I thought of you, AR! LOL!
Jeska, Thanks for the feedback and congrats on lowering your A1C. Let me ask you, does it pop off easily as some have shared with me?
Usually i can bring even a stubborn high down after two attempts… But the key for me, as many have said… is am i nauseous, and can I drink/eat… Seriously its amazing how much better one feels after some intravenous fluids and some (insert favorite prescription antiemetic here (rather fond of Zofran myself)… High ketones usually warrants a phone call at the least to the endo but usually they have you dose and wait another 4+ hours…
Like others have said, when it’s just a high, I bring it down at home. When it’s ketones + vomiting and I can’t keep fluids down, the hospital can get IV fluids in me a lot faster and more adequately than I can. I’ve only taken myself to the ER once in that condition (this last January), but I headed off DKA and got 3 bags of saline over the course of a few hours. Without being able to keep water down, I’m sure I couldn’t have gotten that equivalent of fluids any other way.
I am , after 28 years of diagnosis happy to report : never went to ER because my BG is too high and I can’t get it down by adding extra insulin and lots of H2O ( I do get frustrated …another story !) …never had the pukie feelings, or could not eat . Never did the intramuscular injection trick either…I watched Dr. B’s video bsc posted and not sure if I want to go there
If I have an unexplained high, I check ketones. If I don’t have ketones I do a correction bolus. If I have ketones, I change my pump site and correct with an injection. I’ve never had an issue with ketones that wouldn’t go away. If I’m worried I call my doctor, they generally have someone on call that can suggest the best course of action and will tell me if I should head to the ER.
I can usually correct mine with lots of water. By lots of water, at least a 16 oz. bottle every hour. Checking blood glucose every hour and correction insulin about the same. I rarely go low because I am usually ill when I have ketones and high bs. I have Hidrenatis Supportiva, which causes abcesses, therefore infections. Which as we all know equals ketones and high bs. Everytime I have an outbreak, I can expect bs in the 400’s and ketones. A note to anyone who suffers from recurring boils, this may not be just boils but actually Hidrenatis Supportiva. Find a dr. who is willing to look it up.
I got about the same answer a year ago, when I had moderate ketones and >200 BS a whole night. He said, I could go to the hospoital if I didn’t feel secure enough to cope on my own, otherwise he would be fine with letting me go home. So I went to the hospital, which made me feel much safer.
I had BGs of 400 - 600 and up, with small ketones, and couldn’t get them down, and ended up in a stupor, and then in a coma. If my friends hadn’t come looking for me after I didn’t show up for a picnic, I would have been dead by morning. I had visited my endo a week before with a fasting of 302, and A1c of 10.7 (extremely high for me), and liver enzymes in the 100’s (normal is below 40), and in acute kidney failure. And he did NOTHING about it. Needless to say, I now have a new endo, who told me that if I ever go above 300 and can’t get it down, to call him if it’s during the day, or go to the ER. High BG, even without ketones, is serious, and can be life-threatening. It makes sense to try to get it down by yourself first, but if it doesn’t work, and you’re taking insulin, you may not have ketones, but still be in serious trouble. At 600, your blood is like maple syrup, and ALL your systems can begin to shut down, as mine did. My brain was so fried, I had horrible hallucinations for days and days, compounded by the fact that they were using Type 2 protocols on me, and those were inappropriate (the hospital and nursing homes are places where the staff SHOULD know the difference between Type 1 and Type 2, but it’s fairly rare). So it took a month before my BGs were in a place where they felt safe to let me go home. AWFUL!!!
ketones + vomiting = hospital
anything else you should be able to rectify by drinking ungodly amounts of water and taking some extra insulin. they say 50% more fast acting if ketones. but don’t over-correct. drink water every 15 minutes. pee on the ketone stick every hour… if they don’t go away after a few hours you have a problem.
I’ve been in DKA about 6 times in 15 years. You’d know the difference from just some minor ketones. (Your whole body hurts, you’re nauseous or vomiting, you are so exhausted you can’t walk.)
I’m still a newbie so haven’t had to go to the ER. I should have gone prior to diagnosis (large amt ketones and pretty high Bg) but was too stupid to admit I had a problem. The only problem I have is when I get over 250 I feel very irritable and angry and may not understand that I’m having a problem. So far I’ve been able to jab in a few units and BG usually drops right away (very sensitive).
Unless, of course, I’m dumb enough to eat pizza or tempura, but that’s another story!