Preventing DKA

DKA mostly happens in type 1 diabetes, but can occasionally happen in type 2 diabetes.  

It is important for all women with diabetes to know what DKA is, what the warning signs are, and what to do if you suspect DKA.  

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Pregnancy changes the way your body uses insulin. DKA (diabetic ketoacidosis) can develop more quickly during pregnancy, sometimes even when blood sugars are not extremely high. DKA is dangerous for both mother and baby, but it can usually be prevented with early action. 

Know the Warning Signs of DKA 

Call your diabetes provider or go to the ER immediately if you have: 

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• Blood sugar over 180- 200 mg/dL for more than 2 hours 

• Moderate or large ketones 

• Nausea or vomiting 

• Stomach pain 

• Rapid breathing 

• Fruity or sweet breath smell 

• Severe fatigue or confusion 

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⚠️ Do NOT wait if you feel very sick. 

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When Should You Check Ketones? 

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Check ketones (blood or urine) if: 

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• Blood sugar is over 200 mg/dL 

• You are sick with vomiting or fever 

• You miss insulin doses 

• Your insulin pump stops working 

• You feel symptoms of DKA 

How to Check Ketones 

• Make sure you have urine ketone strips or blood ketone meter handy (most insurances cover urine ketone strips, but either can be purchased OTC) 

• Get a script from Diabetes Health Care Provider for these 

• Guide on how to read strips will be on box of strips 

• BEST way to check ketones is through plasma blood (blood draw), which would be done at Emergency Room (ER).  

High Blood Sugar? Follow These Steps: 

1. Check your blood sugar 

2. Check ketones 

3. Give a correction dose of insulin 

4. Drink water (1–2 cups every hour) 

5. Recheck glucose in 1 hour 

6. If glucose is not improving after 2 corrections, call your provider. 

If You Use an Insulin Pump 

Pump problems are a common cause of DKA. 

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If blood sugar stays high: 

• Change your infusion set 

• Use insulin by injection 

• Check ketones 

• Call your provider if sugars remain high 

Always keep backup insulin and syringes/pens available. 

Important Safety Tips:

✔ Never skip insulin 
✔ Stay well hydrated 
✔ Treat illness early 
✔ Keep extra pump supplies available 
✔ Always have rapid-acting insulin and long-acting insulin available in case of pump failure 

When to Seek Immediate Medical Care 

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Go to the Emergency Room immediately if: 

• You cannot keep fluids down 

• You have moderate or large ketones 

• Blood sugar remains over 200 mg/dL 

• You feel short of breath, very sleepy, or confused 

💡 Remember: Acting early can prevent DKA and protect your baby.