High risk for dka?

Type 1 and LADA
#1

Does anyone ells here have a high chance for DKA?

I clearly have a problem. last year I had my first dka ever (in 12 diabetic years) - but since, I’ve been on high alert. and now had my second one in less then a year - but i have also gone to the er for fluids to prevent actually going into another dka.

This time it took a little over 2 days and i was out - since we caught it right in the beginning.

But since i get migraines that make me throw up - i’m always running a risk of dehydration.

can anyone ells relate? :confused:

#2

I’ve never been in DKA but was close at diagnosis. I think since I was a slow onset as an adult, I lucked out in that way.

I understand that it’s the loss of active insulin that triggers DKA, with subsequent dehydration as a complication. Is there something that threatens your consistent delivery of insulin? Are you on MDI or a pump?

#3

Yes if I do not have any insulin in my body I will start developing DK
Why are you going into DK?
Are you skipping or forgeting your insulin?

#4

After 41 years I have never had DKA. I was not even close before DX. In many ways that comes form growing up around a t1D and having a good sense of what to avoid and what to do about it. it is not a perfect way to avoid DKA, but except for one week in June 1974, I have never been close.

#5

I would try to make sure that you get a good treatment plan in place for your migraines if that is the main cause of your dka events. Are there other reasons or is it just from being dehydrated? Usually you need very low or non existent insulin levels to go into dka. Maybe you need to increase insulin doses when you have a migraine? Maybe you can try to drink more water if you don’t drink a lot now or some other drinks to help prevent the dehydration from happening when you get a migraine.

The only time I have been close to it again since my diagnosis was when I had inset failures and I had 0 insulin, my bg shot up very fast, but fortunately I got it down quickly with injections and water.

I had one episode where I was vomiting from a virus or something but my bg was dropping- I was on mdi then and I had plenty of long acting on board. Being on a pump is much worse for risk of dka because once you have no iob and no basal flow, you really have zero insulin.

#6

When i hit migraines it’s a long event - that makes me throw up. Mostly i drink and take extra insulin and monitor very closely. (before the cgms i would test every 40 mins when throwing up).

For some reason right after throwing up - me ketones start showing up. I guess it’s the stress levels going up.

For the most part - it’s enough. but as soon as i start, even a little - to throw up water - i go to the er. they gave me fluids and i’m home with a few hours. not going into dka. I just don’t take a chance.

1 Like
#7

Are you taking any type of preventative for migraines? I take 100mg of Topamax 2xday to avoid them. I also have imitrex as a backup.

Sarah :four_leaf_clover:

#8

I’m trying to find something. topamax was so bad for me… tried and i had side effects as soon as i started it… it was so bad for me. :confused:

#9

the only times i have had dka was when i was first dx and then once in college when i was “partying” w/ alcohol. ( i just wanted to fit in, and i don’t recommend this) i couldn’t stop vomiting and even though i couldn’t hold down water, i kept on drinking it. but then vomiting was so bad that i called an ambulance and went to the hospital for some IV fluids. i was out by the afternoon. i used to get migraines frequently, even before Imitrex came out. i would take Fiorinal and it helped a bit. then when Imitrex came out i started w/ that. it worked like a charm ,and i didn’t get those nasty “rebound” headaches.also, the vomiting stopped completely. Phew. otherwise, sit in a dark room w/ sunglasses on and a wet towel over your eyes.

#10

Never had DKA. Been diabetic since sometime (years) before dx in 1978. My highest that I know of was roughly 500. I didn’t feel too well. :slight_smile:

#11

Sounds horrible. I have had migraines for years on and off but no vomiting. I get a lot of other neurological symptoms as well as the runs and mania. When a pain killer won’t knock it out I take imitrex, that is the only thing that will get rid of a bad one. I have also used beta blockers to prevent them. I’m not sure if you want to try a long term prevention med- maybe there are some new ones out now. Are you on a pump or mdi? Sorry if you mentioned this already.

#12

Imitrex can be a godsend for folks with migraines. Thankfully, I’ve not had migraine headaches–I only get ocular migraines, and those don’t hurt at all.

#13

@Kittywolf, you might consider asking your D and neuro teams about utilizing any/all of these options:

• An anti-emetic – e.g. Zofran (sublingual and suppositories are available)
• Mini-dosing glucagon – FMI >> http://www.hamiltonhealthsciences.ca/documents/Patient%20Education/GlucagonMiniDose-lw.pdf
• Apidra for mealtime boluses – taken at the beginning of your meal (versus prebolusing) – or even postmeal SubQ.