Causes

Sugar is a main source of energy for the cells that make up your muscles and other tissues. Normally, insulin helps sugar enter your cells.

Without enough insulin, your body can't use sugar properly for energy. This prompts the release of hormones that break down fat as fuel, which produces acids known as ketones. Excess ketones build up in the blood and eventually "spill over" into the urine.

Diabetic ketoacidosis is usually triggered by:

• An illness. An infection or other illness can cause your body to produce higher levels of certain hormones, such as adrenaline or cortisol. Unfortunately, these hormones counter the effect of insulin — sometimes triggering an episode of diabetic ketoacidosis. Pneumonia and urinary tract infections are common culprits.
• A problem with insulin therapy. Missed insulin treatments or inadequate insulin therapy or a malfunctioning insulin pump can leave you with too little insulin in your system, triggering diabetic ketoacidosis.

Other possible triggers of diabetic ketoacidosis include:

• Physical or emotional trauma
• Heart attack or stroke
• Pancreatitis
• Pregnancy
• Alcohol or drug abuse, particularly cocaine
• Certain medications, such as corticosteroids and some diuretics