DKA... how much do you know?

Yes, it is NOT inevitable. I really thought I was going to die at a younger age and that would be that. Let me tell you it is so GRADUAL, subtle, its almost like a “torture”…you get a little bit of tingling, a little bit of hazy vision, a little of spilling protein in your urine…it progresses ever so slowly. In my defense I didn’t have the tools available to have home meters. You had to wait “DAYS” for a blood test result and thinking back on testing the urine for sugar - well the sugar is leaving your body, so what is the point of that ?? Your kidneys have already flushed it out of you !! I can remember just drinking an awful lot of liquids and never being able to stop going to the loo. Really, though you are completely ruining your kidneys. Trying to make them work three times as hard to flush the sugar out of you is way too hard on them. A trip to a dialysis center straightened me right up !!! Don’t think it won’t happen to you because it will…its hard to put a mature mind into the logic of a young mind. You can be slim without being in DKA. Carefully match your carbs with exercise and your weight will stabilize. AND its never too late to start counting carbs and checking blood sugars. Withholding insulin and the high blood sugars make you feel absolutely AWFUL. Tired, lethargic, bad tempered…not pleasant to be around.
Any help I can give let me know.

Hi Sheila,

Would you allow me to put your story up on the new website?

This is the first useful info I’ve been able to find. I’ve felt like crap the last 3 days, achy, nauseous, very tired and hard to concentrate and my BG is elevated but not high like the article. the symptoms seem spot on though and only a few things help at all, like water, although it tastes funny.
as a t2 on pills i have only exercise to lower BG is there any risk to that? I’m going to get these test strips as this has happened before. no one has ever dx’ed DKA and if this is what i’m getting I need to know what to do about it. if it’snot it becomes important to know why i feel this way
It’s so stupid that we can’t get answers from our medical teams

Sorry that you are not feeling well. Generally, as a diabetic you will start generating ketones when your blood sugar gets really elevated to 200-300, or even higher. You can buy a little container of ketostix at any old pharmacy, about $10 for 50. You just pee on them and see if they change color. Most of the symptoms of DKA can be the same as when you have the flu or otherwise sick, so sometimes it is hard to know based on how you feel. But feel confident, if you get the ketostix and you see ketones and have a high blood sugar in the several hundreds, you need to consider it as DKA and take appropriate action. In that case, even if you don’t have insulin, start drinking water and get yourself to the doctor/ER quickly. You should NEVER exercise when you have a highly elevated blood sugar and ketonies, that is going to make it worse.

So do get some test strips. Chances are that you are fine, but it is always best to make sure.

I’m definitely a contributor to those stats in the US.

I’ve had several bouts with Dka due to pump failure (with no alarm while asleep- whcih is partly why I’m back on MDI) as well as Dka due to vomiting and sickness- unable to eat, staying hydrated, taking insulin, and still could not keep BG down.

Dka is very painful and I would not wish it on anyone. Haven’t had Dka for about 4-5 years now and am crossing my fingers it never happens again. Feels like your blood has turned acidic and you can feel it coursing through every single vein in your body. Internal organs feel badly bruised. Hurts to breathe. Severe heartburn. Horrible taste on the tongue. Severe dehydration. I had a horrible time keeping my eyes open. When I was driven to ER, they had to carry me in because it was too painful and difficult to walk. Couldn’t talk- took too much effort. Takes a few days to feel “normal” again. Lots of bruising. Extreme muscle fatigue.

Unfortunately, the American Diabetes Association continues to perpetuate myths about Type 1 diabetes that are a “cause and effect” relationship for DKA. ADA says that most new-onset Type 1 diabetes is seen in children and adolescents, when in fact the majority of new-onset Type 1 is in those greater than age 20. This article states that “a third of DKA cases occur in those with Type 2 diabetes” but how many of those are actually misdiagnosed Type 1s, since misdiagnosed Type 1s represent 10 to 20% of “Type 2” diabetes? As many in this discussion point out, if someone with Type 1 diabetes is misdiagnosed as having Type 2 diabetes and denied exogenous insulin by their physician, the person can go into DKA. If ADA promoted getting a correct diagnosis and giving people with Type 1 diabetes (at any age of onset) life-saving exogenous insulin, the rates of DKA would be much lower.

Hi Jacq: Thanks so much for the work that you are doing. There are several elephants in the room when it comes to Type 1 diabetes, and a big elephant is diabulimia (another is the fact that about 6% of Type 1 diabetics die of hypos). I do think that raising awareness of the issue is so important. I think people fear that if is discussed, then more women (and some men) will do it. Perhaps a risk, but I think awareness is preferable. The bigger issue is the societal problem that says women must be skinny.

Actually, I think that 6% rate is highly inflated. The sources often track back to commonly cited rate of 4% which as far as I can tell has no basis. The DCCT found no statistically significant increase in death in the intensive treatment arm, there was only a single death in both arms that could be attributed to a hypo. And unfortunately, the “best” quality data is on so call Iatrogenic hypoglycemia, which are observed rates of hypo deaths under doctors treatment (in hospitals). And those rates don’t even approach 6%, and we know how terrible hospitals are at insulin regimes. I’d be interested in what you have on the 6% number.

Hi Brian: You could very well be correct that the 6% is inflated. That was the statistic that Bruce Buckingham MD (Stanford pediatric endo) cited at a talk I attended in Santa Clara in 2009. One of Dr. Buckingham’s clinical trial subjects actually died of a hypo in her sleep while she was hooked up to a CGM, so he had that data. I have seen 6% cited other places but have never seen the backup. In the future, I should probably just say “some Type 1s die of hypos.” There is the whole “dead in bed” syndrome.