I have a 16 y/o son that is a type 1 and won't take his shots. Any ideas on how long before he might become DKA?
myste - I'm so sorry for your troubles. I've never been in DKA so I can't speak from experience. I've always been warned by medical professionals that being on a pump means I need to be extra vigilant about infusion set occlusions and bent cannulas. They said that DKA can come on in a matter of hours but I'm sure that depends on many factors specific to your son, such as whether his pancreas makes any insulin at all. This is not unusual for T1Ds that are recently diagnosed.
I fear that you have larger problems to address with your son and I won't intrude beyond your stated request. I can tell you that persons with diabetes are twice as likely than the general population to suffer from depression. Others here will have more specific knowledge of DKA. You've come to a good place. I wish you the best!
Thank you Terry my son was diagnosed 19 months ago and isn't on a pump. he takes 4 shots a day.
I was diagnosed at twelve and stopped taking insulin and metformin at 16 due to insurance issues. I am 24 now and just started taking care of my diabetes last year. I never had any complications but I think it is different with everyone. Whenever I refused my doctor would suggest taking me to a dialysis center to see what could happen. Maybe you could try that. Sorry for not answering your actual question, I just wanted to let you know that it's not always bad.
Myste, I have never been in DKA either. It is rather uncommon these days because of the quality of modern insulin. Of course if he is not using his insulin that will do little good. I suggest a different approach than you may have thought of. I was diagnosed at 17 I hated diabetes and frankly I went on a binge for two years that was close to killing me before I got it under control. Then I had long term issues that lasted for over 20 years.
Given that background, I suggest you get him into therapy quickly. Teenage diabetics are especially at risk for difficult circumstances and perhaps seeking professional help might help. My best advice is to find a competent therapist and psychiatrist to both help him with depression (likely a drug therapy) and sort out his issues with insulin and diabetes.
Frankly talking about his feelings may turn the tide. It did with me but I was older when I started seeing a therapist. Folks may not need therapy long and a good therapist will lead the conversation as far as they can.
I know this is an awful feeling for a parent, and I am sorry. Please let us know what happens and let me know if I can help out in some way.
Rick
Hi Myste,
I think it varies with each person when they may go into dka. DKA happens when you have no insulin production left or very little, it can also happen when you're ill or stressed. I think once you have gone into dka the first time naturally from running out of insulin, you are likely to go into it more quickly the next time provided you have very little or no natural insulin production left. It will be slower on mdi/shots if he is on a basal insulin because that stays in your system longer, people who have pump failures and tangled tubing etc. can go very rapidly to high bg and dka. As Terry said if you haven't been in dka, and you still have some natural insulin production it could be a lot longer but the dangers of very high bg are still there and they're still going to cause damage and eventually death even if they don't cause rapid dka.
I was in dka at diagnosis(adult onset) and it is truly horrible- it isn't something you ever want to experience, show your son my comments here. I was very ill. I was in an icu unit for 4 days, then I was released with a dvt in my leg and multiple blood clots. I was back for 4 more days. While in dka I had multiple serious complications and my vision went totally blurry, it hasn't completely recovered although it improved a great deal. While most people do survive dka now, provided they get treatment, it is still a life threatening and precarious condition to be in which you do want to avoid at all costs. Anything can happen while you're in dka.
I'm sorry he isn't taking his shots and I hope you figure out a way to get him to start treating his D properly again soon. I hope he will be one of the lucky ones who doesn't go to dka and that he will be more at ease with everything soon. I think some counseling is a good idea if you haven't tried that.
I was in DKA about 12 years after my dx. My wife and I had split up, and I was seriously broke. I had enough money to either buy insulin or buy beer. I chose beer.
Within 24 hours after I took my last shot - I was on NPH/R regimen then - I got deathly ill. I somehow drove myself to the hospital and was in ICU for about 4 days while they stabilized my BGs, and then another week on the floor while my electrolytes got straightened out.
It sounds like your son is recently diagnosed and is still honeymooning. Get some ketostix and make him pee on them. When he starts showing large amounts of ketones, he's going to need help. He will be shocked at how much better he'll feel when he gets insulin.
This is a life-threatening situation, but your son will be begging for help if he does go into DKA.
As an aside to Meeee: This is the first I've heard of a DVT (deep venous thrombosis - a very large and deep blood clot) at dx, but it makes a lot of sense. I wonder why I've not seen it mentioned before.
Tom
I was told that in the absence of insulin, it takes about 2 hours for ketones to develop, and a day or two for full-fledged DKA to hit. How long has he gone without? If he has skipped just a day, and you can find a way to convince him to take at least his long-acting insulin, then you can keep him from developing DKA. If he won't take ANY insulin, he'll need to go to the hospital inside of 48-72 hours for treatment — fluids (he'll be dehydrated) electrolytes and insulin.
