DKA at diagnosis

Did you present DKA when you were diagnosed?

  • Yes
  • No

0 voters

What symptoms you had?

My mom took me dr due to weight loss, excessive drinking and peeing, at 5 years old, in 1965.
Doctor smelled my breath and sent me direct to hospital, so assume I had ketones!!

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In 1959 I lost 20 lbs off of my little body. My thirst couldn’t be quenched and I was peeing all of the time. The toilet bowl was coated with sugar, and my mom yelled at me for throwing in chemicals from my chemistry set, which I wasn’t doing. My pediatrician hadn’t seen a case of diabetes before, so he didn’t diagnose me until I was dying. I have no idea if was experiencing DKA. I have no memory of being in the hospital. I was 8 yrs old.


I had all the above warning signs plus family history of T1. But I was 62 and the NP insisted I was T2 and refused to prescribe insulin. I found an endo who immediately prescribed insulin as well as c-peptide and GAD65 tests. C-peptide was low and GAD65 was high. Classic T1 not even LADA. But no DKA.

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I was dehydrated, my fasting glucose was over 600.
I had blurry vision. My doctor kept sniffing me too. I already knew my hands smelled like Froot Loops. But I hadn’t eaten Froot Loops since I was 10 years old.
I was also sick to my stomach.
I stayed 3 days in the hospital.

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I had very blurred vision, BG over 400 when I finally went to a doctor. Had lost about 35 lbs over the prior 2-3 months, constant drinking and peeing. My A1c was in the low teens.

I had been working my butt off for those 3 months and attributed the weight loss and thirst to heavy manual labor. Ha, glad I survived.

I showed PPO at diagnosis. After all Disney gave me diabetes, i got out of the hospital on my 17th birthday and my girlfriend has just broken up with me. Now diabetes? Clearly PPO.


Thirst, increased urination, vomiting, lost all of my baby fat in 2 days. BG was over 1000mg/dl and I went into a coma from DKA as we were pulling into the hospital. 3 days in the PICU and another 2 days in a regular floor. I was 18 months old and was only showing symptoms for 2 days before diagnosis.

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I’d been really sick for a long time. I don’t know why nobody suspected diabetes, given that my grandmother had passed from it’s complications just months before I was finally diagnosed. Everyone just thought I was a tiny hypochondriac. It’s amazing the resistance to the ketones you can develop, though!

I was 8 years old and 32 lbs. Legally, I should have been riding in a car seat in third grade. I weighed less then, than when I started preschool. Constant thirst. I had to pee every hour on the hour like clockwork. Lots of accidents because adults thought they should be able to dictate how my bladder worked. I don’t remember feeling tired or lethargic, but I must’ve been. I was a little bookworm and spent all my time in my room reading, never going out to play. I went home sick from school everyday after lunch. I vividly remember my mother snapping at the church ladies who were trying to fatten me up, “don’t feed her! You’ll make her sick!”. Yet I had a voracious appetite for salads. We went to restaurants like Rax and Ponderosa every night so I could eat everything on the salad bar. Didn’t know I was subconsciously choosing low carb foods. I was just hungry!

It was my school nurse who finally figured it out. She made me pee in the cup in did the dipstick, then called my mother and told her to meet us at the hospital. Blood sugar was over 1500 when we got there. I didn’t get critically unill til they started giving me insulin, though. Spent two weeks in the ICU, but I don’t remember much of it. I don’t think I was conscious a lot. I might have just been doped up on morphine, though, for the lung pain. DKA always seemed to hit my lungs the hardest. I’d hold my breath until I passed out because it hurt so much to breathe.

Actually, that’s something I’ve never really bothered to learn, despite what a clinical person I am. I don’t actually know the clinical definition of “DKA”. I’m sure it’s defined as a minimum concentration of ketones, but I can have large ketones and not feel ill at all. (At least I used to, my resistance to them has faded since I’ve gotten so good at control now.). I don’t really consider it DKA until the nausea and pain set in.

Dka is usually diagnosed if your urine ketones are 3+ or more and you have symptoms like vomiting blurred vision and ketone odor.
Since some ketosis is normal when you fast or losing weight, it’s a tough diagnosis to call.

However at 3+ your blood is acidic enough to cause coma.
I have had 3+ and feeling sick. If I act fast enough by taking extra insulin and drinking lots of water. This has not happened to me since cgm but before if my set pulled out it could happen within an hour

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Best I found was a collection of symptoms, which many have posted here.

But found this interesting too.

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I had an infection that wouldn’t heal, and a sister who had type I. I think my BG was around 700 and I didnt even feel sick. Not at all…

Dka is diagnosed based on a few different criteria, anion gap from an artery, bicarbonate 18 or less, ph level below 7.3, and bg of 250 or higher with high ketones. You can be in severe dka/ acidosis and not have super high bg which is what happened to me at diagnosis. Bg was 279 in early dka and then 350 I think by the time I got to the er in severe acidosis. I was having trouble breathing early and a few weeks before on and off as well. At the er I was gasping which I barely noticed, but they asked me why, hmm wtf? And I had started seeing bright lights and could barely walk, they got me a wheelchair as I walked down the hall. Bp was 179/ 100 or more as I recall.

