Diabetic ketoacidosis (DKA) is a condition that occurs due to a build-up of poisonous chemicals, called ketones, in the bloodstream. DKA occurs in approximately 30% of children who present with type 1 diabetes. This causes the blood to become acidic, and the combination of acids and dehydration can lead to comas and potentially death. DKA is a medical emergency and requires immediate medical treatment. Ketones can often be smelt on the breath and has a distinctive 'nail polish' smell. Low levels ketones are often normally present in prolonged starvation with or without diabetes. In a person who has type 1 diabetes, the body isn't able to use glucose for energy. Instead, stored fat in the body is used as a source of energy. It's the breakdown of these fatty acids that results in the build-up of ketones, which can also appear in your urine. Some symptoms of DKA include: Moderate to heavy ketones in the urine Rapid breathing Flushed cheeks Abdominal pain Sweet acetone (like nail polish remover) smell on the breath Vomiting Dehydration