When blood glucose is normal and there is ketones,you need extra insulin bolus so you need food to raise your blood glucose and then bolus.But usually high ketones cause nausea and vomiting,so you end up with lower blood glucose.The stress of the situation can accelerate progression to DKA.
hi everyone,
thank you for so many responses! the next time (IF!) this ever happens to me, i will probably come back and re-read all your replies. I ended up stuck at my endoās office for most of the day, since when i woke up my bs was 320, i took 13 units of humalog, and by the time i was at her office, i was up to 460 (!!!), with moderate ketones. they gave me more humalog and my morning levemir, and had me drink tons of water, since i was not thrilled with being admitted again. fortunately my numbers finally came down enough for me to go home. (and since my husband is a resident at the hospital, he was able to sneak off and visit me, which was a nice treat).
my dr. said it could be a week or two more before the steroids are out of my system, and increased my insulin to what seems like a ton to meāi am now using a 1:3 ratio for humalog, and 23 units of levemir in the morning and 27 at night (up from what was usually around 1:12 or 15, and 22 units total of levemir!) she wants me to increase the levemir by 2 units every other day at night until i am waking up below 150.
i am still baffled by how much of an impact one shot has had on my system, and hope i wonāt need so much insulin for longā¦
thank you everyone so much for your replies, it is reassuring to read about othersā experiences and know that youāve ended up okay.
best,
alli
Thank you please stay rested and keep as well as you can.
Be loved
Glad you are fine,best wishes Alli.
I ended up with severe DKA while backpacking in the wilderness here in California. My infusion set had come out due to friction between it and my backpack. I did not feel it come out, and with the exertion of hiking did not realize for hours that I had been going on 0 insulin.
I was able to get my blood sugar under control within a couple of hours, but the DKA persisted. When I awoke the next morning I was vomiting everything and had this horrible physical sensation in my chest. My brother helped me hike out about two miles to the car, during which I kept having to stop, vomit, drink more water, and then press on until I had to vomit again and repeat the cycle.
It was not until we were able to get some Gatorade in me that I began to feel better. I probably should have sought medical attention at that point but now I have a better understanding of what DKA does to your body and how unlike mere high blood glucose levels, it canāt be bolused away quickly.