following your meal plan and taking your medications as directed. Make sure you have a “sick day” plan for taking medications and managing your diet during an illness.
Diabetic ketoacidosis (DKA)
Diabetic ketoacidosis is a life-threatening condition caused by too little insulin. Your body uses sugar for fuel, but it can’t burn that fuel without the help of insulin. If you don’t have enough insulin, your body is forced to burn fat instead. This is only a stopgap solution, however: When fat is broken down for energy, it releases highly acidic poisons called ketones. If ketones start collecting in your blood — a condition called ketoacidosis — you could face a life-threatening emergency. Patients with type 1 diabetes are especially vulnerable to ketoacidosis because they can’t produce insulin on their own. Although rare, patients with type 2 diabetes who don’t produce enough insulin can also develop the condition.
Prepare yourself: Test your urine for ketones anytime your blood sugar climbs to 240 or higher, the American Diabetes Association advises, or anytime you don’t feel well. Make sure you have a testing kit available at all times. You may also have to check your ketones regularly if you have type 2 diabetes and low levels of insulin.
If you’re at risk for ketoacidosis, take the time to learn the warning signs:
- Nausea and vomiting
- Deep and rapid breaths
- A rapid heartbeat
- A fruity odor on the breath
- Abdominal tenderness
If your ketone levels are high or if you have symptoms of ketoacidosis, call your doctor immediately or ask someone to take you to the emergency room.
Prevent trouble: Most patients can avoid ketoacidosis by taking their insulin as directed. It’s also important to get enough to eat, even if you don’t have much appetite.
If you take insulin or pills that lower blood sugar, there’s a chance your blood sugar could fall too low, a condition called hypoglycemia. Hypoglycemia can occur if you overdo your insulin or medications, if you don’t get enough to eat, if you burn too much sugar during exercise, or if you drink large amounts of alcohol. Hypoglycemia usually isn’t fatal, but it can cause a sudden loss of consciousness — a serious complication if you happen to be climbing some stairs or driving down the highway.
Prepare yourself: If you manage your blood sugar with insulin or drugs, be sure to check your sugar levels regularly. Your doctor can tell you how low is too low in your particular case.
If you’re at risk for hypoglycemia, you and the people around you should know the symptoms of low blood sugar. If levels are just slightly below normal, you may experience one or more of these conditions:
- You may feel hungry or shaky.
- Your heart may start pounding.
- You may start to sweat or tremble.
- If your sugar drops even further, you may become confused, weak, disoriented, and combative; you may have seizures or fall into a coma.
Recognizing the warning signs can help you avoid an emergency, but only if you’re prepared. Anyone at risk for hypoglycemia should always carry some hard candy, juice, sugar tablets, or some other instantly available source of sugar. Instruct your friends and family to