DKA nearly took me down. Here’s how you can stay ahead of it.

DKA happens when your body doesn’t have enough insulin to use glucose for energy, so it starts breaking down fat instead. This process releases ketones—acids that build up in the blood and can become toxic. If untreated, DKA can lead to coma or even death¹.

But here’s the thing: the symptoms of rising ketones and early DKA are ambiguous. They can look like the stomach flu, food poisoning, or just a bad cold². That’s what happened to me during my most recent episode in 2024.

I was 21 and in college, majoring in political science with a minor in writing. It was a busy time with homecoming, exams, and a lot of stress. I started feeling sick: body aches, fatigue, cold-like symptoms. I thought I had COVID, but I tested negative. I figured it was just a bug and tried to push through.

One night, I went to bed with normal glucose levels. But I didn’t wake up until 1 p.m. the next day. I couldn’t move, I had sleep paralysis, and my heart was racing. I tried to get to my insulin but couldn’t. I screamed for help, but my roommate wasn’t home.

Thankfully, my phone was nearby. I said, “Hey Siri, call my mom.” She was my foster mom, and even though I wasn’t living with her, she told me I could always call. She called 911, and my roommate, who then rushed to our dorm.

When the ambulance arrived, they couldn’t even read my blood sugar because it was too high. They checked my ketones and said they were dangerously elevated. I started vomiting in the ambulance. At the hospital, my blood sugar was well over 700.

The doctors told me that stress had triggered insulin resistance and that my body couldn’t absorb the insulin I was taking. That episode forced me to take medical leave from college. It was terrifying—but it wasn’t my first time dealing with DKA.

My first DKA episode happened in high school, around the time I was diagnosed with polycystic ovary syndrome (PCOS). My cycle was off, and my glucose levels were erratic. I was taking insulin, but it wasn’t working. I kept going to the bathroom and felt dehydrated. Eventually, I started throwing up.

I had managed my diabetes well for so long and suddenly I felt completely out of control. That’s the scariest part of DKA—it can sneak up on you even when you’re doing everything right.

Even though my pediatric endocrinologist had told me about DKA, no one really explained the symptoms to me. I didn’t know that DKA can look like a simple stomach bug. I didn’t know that you can have normal glucose levels and still have elevated ketones. And I didn’t know that being on an insulin pump can increase your risk if something goes wrong, like a bent cannula or a site failure.

Now, I always carry ketone test strips, a blood meter, extra pump supplies, and manual insulin injection backup supplies.

If I feel nauseated or have tummy issues, I immediately test for ketones even if my glucose levels look fine. If I test and don’t have elevated ketones, that’s fine because I’d rather be safe than sorry!

If you’re the parent of a child with diabetes or you are living with diabetes, here’s what I want you to know:

• DKA is preventable, but only if you recognize the signs early.
• Symptoms like nausea, vomiting, stomach pain, and fatigue can be signs of rising ketones or DKA—not just a virus.
• Always have ketone testing supplies on hand—urine strips or a blood ketone meter.
• Have a support system—friends, teachers, roommates—who know what to do and how to help if something goes wrong.

One of the best pieces of advice I ever got was, “No one knows your body better than you.” That’s true for your child, too. Help them learn to listen to their body and speak up when something feels off.

I’ve been through a lot, but I’m still here. I’m finishing my degree and continuing to advocate for myself and others with diabetes. DKA is serious, but with awareness, preparation, and support, it doesn’t have to be part of your child’s story.

If you take one thing away from my experience, let it be this: Don’t ignore the signs. Don’t wait. Act fast. You could prevent a hospital visit or even save a life.