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Cellular dehydration is one of the potentially life-threatening

consequences of diabetic ketoacidosis (DKA), which is a condition that

occurs when the body does not have enough insulin to use glucose for

energy and starts to break down fat instead. This produces ketones, which

are acidic substances that accumulate in the blood and urine. DKA causes

hyperglycemia, which is a high level of glucose in the blood, and osmotic

diuresis, which is the loss of water and electrolytes through the urine. This

leads to cellular dehydration, which is the shrinkage of the cells due to the

loss of water from the intracellular fluid. Cellular dehydration can affect the

brain and cause neurological symptoms, such as confusion, lethargy, coma, and death12.

Other potentially life-threatening consequences of DKA include metabolic acidosis, which is a low pH

of the blood due to the excess of ketones, and respiratory compensation, which is the increase of the

breathing rate and depth to expel carbon dioxide and lower the acidity of the blood12. These are not

the same as metabolic alkalosis or respiratory alkalosis, which are conditions that cause a high pH of

the blood due to the loss of acids or the retention of bases2. Intracellular hyperglycemia is not a

consequence of DKA, as the glucose cannot enter the cells without insulin and remains in the

extracellular fluid12.