I haven't had ketoacidosis since I was diagnosed. If you buy ketone test strips (they're cheap at the drug store) you may find that you spill ketones occasionally (e.g. if you get a high BG >250), but the amount isn't large (the darker the color the more ketones) and they go away once you get your BG back down. Spilling ketones isn't the same thing as ketoacidosis - ketoacidosis requires your BG staying up for a longer period of time. The only time you really need to be concerned about ketoacidosis is if you get far too little insulin either because of not taking it or from becoming sick and very insulin resistant. In my experience ketoacidosis is very unlikely if you test your BG at least a few times a day and treat it when high to get it back to some semblance of normal.
When diagnosed I was spilling ketones and glucose in the urine, my stomach hurt, blurry vision, lost 15 lbs in 2 weeks, drinking and peeing constantly , sleepy, no labored breathing, BG over 500, but was probably not in full blown DKA yet.
Blood tests showed still showed reasonable bicarbonate, etc...so acidosis had not developed.
It can happen if you have a pump failure and no insulin is being delivered for an extended period and you don't notice it. (i.e. you are not testing). If you take a long acting insulin, like Lantus, you will have SOME insulin in your system at all times
so it is harder to get into full blown DKA. The other situation is if you are sick and not giving yourself insulin, insulin demand goes up due to the illness, and the insulin in your body is depleted.
As jag1 says, if you test and act, it is far less likely to happen.
Yes, there are a lot of us here who has experienced DKA, which is when you had keytones for too long and its poisoning your body...I think its different for everyone but for me I got a bad stomach virus, so I thought...I had horrible stomach pains, I threw up everything, I was completely dehydrated (i lost 20 pounds in like a day literally). I could not control my breathing or my heart beats. My kidneys started to shut down so my back hurt like hell and I couldnt walk. Ended up in the ICU...
I notice when I develope keytones my very first symptoms are I use the bathroom like crazy and I get nervous energy with heart beats slightly faster than normal. At that point I check and give myself a correct dosage of insulin. DKA/keytones usually occurs when your bloodsugars are extremely high for a period of time. Funny thing is just because your bloodsugar is high doesnt always mean you will develope keytones. You can also get them when its just slightly high.