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Question on Euglycemic DKA

Discussion in 'Diabetes Complications' started by AlexJD, Nov 4, 2017.

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  1. AlexJD

    AlexJD Type 1 · Member

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    Good morning team

    Quick question on a type of DKA: does anyone have any information, experience or reliable sources of information on Euglycemic DKA? (which is mentioned on the DKA page of diabetes.co.uk, but I can't seem to find any substantial info online on this)

    As a way of background, I am a 30 years-old male and diagnosed with type 1 about three months ago. I've always had medical food-related issues before so I had, fortunately or unfortunately, little difficulty in adapting to new eating habits. I've briefly tried the low carb diet after being diagnosed, and am currently on a keto diet. As many T1D and T2D will have experienced before me, this is proving remarkable to manage diabetes as my BG is very stable around the 4.5-5.0 mark, I am losing weight steadily and have no hypo or hypers. I suspect I am now entering the honeymoon period, but prior to this I was on no fast-acting insulin and on 9 or less units of Lantus a day.

    I am acutely aware that the key thing to look out for for T1D on a keto diet is BG to avoid DKAs. However yesterday the consultant on my medical team said he did not "believe" in the keto diet, without supporting this with any evidence, which really was a bummer for me because that diet has been so good for me. As a result I am taking a belt and braces approach on my precautions and doubling up on the research I had already done. I stumbled upon this Euglycemic DKA concept and would really appreciate any insight.

    I could not find anything specifically on this on the forum, but please feel free to point me in this direction if you're aware of any discussion on that topic.

    Thanks all

    Alex
     
  2. robert72

    robert72 Type 1 · Well-Known Member

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    Hi @AlexJD

    Euglycemic DKA is usually associated with starvation or alcoholism. You are unlikely to get it from following a keto diet. Sorry I don't have any sources but that might help your search.
     
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  3. catapillar

    catapillar Type 1 · Well-Known Member

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    Euglycaemic DKA is basically a complication risk for those taking SGLT2 inhibitors. These drugs are an oral medication for type 2 diabetes (although they can be off licence prescribed to type 1s) they work by making your kidneys pee out excess sugar so keep blood sugar levels down, but if you don't have enough insulin then the blood sugar being down won't stop your body trying to get fuel from your body fat and making ketones when trying to burn it, which will turn your blood acidic.

    If you aren't taking SGLT2 inhibitors, you don't need to worry about euglycaemic DKA. I think it can also happen when severely dehydrated.

    If you are low carbing and in ketosis then you don't have DKA. The presence of ketones and the presence of diabetic ketoacidosis are two entirely different things. You will have nutritional ketones. These are different from ketones caused by a lack of insulin. And you tell the difference by checking your blood sugar.
     
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  4. AlexJD

    AlexJD Type 1 · Member

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    Thanks both, that’s really helpful!
     
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