Diabetic Ketoacidosis (DKA)
If you have diabetes, pregnancy can increase the chance of you developing DKA. This can be life threatening if not spotted or treated quickly.
DKA develops when your body doesn't have enough insulin to allow blood sugar into your cells for use as energy. Instead, your liver breaks down fat for fuel, a process that produces acids called ketones. When too many ketones are produced too fast, they can build up to dangerous levels in your body.
People with type 1 diabetes are at higher risk of DKA (although anyone with diabetes can get it). If you have any form of diabetes, your healthcare team should advise you to get urgent medical advice.
For type 1 diabetic patients, you should be given ketone testing strips and a monitor. Your healthcare team should advise you to test the ketone levels in your blood if your blood glucose is too high (known as hyperglycaemia) or if you are unwell.
If you have hyperglycaemia or you are feeling unwell, it is important to make sure you don't have DKA. Your ketone levels should be checked as soon as possible. If you are thought to have DKA you should be admitted straight away to a unit where you can get specialist care.
High blood glucose (hyperglycaemia) that is not treated can be serious and if you are unable to control and manage it alone, it is strongly advised to seek medical advice.
Call 999 or go directly to Hillingdon Hospital Emergency Department (A&E) if you think you have DKA, especially if you have a high level of ketones in your blood (above 3mmol/l in your blood, or 2mmol/L in your pee).
Contact your Diabetic team or call NHS 111 immediately if your ketones are over 1.6mmol/L, or over 0.6mmol/L if you feel unwell. When in doubt, always seek urgent advice to be on the safe side.
What is the treatment for DKA?
The early signs of DKA can often be treated with extra insulin and fluids if it is picked up quickly. But if it isn’t, DKA needs urgent hospital treatment and can be life-threatening.
Treatment of DKA includes:
- being given insulin through a vein
- being given fluids through a vein to rehydrate your body
- being given nutrients through a vein to replace any you've lost.
If you feel you have symptoms of DKA:
- check your blood sugar immediately
- check your ketones level- If >1.6mmol and you are above 18 weeks pregnant, please go to A&E for immediate review by the medical team
- any woman suspected of having diabetic ketoacidosis needs to be admitted immediately to the Acute Medical Unit (AMU) if < 24 weeks gestation or Labour Ward ≥24+0 weeks, unless they need care on HDU or ITU.
Contact numbers
Diabetic specialist midwives: 01895279025
Triage: 01895279054