even if their sugar seems "normal." And if you’ve ever switched generics or dealt with a drug shortage, you know how easy it is to miss a dose—or get a different version that doesn’t feel the same. That tiny gap in consistency can be enough to tip someone into ketoacidosis.

You won’t find a single post here that says "take this pill and you’ll never get ketoacidosis." But you will find real, practical advice on how insulin works, why some diabetes drugs carry hidden risks, how to spot early warning signs before it’s an emergency, and how to manage your meds safely—even when life gets messy. Whether you’re managing your own diabetes, caring for someone who is, or just trying to understand why this condition keeps popping up in headlines, the articles below give you the tools to stay ahead of it.