The best way to prevent diabetic ketoacidosis (DKA) is to follow a proper plan for diabetes health. It is helpful to have one main physician to oversee a care plan. There are other steps that diabetic individuals can take to lessen their risk of developing DKA, including:

• Monitoring ketone levels. Above-normal ketone levels are dangerous. They can signal a blood imbalance and lead to DKA. Patients can check their ketone levels regularly with a simple urine test or blood test.
  
  
• Eating a proper diet. Missed meals can result in ketones forming from the breakdown of fats. A physician or registered dietitian may prescribe a carbohydrate-restricted diet, such as one incorporating the glycemic index. However, patients are advised not to start low-carb diets on their own because these plans can trigger ketosis. 
  
  
• Ensuring insulin dose and safety.
  
• • Take insulin doses on time and in the recommended dosage.

• • When sick or under extreme stress, adjust insulin levels accordingly, as recommended by the physician. The body may require extra insulin at these times.
    
    
  • Test ketone levels in the morning. While sleeping, people with diabetes may experience insulin reactions (hypoglycemia), excessively low glucose (blood sugar) levels (below 50 mg/dL [milligram per deciliter]).  High ketone levels may signal a reaction.
    
    
  • Throw out any expired insulin or any insulin that does not look normal, as a supply of insulin may be ineffective or spoiled. Never expose insulin to temperatures of 80 degrees Fahrenheit or higher or at freezing level or below.
    
    
  • Ensure that insulin pumps are working properly.
    
    

    

• Avoid infections and injuries. Diabetic patients, especially those with type 1 diabetes, can develop DKA from various conditions, including acute infections, injuries or trauma, infarctions (obstructions in the blood supply such as a heart attack) or surgery. All of these can cause insulin treatments to fail. The flu or a cold may also cause ketoacidosis.
  
  
• Make a sick-day plan. This is written for the patient by the physician and it includes all of the important phone numbers (including the physician and hospital), glucose goals and information about using short-acting insulin, directions for reducing fever and treating infection, a schedule and instructions for taking insulin and guidelines for when it is necessary to call the physician. Other steps to take during sick days include:
  
• • Check glucose levels. High levels may require extra insulin.
    
    
  • Check ketone levels. When diabetic patients are sick (especially vomiting or diarrhea) and their blood glucose level is higher than 240 mg/dL, they should check ketone levels every four to six hours.
    
    
  • Adhere to the diet. Even though it may be hard to eat, it is important to stick to the usual schedule as much as possible.
    
    
  • Drink fluids. It may be hard to eat during illness. Carbohydrate-heavy drinks, such as sports drinks or fruit juice, may be advised to provide carbohydrates and electrolytes and to avoid dehydration.
    
    
• Ensure caregivers’ education on prevention and treatment of DKA. This is especially important for the caregivers of children with diabetes.

In addition, several organizations train dogs to detect ketoacidosis and other diabetic emergencies, but the demand for these assistance animals outstrips the supply.