Diabetic Ketoacidosis??

Nursing Students Student Assist


Specializes in LTC, SNF, Rehab.

In lecture, my instructor said that a symptom of DKA is warm, dry skin. My sister has gone into DKA twice, but both times she said she was cold. I checked the mayo clinic website & it doesn't say either way. So, is my sister just odd or was the instructor wrong or can it be either way? (I have a test on endocrine disorders Monday, so I want to make sure I understand this)


Fever can be a later symptom which would cause the warm skin and usually when people have a fever they "feel" cold.

Hot and dry, sugar's high. (Hyperglycemia) Cold and clammy, need some candy. (Hypoglycemia)

Specializes in LTC, SNF, Rehab.

Oh that's a great way to remember it KatePasa! Thanks!

In DKA, will the person feel cold even tho their skin is hot to anyone who touches them? Just trying to understand why my sister said she was cold when her sugar was high. (but, she doesn't have a pancreas at all, so her case is extreme)

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Every patient will have their quirks. The standard is "Hot and dry, sugar's high. (Hyperglycemia) Cold and clammy, need some candy. (Hypoglycemia)" Every patient is an individual. It is possible If she was in a very advanced stage of shock and responsiveness.....she could be cold and clammy.

The signs/symptoms of DKA can be figured out from the initals of the disorder.

D - dehydration. Think about all of the signs and symptoms of dehydration - low BP, Increased HR, increased temp, dry mucous membranes, confusion and irritability, etc.

K - ketones, kussmauls, K+

A - acidosis, acetone breath, anorexia d/t n/v

The old hot and dry ... is a good way of remembering, but it only helps with the skin s/s and doesn't help with the rest of what is going on. One thing to consider with your sister is that people often feel cold when they are feverish. Her perception of her symptoms does not mean that she wasn't feverish. On the other hand, as many have said - we are all individuals and just because a textbook says DKA patients have fevers does not mean that will hold true for every DKA patient.

Dehydration is an important component of DKA which may lead to dry warm skin. At least that is how I understood it.

Specializes in LTC, SNF, Rehab.

windowrn, thanks so much! I'm going to share that with my classmates. :)

Specializes in Emergent pre-hospital care as a medic.

Your instructor told you right. In my experience you always go with what you learn from your instructors and forget what you've seen/heard/experienced anywhere else because you're testing on what those instructors have taught you, not on what you've witnessed outside the classroom.

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