I've only seen DKA once, when my little guy was diagnosed, but it is not at all pretty. If you can get him to at least take his long-acting shot, you can spare him the dangers of DKA. If he won't even do that, though... it may be that he needs to experience just how awful it feels to get the message. I would, however, keep a very close eye on him and restrict his movements so that when he gets to where he needs medical intervention, you can get him to it fast.
Hi Myste:
So sorry that you and your Son are going through this tough and dangerous experience. I know teenagers are difficult to guide sometimes. Your Son is probably still producing a little Insulin since he was dxd. recently. Normally, a Diabetic is in DKA when their blood glucose is 240 mg/dl(13.3 mmol/l) and over
I was dxd. at age 3 and went into a DKA Coma at age 18. The timing differs with each Diabetic somewhat due to circumstances. I had forgotten to take my Insulin before rushing off to work. I ate the forbidden Mc's for lunch since someone had offered to buy our lunches. We didn't know about low carb and I hadn't realized that I had forgotten my Insulin. At that time, I took 2 shots a day and never took my Insulin with me anywhere since that was the way were were raised. There was also only urine testing back then, so the Clinitest and tubes also stayed at my apartment.
It took about 36 hours for me to be in a DKA Coma. The Doctors told my Parents that I wasn't going to make it. The next day, I surprisingly came out of the Coma with my Boyfriend(Hubby now) sitting beside my bed with his hand over mine. The Dr. caught me walking in the hall later. He asked how I was feeling and commented that I was a Very lucky Girl.
I do hope and pray that your Son comes around and follows your wise suggestions. As mentioned by these knowledgeable Friends above me, he needs to go to a medical facility for treatment ASAP. Hopefully he isn't consuming high carb foods. You could have some low carb foods(veggies, etc)around for him to munch on instead(if he still has an appetite).
http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm
In the long run, perhaps you could find a Friend(s) for him with Diabetes who has similar interests and who has accepted their Diabetes and understands how this disease works. Someone who is positive, around the same age with this condition can be quite motivating, especially with a teenager who has many questions and worries about Life.
You are both in my thoughts and prayers. Good Luck!
I doubt he'd go more than a couple of days with no shots before he'd start having DKA, I don't think it takes very long.
You might be able to stave it off with a super low (like no...) carb diet, as that's what they used to do back in the pre-insulin days. If you look up Elizabeth Hughes, she lasted almost 4 years but was in pretty grim shape. She was affluent and her parents correctly understood that they were racing against time as they knew that scientists were close to discovering how to manufacture injected insulin and she was c. 400 calories/ day, no fat, etc. She survived until Banting was able to provide the insulin and lived until the mid-1980s. I think she was like an ambassador to the USSR at one point.
She recounted getting in "big trouble" for filching a piece of turkey skin or something like that in one account. I don't know too many teenaged boys that have the discipline or the inclination to do 400 cal/ day.
I didn't mind shots too much when I was DX'ed at 16 although I was into punk rock, etc.
Thanks everyone He worries me alot because he has seen DKA before. Almost 2 years ago i went into DKA was in ICU 7 days 3 days in coma. He was diagnosed shortly after I was released 2 weeks.
He sounds depressed. Maybe he needs someone to talk to. Other than his parents.
For me dka starts fast if my pump tubing comes out and I don’t notice. About an hour and I’m feeling symptoms. Dka makes me feel so sick that I avoid it at all costs. It takes many hours to rebound. And I have to take up to double the insulin in order to make it through the next day. I guess that since you had it, one here needs to tell how dangerous it is.
I hope you get him some help fast. He could slip into coma and never come out.
At some point he has to take over responsibility for his disease. May as we’ll be now.
Hi gigem99, I read about this and found out that dvt is listed, on some sites at least, as one of the many possible complications of dka- for several reasons: 1- when you're in advanced dka you're severely dehydrated, 2- If you're in the ICU etc. you're also immobilized, 3- dka causes chemical changes in the cells/blood/reactions which make it more likely to form a clot 4- pwd are 2x more likely than others to form a clot in any situation where a clot can form ie: surgery, planes/cars/dehydration & immobilization. I believe there were a few factors that contributed to my dvt including one of the other complications I had. One of my superficial clots was caused by the nurses and others trying 3x unsuccessfully to put another iv line in.
I recommend asking to be anti-coagulated if you're going to have surgery or be immobilized etc. to prevent dvt, provided you don't have major bleeding risks.
YW...I'm really surprised with your history that he isn't more afraid of this- I hope he is ok.
i'm not certain how 'uncommon DKA is these days". it doesn't matter if one is using older insulins or newer ones...if a type 1 doesn't take their insulin, they'll go DKA...if one's pump gets messed up...they can easily go DKA and quickly. DKA when diagnosed I would imagine is still common, as much as type 1 is 'common'.