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My point about the clinical definition of DKA was more in regards to the poll here. I’m wondering what criteria people are using to answer it. A lot of us were diagnosed an eon ago, and might remember how sick or not sick we were, but don’t likely remember the specific labwork… If it was even done.

The clinical definition and the specific numbers have never mattered to me. How sick I am, does. I define DKA as the point the dam breaks… When my resistance to the ketones is overwhelmed, and I find myself in pukey, painful misery. That can happen at different diagnostic numbers.

I suspect that some people are answering the poll literally, while others are answering based on whether they were sick when diagnosed or if it was caught pre-maturely. There’s a big grey area between “symptomatic” and DKA.

In my case fully diagnosed with DKA, of course I don’t know how else I would have been diagnosed since I was in a coma :crazy_face:.

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I was 30 years old - and they were just switching from juvenile or adult onset to T1 and T2. I had recently retired as a professional ballet dancer and thank God I had a day job with health coverage. Other dancers noticed that I had lost weight rapidly - my working weight was 110 lbs, I’m 5’6". I was proving it was indeed possible to be too thin (don’t know about the too rich part - still waitng on that). One of the dancers in the company had mentioned me to her father, an MD. He told her to tell me to get to a doctor or the ER and if those weren’t possible, he’d see me without needing an appt.

I was down to 100 lbs and was Dx’d with T2 - only by virtue of the age criteria. I had no risk factors - in particular no family history of T2. Sent home after being told to watch what I ate (which ballet dancers don’t do - that is eat) and to lose weight. Did he not look at me? I didn’t know anything about D of any type.

Things went from bad to worse rapidly and I was found in a DKA coma by a (thankfully this one time) nosy neighbor who had a key to my place. She wasn’t the smartest neighbor, she called my work to say that I wasn’t coming in. Fortunately my day job was with a large city fire dept. They knew about my T2 Dx, so dispatched from HQ. Dx’d with T1D in the Emergency Dept.

When I regained consciousness - after more than a week, during rounds an uppity resident presented my case and patronizingly demanded to kow how long I had D, and why hadn’t I taken care of myself. So I looked at my watch. I had known about the Dx for a little over 4 hours. Then the attending Endo spoke up. He said that that is why you read the patient’s chart and that is why the names of the D types is changed. That guy became my Endo.

Edited to add that I presented wioth classic T1D symptoms, peeing all the time, dehydrated, thirst that couldn’t be quenched etc.


You are the first person I have seen diagnosed as an older adult. I was diagnosed last year at 70. I can’t count how many people have said to me “maybe you should get a second opinion. You can’t have type 1, it must be type 2.” I was in DKA, had all the symptoms and spent 4 days in ICU. I don’t think I need a second opinion.

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@sueb, you are right! You do NOT need a second opinion. In the last almost 20 years, I have heard of quite a few older people who got T1 and I have even met several. I heard it stated that over 50% of T1s are diagnosed as adults. Some are classical T1, and some are LADA. But T1 nevertheless, an autoimmune Diabetes. I have several other autoimmune conditions, some of which made their appearance when I was 23. But the frosting on the cake was my diagnosis as T1 at 62. :face_with_raised_eyebrow:

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1986: I had been getting sicker, more tired, more thirsty, and more nauseous for a few months. My family thought that it was stress from final exams (I was 21). I thought that I was going crazy, or maybe dying.

I started throwing up on December 27. My Aunt Sally (a nurse) listened to the symptoms on the 28th, and said “get her tested for diabetes.”

On the 29th, my family doctor said that it was flu, gave me a vitamin shot and sent me home. I was in the emergency room a few hours later. My family brought me in semi-conscious, and when my BG was tested, it was 998. I felt like I was drowning, and the doctor told me repeatedly that he knew that I felt bad, but I wasn’t drowning, and that they were going to help me get better. That was a life-line, and I really appreciated it.

I was in the hospital for 8 days, 2 in ICU. One of the doctors said very sternly that I had ketone acidosis, and that it was very serious. No one bothered to explain what that meant. I didn’t find out what it meant, a real definition, until about 4 years ago when I took an anatomy and physiology class.

At NO TIME in the intervening 30 years did anyone bother to find out if I knew what, or explain what DKA was, how it developed, or what to do about it. I can’t count the number of times that my BG has been high enough to cause thirst and slight nausea. I don’t know how many times I have been close to DKA.

When I went in to the class to learn about insulin pumps (2017), the educator was dealing with a group of people who had a great disparity of experience with diabetes. She explained a lot of basic stuff before explaining about insulin pumps. That’s how I found out about ketone sticks. (Argh! Soooooo frustrating!)

So, yes, DKA was part of the diagnosis when I found out about being diabetic.