DKA in Pregnancy (Diabetic Ketoacidosis)

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What is DKA in Pregnancy (Diabetic Ketoacidosis)

DKA is when there is severe lack of insulin in the body. The body is unable to use blood glucose for energy, and starts to use fat instead, causing the release of ketones. If left untreated, ketones can build up very quickly and make your blood acidic. This can be harmful to you and your baby.

DKA is serious and must be treated in hospital quickly. Left untreated, it could lead to a life-threatening situation for you and increases your risk of having a stillbirth.

Signs you may be developing DKA

You become unwell.
Feeling drowsy / confused.
Blurred vision.
Sweet smelling breath (like pear drops).
Deep or faster breathing.
Signs of preterm labour (contractions).
Vomiting.
Increased need to pass urine/increased thirst.
Blood glucose levels persistently above target (However you can develop DKA with normal glucose levels).

Risk factors for DKA

Pregnancy increases your chances of developing DKA.
Hyperemesis (Persistent vomiting).
Omitted/ missed taking your insulin.
Infections such as urinary tract or chest infections.
Any other pregnancy related condition that is making you unwell.

What can you do to avoid DKA?

Monitor and review your blood glucose levels regularly.
Adjust your insulin according to what you eat and drink and in response to your blood glucose levels (You may need to increase the amount of insulin you are taking if you are unwell).
Remember to always take your insulin!
Keep hydrated.
If you have Type 1 diabetes you should have a glucometer with the facility to check blood ketones. (If not inform the antenatal team and we will provide one for you) Ensure your ketone testing strips are in date and if not collect some more from your GP surgery.

What to do if you think you may have DKA

Check your blood ketones straight away if you have any of the signs of DKA or if you have an unexplained blood sugar reading above 11mmols/litre. (Your blood sugar levels can be normal but you can be in DKA).