Kussmaul Breathing in Diabetic Ketoacidosis

First published in February 2022 – Last edited in September 2022 by Luka Tunjic. © All rights reserved.

Kussmaul Breathing in Diabetic Ketoacidosis -Youtube Video


Kussmaul breathing is caused by Body’s innate responses to mechanically stimulate the pancreas and other internal organs.

Kussmaul breathing involves a deep, gasping, and labored respiratory pattern (increased frequency and tidal volume) that is often seen in severe metabolic acidosis (often associated with diabetic ketoacidosis but can also occur in toxic alcohol ingestion, lactic acidosis, renal failure, or salicylate toxicity).

McMaster Textbook of Internal Medicine

Carbon dioxide is eliminated from the body by the lungs, and a reduction in pCO2 is achieved by increasing the rate of respiration (i.e. hyperventilating). So the compensatory mechanism invoked by DKA is increased respiration. The deep and rapid sighing respiration, called Kussmaul’s respiration, in patients suffering from DKA, provides clinical evidence of this compensatory mechanism. https://acutecaretesting.org/en/articles/diabetic-ketoacidosis#:~:text=So%20the%20compensatory%20mechanism%20invoked,evidence%20of%20this%20compensatory%20mechanism.

The presence of metabolic acidosis will typically generate a respiratory response. Reducing serum bicarbonate and pH will result in hyperventilation and carbon dioxide (CO2) reduction, partially preventing further fall in pH and bicarbonate concentration. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347653/

“Kussmaul breathing is characterized by deep, rapid, and labored breathing.” … “One of the most common causes of Kussmaul breathing is diabetic ketoacidosis, which is a serious complication most often associated with type 1 diabetes. However, it can also be caused by type 2 diabetes.”


Previous in vitro and in vivo studies in rats have indicated that carotid body chemoreceptors are capable of increasing respiration in response to acute hyperinsulinemia. Although increased respiratory rate has also been detected in humans during insulin infusion, it was accompanied by hypoglycemia, which is known to independently stimulate carotid chemoreceptors.


Kussmaul respirations happen when the body tries to remove carbon dioxide, an acid, from the body by quickly breathing it out.


Oxygen Toxicity – Oxygen is vital to sustain life. However, breathing oxygen at higher than normal partial pressure leads to hyperoxia and can cause oxygen toxicity or oxygen poisoning

Cooper JS, Phuyal P, Shah N. Oxygen Toxicity. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430743/

Although Kussmaul breathing appears to be a respiratory problem, helping the person to breathe or preventing them from breathing heavily will not help the situation.


Bariatric surgery leads to significant weight loss in severely obese patients with T1D and results in a significant improvement in insulin requirements and glycemic status. The favorable metabolic effects of bariatric surgery may facilitate medical management of and cardiovascular risk reduction in T1D in the setting of severe obesity. Diabetic ketoacidosis and hypoglycemia are potentially serious complications. Short-term results of bariatric surgery in patients with T1D are encouraging, but larger and longer-term studies are needed.

American Diabetes Association https://diabetesjournals.org/care/article/39/6/941/29644/Bariatric-Surgery-in-Obese-Patients-With-Type-1

Below are links to the authors’ research work on Type 1 Diabetes from 2004 through 2012.

  1. Postural Profile of People with Type 1 Diabetes – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/postural-profile-of-people-with-type-1-diabetes
  2. Musculoskeletal Profile of Normal Weight People without and with T1D – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/musculoskeletal-profile-of-normal-weight-people-withou
  3. A Link Between Occupation and Type 1 Diabetes – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/a-link-between-occupation-and-type-1-diabetes
  4. Weight Loss and Type 1 Diabetes – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/weight-loss-and-type-1-diabetes
  5. Obesity and Type 1 Diabetes – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/obesity-and-type-1-diabetes
  6. Insulin Therapy and Weight Gain – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/insulin-therapy-and-weight-gain
  7. Spontaneous Remission of Type 1 Diabetes – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/spontaneous-remission-of-type-1-diabetes
  8. Post-exercise Hypoglycemia – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/post-exercise-hypoglycemia
  9. What Stimulates the Pancreas to Work Properly – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/what-stimulates-the-pancreas-to-work-properly
  10. Type 1 Diabetes in American Indians, Alaska Natives – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/type-1-diabetes-in-american-indians-and-alaska-natives
  11. Chiropractic Pioneering Research into Type 1 Diabetes – https://www.modernscienceofbiomechanics.com/biomechanology-of-type-1-diabetes/chiropractic-pioneering-research-into-type-1-diabetes

This page was last time updated on August 25, 2022. I hope my presentation is understandable. Still, I think that can be better explained, and I will continue to work on this subject. If you find this interesting, please revisit this page because it will be from time to time updated.

Please support me here if you like my research work and find it helpful. ― Support Research for a Better World. The world without Type 1 diabetes.

%d bloggers like this: