Diabetic ketoacidosis
by Eileen B. Wyner, NP
Bulfinch Medical Group 

Diabetic ketoacidosis occurs when the body cannot use sugar (glucose) as a fuel source because there is no (or not enough) insulin. Fat is used for fuel instead and the byproducts of this fat breakdown, called ketones, build up in the body. This is a potentially life threatening condition that can happen in both Type 1 and Type 2 Diabetes, although it is very rare in the latter. Symptoms may include fatigue, fruity breath, stomach pain, nausea and vomiting, and blood sugar greater than 300 mg/dL. Immediate medical attention is required to treat these symptoms.

Dawn Phenomenon
by Eileen B. Wyner, NP
Bulfinch Medical Group

This phenomenon is one factor responsible for morning hyperglycemia in people with both Type 1 and Type 2 Diabetes. It also occurs in people without diabetes. It is caused by the early morning (4 a.m. to 8 a.m.) surge of hormones such as growth hormone and cortisol. The hyperglycemia in people with diabetes is a result of insufficient insulin production required to maintain normal blood glucose values.