Stress and DKA?

Hi All, we are having a bad blood sugar week in the wake of a very stressful time for my daughter. she has had a really bad week of bullying, online and in person by a girl at her dance class, and we are battling DKA today, over 500 blood sugars for now 12 hours. Shots pump changes, doubling her insulin pretty much, and unable to get it down. Our endo has us heading to ER if it doesn't come down in the next couple of hours..

The past two days have been really bad with this situation with this other kid and this morning I just took her off her phone altogether...

In two years of having this I have never seen anything like this, escalating does and escalating doses and depite massive corrections blood sugar not coming down.

What effects of stress have others seen? Kennedy's teacher said the only time of her 30 some odd years of type one that she was admitted for DKA was stress related.

What about everyone else?

Wish us luck!

I've seen some "redline" stress, a couple of times, sometimes after encounters w/ my 14 year old but I've never really had anything that didn't respond to insulin or a walk or site changes. I suspect that your daughter's situation is much more difficult and sounds horribly unpleasant. I know my daughter *utterly* flips out when we ground her from her phone so that may, if anything, exacerbate the situation although I totally agree with that sort of approach.

Generally, when I'm having issues like higher BG than I want, I'll also crank up my basal rate to 200% of normal (basically doubling it...) and sort of let that ride until I perceive my BG start to drop on the CGM. This can get a bit dicey but I think sometimes being upset or stressed out can interfere with insulin absorption and the "extra" seems to help me with that. I'm not sure though that your endo would agree and I don't recall running into a 500 since I've had a pump and am not 100% sure how long it might take to get that down. I also like walking to boost shots. For something like this, it might clear her head. I know a lot of times exercise will be counterindicated but if I'm running high, I'll walk the dog to help get the insulin going faster too. I'm sorry I don't have experience with your particular situation but I hope that things on all fronts clear up soon!

I've actually never had this happen.
Granted, I have had those "high" days where I wake up in the 170's and struggle with getting my BG's in the low 100's for the entire day. That, in and of itself, stresses me out which, coincidentally, seems to make it go higher. But when I calm myself down then that is when the insulin starts doing its thing. This maybe stress related.
However, definitely get her to the ER if it does not come down soon.

thanks all!! Took astronomical doses of insulin, but she is down now to 120 yea!! I was sweating there for a bit, her doc says stress plus hormones probably, but he says we have made major changes to settings so he wants to leave things there for a few days and see where we are!!

Yay, glad you got it down, Natalie and I'm really sorry about the bullying; it sounds horrible. I hope you get some help in putting a stop to that situation.

When I was 12, I had a low blood sugar at a theatrical rehearsal.. I just got tired and crawled up on a rolling stage platform in a very dark corner, and slept/passed out. The woman in charge had known me for 5-6 (I was about 6 when I started with her) years, knew I had a health condition, but when I was found she demanded my mom remove me from her activities.

REALLY BAD MOVE!! My mom went ballistic (it was 1964) and called everyone--park service, supervisors, the theatre board members, the mayor--she fought!!! She stopped all the misunderstanding by standing up for me. I ended up working with that group, doing my college internship, and becoming a lifelong friend of the woman who my mom took the time to educate.

It had a major impact on my life. She stood behind me and vanquished those who stood in my way. Over 50 years later, I am still thankful for her courage.

wow that is so great!! I feel like the more I do in this situation the worse it gets!! The parents think I make too big a deal of the diabetes and that I am trying to focus attention on her... , we will just do our best to sell our t shirts and see if this family shows up... ha ha

Hi Natalie,

My blood glucose levels run high when I'm very stressed or sick. If I'm having a good day with BGLs below 170 mg/mL, then I can expect highs up to 350 mg/mL when I'm stressed or extremely emotionally taxed. I have a few questions for you about her daily routine, if you don't mind answering them. Does your daughter regularly sleep uninterrupted for more than 7 hours a night (preferably 8-9 hours)?

Have there been any changes to her diet that might exacerbate already high blood sugar levels due to stress? I've noticed that I experience highs around 400 mg/mL or higher when I eat gluten and dairy protien. The highs are long lasting and do not decrease when I dose twice or more for one instance of carb intake containing gluten or dairy. The symptoms consist of highs for up to 48 hours from one incident of gluten or dairy consupmtion. I have a dietician and a health professional that mentioned that ther ehave been several studies that have shown that removing gluten and/ or dairy from a diabetics diet can result in much more stable blood sugar levels. They recommended the Paleo diet and it has changed my life. Now, instead of fluctuations between 500 mg/mL and 40 mg/mL daily, I experience fluctuations between 70 mg/mL and 170 mg/mL on most days.

It is also possible that she may be experiencing highs due to hormonal changes, though that would of course depend on what age she is.

Are there any changes at all in her life other than the bullying that might be affecting her levels?

I'd suggest having her drink lots of water (a minimum of 40 oz. per 100 mg/mL she is over her target) to help the insulin circulate thruogh her blood. it is possible that some of the insulin has not come into contact with the pancreas yet because the blood is so viscous.

I hope that some of this is helpful. I hope that her blood sugar levels decrease soon. Good luck with everything. Please let me know if I can be of any help.

The parents need to STFU I think. We haven't had too many encounters with parents and the kid but that's a line that's inappropriate to cross. Not to mention, if they say *anything* about her diabetes, I believe they'd be in violation of her civil rights and I'd jump all over them about that. One of my buddies used to do those sort of cases and the problem is that they tend not to be worth huge amounts of money but, for the principle of the thing, I would certainly rattle that sword in my scabbard. Particularly if they have any assets. Intentional acts are rarely covered by insurance companies and I would think that it would be almost impossible to argue that running your yap about a 14 year old with a disease is not intentional so they'd be paying their own way. I'm not following the "tshirt" link or whatever but I would defend my kid by whatever means are necessary.

That's a great story Spock! I didn't know it at the time but my mom went to bat for me when I was dx'ed. I had been "behind" for driver's ed, because I was very young for my class, and missed the first week or two of class being in the hospital (or maybe it was a couple weeks into dx date....) so the teacher, who was *really* strict, like comically so, was going to boot me out of the class but my mom took care of it. I had no idea until like 20 years later when it came up in a conversation about something or other. It's great to have cool parents but much harder to be one...

oh just kennedy's tshirts we are selling for our jdrf walk coming up in sept.

I should at the very least write the parents a letter so they understand that the actions of their kid have led to my child having to switch schools and quit an extracurricular activity that she loves. I should at least do that much...

If there's online bullying, you could notify the organization, FB, twitter, etc. and perhaps they shut down or at least tell the kid to cease and desist. I think that many communities are considering these kinds of things to be civil rights violations and perhaps you can sue the kid and/ or parents for something. It may sound kind of extreme but I think the ADA has lawyers who may be able to advise you of your civil rights. There was a pretty interesting story about parents taking action to protect kids from school administrators in a recent DF magazine. This is a bit different but perhaps you'd have a case.