O MeA e tAtAU OnA e IlOA - Australian Diabetes Council

A build up of ketones can lead to a condition called ketoacidosis, requiring urgent medical
attention. Diabetic ketoacidosis (DKA) is a life threatening condition that usually only occurs
in people with type 1 diabetes. It causes dehydration and a buildup of acids in the blood. This
results in vomiting and increased drowsiness.
DKA IS AN EMERGENCY AND REQUIRES URGENT MEDICAL ATTENTION
In very rare cases ketoacidosis can occur in people with type 2 diabetes and is
usually caused by a serious infection.
With type 2 diabetes it is not usually necessary to test for ketones. Discuss with your diabetes
health care team if you need to check for ketones.
There are two methods of testing for ketones – testing urine and
testing blood :
Urine Ketone Test
Urine test strips are available to check for ketones. Ask your
pharmacist about the types of urine ketone strips available and
carefully follow the directions for testing. Urine ketone tests must be
timed exactly using a watch or clock with a secondhand.
Blood Ketone Test meter
There are meters available to test blood for ketones. The same drop
of blood to be tested for glucose can be used to test for ketones. Different test strips are
used for testing glucose and ketones. Ketone test strips are not subsidised by the National
Diabetes Services Scheme at present.
Seek URGENT medical attention if:
• The urine ketone test shows medium or high levels of urine ketones.
• The blood ketone test result is higher than 0.6 mmol/L.
Hyperosmolar Hyperglycaemic Syndrome (HHS) - previously known as Hyper
Osmolar Non Ketotic coma (HONK)
HHS is a complication of type 2 diabetes that involves extremely high blood glucose (sugar)
levels without the presence of ketones. This medical emergency occurs in anyone with type
2 diabetes, regardless of treatment.
When blood glucose levels are very high, the body tries to get rid of the excess glucose
(sugar) in the urine. This significantly increases the amount of urine and often leads to
dehydration so severe that it can cause seizures, coma and even death.
The main causes of HHS/ HONK are:
• Undiagnosed type 2 diabetes
• A current illness or infection e.g. pneumonia and urinary tract infection
• Other major illnesses e.g. stroke, heart attack
• Persistent physical or emotional stress
• Certain medication. This is another reason you need to talk to your diabetes health care
team about the medications you are taking.
Signs and Symptoms include:
• Severe dehydration
• Shock
• Changes in consciousness
• Coma.
HHS/HONK requires URGENT medical attention.
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