I have had diabetes for 14 years now and normally have little to no issues with high blood sugar unless I am sick. I woke up this morning very nauseated and checked by BS and it was high. I did a bolus correction and repeated this process several times but BS continued to rise. I also checked my urine for ketones and it too was large.
I then called my endo who would normally say go to the ER (I have had DKA 3 times in 14 years) but today he said to take 12 units of insulin via syringe and call back in one hour. While my BS is going down, the urine ketones are still present. He also wants me to come in this afternoon. So, two questions for you - why does he want me to come into the office vs. going to the ER for IV fluids to help flush the ketones out and secondly, will the urine ketones go away on their own if the BS levels go down? Any feedback greatly appreciated.
Yes, the ketones will go away on their own. Drink lots of water to flush your system and stay away from juices or anything else that will raise your BG. Pretty much stay on lots and lots of water for a few hours. The ketones will flush out of your system on their own.
If you go to the ER, doesn’t that cost money? So maybe your endo is trying to save you the trouble and the hassle of going to the ER?
Use your own judgment though. Once, I called my endo, told her my symptoms, she told me to just rest- two hours later I was in Dka. I stopped seeing her after that.
He might be doing it to save you money since the ER does cost an arm and a leg, but I find that unlikely since your health is at risk. Basically if he told you not to go the ER when you should have that makes him partially responsible and faces a malpractice lawsuit. I can’t think of why he would give you that advice without being inside his head. Personally I have had many DKA episodes over the years and never mess around with them. I’m so paranoid about it that I have even gone to the ER with a stomach virus I confused with DKA.
As far as your second question goes Marps is right, the ketones will get flushed out of your body if you drink plenty of fluids (every 30 minutes I believe is the rule). If you can’t keep fluids down however it’s not going to help you any.
I hope you have already changed infusion sets and site, reservoir and insulin. Good luck.
I ended up going to the ER where they gave me two rounds of IV fluids, only checked my BS twice and took labs when I first arrived. They did confirm that I was in the beginning stages of DKA but only gave me 5 units of insulin while I kept my pump on - after 4 hours, they sent me home without repeating labs or checking BS upon discharge. Completely shocking - our healthcare system sucks. As soon as I left, my BS was 225. It was 195 about an hour before they discharged. I feel better because they gave me zophran for the nausea but I am still kinda pissed that they didn’t confirm my DKA was improving before letting me go - wouldn’t you be? Thanks for all the responses.
Hi Rebecca,
I might get rotten tomatoes thrown at me for this but the only way I can get rid of ketones fast is to eat something along with water (in my case it is electrolyte water) and take am injection of insulin. It gives your body something to digest other then itself for fuel like it is doing in pre dka status. I mean small things like beef or chicken broth, string cheese and maybe a single saltine. If your BG is high your might pee out to much salt since sugar pulls salt plus all the water to help hydrate you so a bit is helpful.
Also I have learned I ask what I want form the ER or hospital and that is what is done or I don’t leave. Period. If the don’t want to I ask for the head of the department and then ask him or her to explain why this or that test can’t be done so I am going home safe. Every time they order the test rather then try to explain to me logic that is anything but logical. However because I know everyone in the ER by now this never happens
oh i had unexplained highs for two days this weekend, i kept bolusing but nothing was making it go under 150. so on sunday morning i was just finishing watching a movie and the thought occured to me. “what if the tubing isn’t screwed on tight enough onto the cartridge?” i immediately sat up and unplugged myself from the tubing and checked it out, sure enough it wasn’t on tight enough.
Wow Rebecca - so sorry to hear about what you had to go thru’. Does not sound like fun at all. I’ve never been thru’ what you’ve been thru’ - except for when I was a teenager and pretending I wasn’t a diabetic (ended up in a coma for a few days - got lots of s#$t from my parents - got my head shaved due to knots in my hair - fun, fun, NOT). Do you know what maybe caused your BG’s to rise so much - bad infusion site or ???
