Signs of dka?

Never had DKA before and unsure what to do;

Started with stomach cramps and lots of burping and farting all day yesterday.

Today I was up from 4am to 8am plus going almost constant diarrhea. Almost threw up twice.

Dexcom says 176

Wife says no fruity breath

Very week and just want to sleep but I can’t because every time I go lay down another round hits me.

Been burping sulfur taste and smell 12 hours plus. Lots of stomach churning.

Was able to eat normal foods yesterday but no energy.

Took anti diarrhea med about 4 hours ago.

Wife gave me beneful with mio energy drops about 30 min ago in an 8 oz glass of water.

Should I have my son go get me ketostix? Never used them before and have never needed them.

I hate to go to the er unless I have no choice.

Ideas?

Sorry for any type os. Typing on my phone sux.

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Does your insurance have a 24hr nurse you can call or an urgent care nearby?

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Have you done any fingersticks? Are you on MDI or a pump? If you’re on a pump, I’d give any correction doses via a syringe. I’d also preemptively change the infusion site regardless of its age.

If you’re on MDI, when did you last take your long-acting insulin? Is it possible that you forgot that dose?

Start keeping some hand-written notes as to insulin delivered doses, size and timing.

Ensuring sufficient hydration is a precaution without any downside. Yeah, a ketone measurement would help here. A blood ketone system would be a plus at this point. If your urine ketones were clearly high, I’d definitely go to the ER. If you are in DKA, timeliness of treatment is critical.

While this episode may turn out to be a garden variety virus, you’re right to keep your suspicion high regarding DKA. Good luck! Please keep us posted.

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OMG, Brad. You guys really think this is DKA? I’m not sure. I think it might be stomach flu.

You gotta check ketones, though, just to be sure. Send the kid to the store.

Hang in there, Brad. This sounds terrible.

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@Terry4, I would expect him to be thirsty if this was DKA. Like, complaints about how much he was drinking and peeing. Would you?

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@mohe0001 – Yes, increased thirst would be another sign of DKA.

@BradP, are you taking any SGLT-2 inhibitor class drugs? These drugs lead to urinating out “excess sugar” at a much lower than usual level. They’re also known to lead to euglycemic DKA, or DKA at normal glucose levels.

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Some excellent advice here.
Every person with IDDM should have ketone testing available.
While glucose would usually be much higher than you are seeing, “Glyptin” drugs can give false reassurance. “Check ketones when ill” is a good plan.

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Took 20 more units of nova log via pen when I typed the above and I’m back in the good zone a few hours later at 104 abs dropping actually so May need to take a tab or two if I go much lower.

Now it is 10 09 my time and back on the toilet. More diarrhea and no energy. Extremely thirsty but my stomach also is churning and aching so unsure if I could keep it down.

Every time I call the nurse line they basically plug in symptoms into a computer and tell me to go to the ER so I wanted some non medical peoples advice if what to watch for. Really don’t want to go to the er unless no choice. Copay is $250 abs a bunch of sick people do I’d be there all day on a Saturday.

You don’t think this could be a breakthrough of COVID19 do you?

I also get the chills off and on.

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That sulphur burp thing rings all too true with the stomach virus that’s been going through my area.

DKA feels like every single cell in your body is doing a painful death… Because that’s exactly what is happening. You get an the usual hyperglycemia symptoms, like thirst, lethargy, and frequent urination, but then it ramps up more into misery.
Muscles stop working and lock up.
It hurts to breathe. While yes, vomiting usually comes with it, there aren’t really any other GI symptoms. The vomiting is just a desperate attempt for your body to purge the toxins.

You should at least have urinalysis strips on hand anyway, though. Even type 2s can develop DKA, it’s just more rare. And all bets are off when we’re sick, since you’re already in metabolic distress.

I haven’t been in DKA since I had a wicked kidney infection in college, but I still do a dipstick anytime I feel off. It’s massive peace if mind for me, and helps me be proactive before a little bit of ketones becomes too much ketones.

I hope you feel better, soon! Remember that dehydration is brutal killer. If you can’t keep fluids down, don’t hesitate to go get IV fluids. Better safe than sorry.

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There are lots of viruses going around. My son and I have one now. Extreme fatigue and he had a bit of a stomach problem, not like you though. I am having bouts of horrible heartburn.

I try to keep exercising and I need much more insulin or I will shoot up to 220+ which is really odd for me.

I don’t know about DKA since I have never had it unless I had it in 1959 when I was first dx and almost comatose.

