When there is no insulin in your blood, glucose cannot be transported into your cells to fuel them. Your body then begins to break down its fat stores to provide an alternative source of energy to the glucose. The breakdown of fat stores produces an acidic by-product called "ketones". Ketones can be used as an alternative source of fuel to glucose. However, like glucose, they also need insulin to be used as energy for your cells. If there is no insulin in your bloodstream, the amount of ketones and glucose in your blood will rise. If ketones and glucose build up in your bloodstream, they will unbalance your blood chemistry and could be harmful.
If you have high levels of ketones in your blood, you may feel very thirsty, because your body will try to flush them out through your urine. Sometimes ketones can be smelt on the breath. This smell is often described as being similar to pear drop sweets or nail varnish. When the ketones in your bloodstream continue to rise, you will start to feel nauseas and may vomit. If left untreated, ketones and blood glucose will rise even faster and could lead to a coma, which can be fatal. However, ketoacidosis can be treated, and the sooner the better to help avoid any serious health complications.
Anyone who uses insulin therapy can develop ketoacidosis. This includes all people with Type 1 diabetes and some with Type 2 diabetes. In extremely rare cases, people controlling their diabetes with diet or tablets have developed ketoacidosis when they are very unwell.
If you are unwell, you are more prone to ketoacidosis and should self-test your blood glucose levels more frequently. You can get test strips for detecting ketones in your urine, which are available on prescription. If your blood glucose level is high, test your urine for ketones. If you discover ketones in your urine, you should call your doctor immediately. Speak with your diabetes healthcare team for more advice about coping with sickness.