Diabetic Ketoacidosis: Unexpected Signs

Diabetic ketoacidosis is deadly if missed. The earliest warning sign isn't fruity breath,

but severe abdominal pain, often mistaken for appendicitis. DKA affects type

1 diabetics, now rising in type 2 patients on SGLT2 inhibitors. Insulin deficiency leads

to ketone buildup. Euglycemic DKA is easily missed. Diagnose with blood glucose,

pH, bicarb, and a beta-hydroxybutyrate level. Treat aggressively with

fluids and insulin, but never before potassium reaches 3.3 to avoid fatal arrhythmias.

For unexplained severe abdominal pain with normal imaging, always check glucose and ketones.

DKA mimics surgical emergencies better than any other metabolic condition.