"Knowing About Ketones Isn’t Enough"

I’ve lived with type 1 diabetes for 27 years, and I’ve experienced diabetic ketoacidosis (DKA) more than once over that time. My first experience was actually at diagnosis in 1999 when I was 8 years old. My blood sugar was 53 mmol, and I was already in DKA when diabetes was identified.

My second and most severe experience happened in 2017, and it changed how I approach my diabetes to this day.

That year, my grandma — one of the most important people in my life — was given a terminal diagnosis. The emotional stress of receiving that news was overwhelming. Looking back, I started feeling unwell that morning, but I didn’t recognize it as anything serious. I had an upset stomach and a heavy chest, and I assumed it was just stress and grief.

As the day went on, I continued to deteriorate. I left work early thinking I just needed rest. I had a 4-year-old daughter at the time, so we went through her normal bedtime routine, but shortly after I became extremely unwell.

My blood sugar was 16 mmol, which didn’t immediately alarm me, but when I checked my blood ketones they were 3.9 — dangerously high. That was the moment I knew I needed urgent medical care.

Walking from my house to the car for my husband to take me to the hospital, my condition worsened rapidly. I couldn’t walk properly, started vomiting in my front yard, and we called an ambulance. I was admitted to ICU and stayed there for four days in severe DKA. I will never forget being asked by the ICU doctor, “You are very sick. If your heart stops, would you like us to resuscitate you?”

It was one of the most frightening and vulnerable experiences of my life, and it deeply impacted my husband and daughter as well.

Since that hospitalization, I have not experienced DKA again. That experience changed how seriously I monitor my body. I no longer rely on blood sugar alone as an indicator of how I’m doing. If I feel “off” — things like nausea, heavy chest, extreme dry mouth, or unexplained fatigue — I check ketones immediately.

I share my story because DKA doesn’t always present in obvious or predictable ways. It can develop quickly, and it can be triggered by things people don’t expect, including extreme emotional stress. High blood sugars alone don’t always tell the full story.

For me, awareness and early action have become critical. I’ve learned to trust symptoms, not just numbers, and to act quickly when something feels wrong.