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Diabetic Ketoacidosis in Children

Medically reviewed by Last updated on May 1, 2023.

Diabetic ketoacidosis (DKA) is a life-threatening condition caused by dangerously high blood sugar levels. Your child's blood sugar levels become high because his or her body does not have enough insulin. Insulin helps move sugar out of the blood so it can be used for energy. The lack of insulin forces his or her body to use fat instead of sugar for energy. As fats are broken down, they leave chemicals called ketones that build up in the blood. Ketones are dangerous at high levels.


Informed consent

is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.


is a small tube placed in your child's vein that is used to give medicine or liquids.

Your child may need extra oxygen

if his or her blood oxygen level is lower than it should be. Your child may get oxygen through a mask placed over his or her nose and mouth or through small tubes placed in the nostrils. Ask your child's healthcare provider before you take off the mask or oxygen tubing.


Your child's weight may be measured each day to monitor dehydration. Healthcare providers compare your child's weight from day to day to record how much body fluid he or she has. Your child may also need any of the following:

  • Intake and output may be measured. Healthcare providers will keep track of the amount of liquid your child is getting. They also may need to know how much he or she is urinating. Ask healthcare providers if they need to measure or collect your child's urine.
  • Neuro signs , or neuro checks show healthcare providers your child's brain function. They will check how your child's pupils react to light. They may check his or her memory and how easily he or she wakes up. Your child's hand grasp and balance may also be tested.


  • IV liquids help treat dehydration. Electrolytes may be added to the fluids to replace what has been lost from your child's body.
  • Insulin decreases the amount of sugar in your child's blood. Your child may need to take insulin until his or her blood sugar level becomes normal.
  • Glucose may be needed when your child's blood sugar level begins to decrease. This is to prevent your child's blood sugar level from dropping too quickly while he or she is getting insulin.
  • Potassium may be given if your child's blood potassium level is low. This can happen when large amounts of insulin are given.
  • Antibiotics are given if a bacterial infection caused your child's DKA.


  • Blood and urine tests will show your child's ketone and blood sugar levels. They will also show if he or she is dehydrated or has an infection.
  • An arterial blood gas (ABG) test measures the amount of oxygen and carbon dioxide in your child's blood.
  • A chest x-ray may show signs of infection.
  • An EKG test records your child's heart rhythm and how fast his or her heart beats.


  • A Foley catheter is a tube put into your child's bladder to drain urine into a bag. This allows healthcare providers to measure how much your child is urinating. Keep the bag below your child's waist. This will prevent urine from flowing back into the bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out.
  • A nasogastric (NG) tube helps remove fluid from your child's stomach. The NG tube is also used to give your child medicines or liquids if he or she cannot swallow. The NG tube is put down the nose and into the stomach.
  • An arterial line is a tube that is placed into an artery (blood vessel), usually in the wrist or groin. An arterial line may be used for measuring your child's blood pressure or for taking blood.
  • A ventilator is a machine that gives your child oxygen and breathes for him or her when needed. An endotracheal (ET) tube is put into the mouth or nose and attached to the ventilator. Your child may need a trach if an ET tube cannot be placed. A trach is a tube put through an incision and into the windpipe.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

View more treatment options

Diabetes education:

Healthcare providers will teach you and your child the following:

  • How to check his or her blood sugar level: You and your child will learn what your child's blood sugar level should be. You will be given information on when to check your child's blood sugar level. You will learn what to do if your child's level is too high or too low. Write down the times of your child's checks and his or her levels. Take them to all follow-up appointments.
  • About insulin: You and your family members will be taught how to draw up and give insulin. You will learn how much insulin your child needs and what time to inject insulin. You will be taught when to not give insulin. They will also teach you how to dispose of needles and syringes.
  • About nutrition: A dietitian will help you make a meal plan to keep your child's blood sugar level steady. You will learn how food affects your child's blood sugar levels. You and your child will also learn to keep track of sugar and starchy foods (carbohydrates). Do not let your child skip meals. Your child's blood sugar level may drop too low if he or she has taken insulin and does not eat.
  • Exercise and diabetes: You and your child will learn why physical activity is important. You and your child's provider will make a plan for your child's activity. The provider will tell you and your child what a healthy weight will be. He or she will help your child make a plan to get to that weight and stay there.


Your child may develop severe dehydration. This can cause abnormal heartbeats. Blood flow may be decreased and cause organ failure. Decreased blood flow to your child's brain may lead to seizures, swelling, or a coma. Treatment may cause your child's blood sugar level to become too low. Very low blood sugar levels may cause seizures, or your child may become unconscious. Too much fluid replacement may cause trouble breathing or cerebral edema (water around the brain). DKA can be life-threatening.


You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.