What is diabetic ketoacidosis? Diabetic ketoacidosis is a complication of diabetes that occurs when compounds called ketones build up in the bloodstream. Ketones are produced when the body breaks down fats instead of sugars, which happens when the body does not produce enough insulin to process sugar properly. Ketoacidosis generally develops in people with type 1 diabetes, a chronic condition in which the pancreas produces too little or no insulin. It can also happen, although uncommonly, in those with type 2 diabetes, a chronic condition in which your body is either resistant to insulin or your pancreas does not produce enough insulin. Symptoms worsen over time as the body attempts to use fat instead of sugar for energy. Blood sugar levels generally increase dramatically during the development of diabetic ketoacidosis, as the liver attempts to compensate for the lack of sugar-derived energy. Diabetic ketoacidosis can lead to rapid breathing, flushing, fruity-smelling breath, nausea, vomiting, pain, fatigue, headache, and muscle stiffness. In severe cases, ketoacidosis can lead to a slowing of mental activity that can progress to a coma. The consequences of ketoacidosis can be severe, even life threatening, but modern treatments are usually very effective at preventing serious complications if treatment is obtained early. Seek immediate medical care (call 911) for serious symptoms of ketoacidosis, such as decreased consciousness, difficulty breathing, mental stupor, or unexplained fruity-smelling breath. Seek prompt medical care for any symptoms of diabetes or high blood glucose levels, as early treatment is critical for preventing life-threatening complications.