When I am ill I never think of ketones etc. I do think about Covid though. Today my son feels good again.

Glad to hear that your glucose levels are back where they should be. Hope that you get more relief soon.

Certainly wouldn’t hurt to test ketones.

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11:33 update

G6 says101 and steady.
Son is out getting ketostyks or however you spell it along with chicken noodle soup and saltines.
Body is aching
Stomach churning and feels like bad acid reflux.
Body a bit achy all over,
Slight headache
But I think I’m going to live,
I can keep posting updates throughout the day if you guys want, especially once I do the ketosticks.

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So sorry to hear you sick.
I really dont think it’s DKA though. When I have it. I know it
It’s awful feeling. Weird. Sugars over 300 for a long period.
I could take 20 units and has almost no effect.
This was many years ago for me. This was before looping and I would always have some ketones in my urine.
I stopped seeing a reason to check them.
The symptoms of dka come on so strong, there is usually no need for checking them.

I kind of thought if you are on long acting insulin it won’t occur, but maybe in some cases.

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Another possibility is bad insulin. Did you start a new bottle that may have been exposed to high heat??

Did your last injection come from new/different pen??

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Just did a ketostyx test and registered between the lowest and next to lowest so not DKA! Yay!

I think my pancreeas is more dead than it was when diagnosed. I had a bowl of chicken noodle soup with veggies and maybe 3 handfuls of oyster crackers and forgot to bolus and I shot up fron the 130s to nearly 300 before I caught it and bolused 20 units. Now I’m down to 194.

6 to 12 months ago I would have gone to 200 or low 200s.

My endo, when diagnosed, said my pancreas was mostly dead and barely functioned so he would be treating me exactly like a type I with insulin.

I’m on a pump but use so much that I bolus via pen so I don’t have to change the omnipod as often,If I did both it would be 24 hours or less. Now its 48 hours or just over.
Novolog in my Omnipod and Fiasp via pen.

Thanks eveyone for your help.

I bet your insulin needs are higher because you are ill. I am using much more insulin because I have a virus. It is frustrating but normal. I just keep giving injections.

Glad that your ketones are normal!

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I wonder if you ever considered using metformin with your pod to bring down your insulin needs.

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Glad to hear it sounds like you are doing better.Remember DKA is caused by lack of insulin. not by a high BG level.

So fluids and insulin are a key to preventing it.

If you don’t make insulin, DKA can always be an issue if you lack insulin or I guess enough insulin. A T2 still making insulin can get sort of a form of DKA that is actually worse than what a T1 gets, but it’s rarer. And then some diabetic drugs can cause issues too.

https://www.ncbi.nlm.nih.gov/books/NBK482142/?

I am curious…I believe you are a T2? But were you ever tested for T1? It sounds odd that your endo would say your pancreas was almost dead when you were diagnosed. Sure some T2’s pancreas eventually lose the ability to make insulin, but I believe that takes a long time to happen. It can eventually wear out. Less than 6% of T2’s lack producing a normal amount of insulin. And I know it’s theorized that some of those people might actually have been T1’s misdiagnosed.

And just because antibody tests are negative, the lack of the pancreas being able to make insulin is usually what makes you a T! initially, not a T2. And you can be a T1 with insulin resistance.

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My first endo said I was type 2 but never tested me for type 1. We tried all kinds of drugs including metformin but nothing worked. We even tried Victoza which helped some but not enough so he put me on a pump and cgm but sliding scale abs wouldn’t train me at all on how to set it.

When I went to a taking control of your diabetes conference I met my now current endo who taught as everyone there says that it is my diabetes and I should know how to control it.

My new doc ran the standard type 1 tests and my peptides were like statistically zero but nothing showed up an the standard antibodies tests. He said there were other more expensive tests he could run to confirm type 1 but why bother as the treatment would be the same - insulin. his records have me coded type 1 for easier for supplies etc.

Hope this all makes sense.

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Earlier this year I suffered with similar symptoms and ended up in the emergency room where I was diagnosed with microscopic colitis. I was prescribed several meds but also Metamucil - two tablets before breakfast and two before dinner.

I had one friend w/ chronic illness who got covid pretty early on while working at the hospital and had almost entirely gastrointestinal symptoms. He had no trouble breathing. He was sick as a dog.

Could be common flu. Did you get your seasonal flu shot yet?

Have you checked your temperature? If your fever hits 103, you ought to go in.