Type 1 DKA advice

[Gill1990]

Hi I’m not sure how to post something on here for help and advice my partner is type 1 Diabetic and was diagnosed 3 years ago. It’s been a big learning curve for us and I meticulously keep reading this forum to see how others cope with the illness so I can try and help him. As you can imagine getting this news in your late 20’s didn’t bode well for him and he rejected the reality of it for a number of months before he would listen to anyone.

2 weeks ago we were all unwell with a viral infection but he was vomiting and couldn’t eat so he didn’t inject his insulin which resulted in him going into ketoacidosis within 3 days, vomit was black couldn’t move so luckily we got an ambulance and he was hospitalised for 4 days with over 14 litres of fluid pushed through him in drips, potassium etc. It was the scariest thing but also a big big reality check in that we need more education on this condition.

The issue is now is that he is signed off work (he works in demolition so burns a lot of energy in one day) and after he came out of hospital he has been very unsteady on his feet, looks like he is drunk although his bloods are hitting around 8.9-13.2 throughout the day. He seems to be high when just waking up but during the night he is staggering around to get to the toilet and is completely unaware he is awake.

I’m asking for advice on if this is normal or not. I understand the severity of DKA now and grateful that is he still alive at this point after our ignorance of diabetes so please be kind with comments as I would appreciate advice on anything I can do to support him.

 

[Daphne917]

Hi @Gill1990 welcome to the forum. I’m T2 diet controlled so cannot help or advise you but I’ll tag some T1s who hopefully can such as @therower, @Robinredbreast, @Juicyj, @porl69 and @Jaylee.

 

[novorapidboi26]

I think after a trauma like a DKA, especially one as severe as the one your partner had, its perfectly normal for his body to need to time to recover and settle down.....

His muscles and brain were starved of energy during that time......

I have every confidence he will recover fully in time....

What I would say is that his insulin must be given at all times, even during illness and times were he cant eat normally.....this brings me on to the next point about the insulin he takes...

What kind is it?

A multiple daily injection regime is best in this case, so a separate long acting insulin and a quicker ones for meals...

 

[Jaylee]

Hi I’m not sure how to post something on here for help and advice my partner is type 1 Diabetic and was diagnosed 3 years ago. It’s been a big learning curve for us and I meticulously keep reading this forum to see how others cope with the illness so I can try and help him. As you can imagine getting this news in your late 20’s didn’t bode well for him and he rejected the reality of it for a number of months before he would listen to anyone.

2 weeks ago we were all unwell with a viral infection but he was vomiting and couldn’t eat so he didn’t inject his insulin which resulted in him going into ketoacidosis within 3 days, vomit was black couldn’t move so luckily we got an ambulance and he was hospitalised for 4 days with over 14 litres of fluid pushed through him in drips, potassium etc. It was the scariest thing but also a big big reality check in that we need more education on this condition.

The issue is now is that he is signed off work (he works in demolition so burns a lot of energy in one day) and after he came out of hospital he has been very unsteady on his feet, looks like he is drunk although his bloods are hitting around 8.9-13.2 throughout the day. He seems to be high when just waking up but during the night he is staggering around to get to the toilet and is completely unaware he is awake.

I’m asking for advice on if this is normal or not. I understand the severity of DKA now and grateful that is he still alive at this point after our ignorance of diabetes so please be kind with comments as I would appreciate advice on anything I can do to support him.

Hi @Gill1990 ,

Welcome to the forum.

Sounds worrying. Your chap could still be weak from the viral infection coupled with the DKA episode.
You should never stop taking the basal insulin whilst Ill.

I was pretty much going to ask the same question as @novorapidboi26 . What insulins is your partner prescribed?

I agree with a little more learning, your partner will be empowered to tackle this head on.

 

[Juicyj]

Hello @Gill1990 What a terrifying time for you both, being close to death can bring with it a harsh reality check. Can I check what support you are getting from his team here ?

Getting his life back to normal will require work and vigilance in checking levels at least 7-8 times a day and administering insulin when required, it takes some work yes but all of this does become second nature in time, embracing the care required to ensure this can happen is vital too, as soon as you take your eye off the care then it all slips rapidly and ending up in hospital is something none of us wants. His team may offer him the libre sensor which will help with testing at work but without doing finger prick tests too, speak to his team to see if he can get access ?

He would do well to join up here himself, we have t1's from all corners of the globe and from all types of industries, including a T1 airline pilot, speaking to others and realising he's not alone and getting support and education is vital. Get him a copy of 'Think like a pancreas' it's good to start learning as much as he can as knowledge is power.

 

[porl69]

Hi @Gill1990 and welcome to the forum. WOW, sounds like the pair of you have gone thru the mill with this episode of DKA. As previously said the infection and effects of the DKA couild still be causing your fella problems. Are you and your other half in contact with his diabetic team at all? May be worth giving them a call and let them know what is happening with your fella. Think like a pancreas is a very good book to get as Juicyj has mentioned.
What insulin regime is he on??

 

[Gill1990]

I think after a trauma like a DKA, especially one as severe as the one your partner had, its perfectly normal for his body to need to time to recover and settle down.....

His muscles and brain were starved of energy during that time......

I have every confidence he will recover fully in time....

What I would say is that his insulin must be given at all times, even during illness and times were he cant eat normally.....this brings me on to the next point about the insulin he takes...

What kind is it?

A multiple daily injection regime is best in this case, so a separate long acting insulin and a quicker ones for meals...

Hi,

Thank you for your reply. It has definitely given us food for thought for when he becomes unwell again!

He is on novorapid and levemir (sorry about spelling) and I can’t remember which one is the long acting and fast acting but he injects long acting twice per day and the other 4 times per day. We don’t count carbs so I think he needs to go on the course to learn how to do that.

We have his diabetes consultant app a week today so I’m going with him to make sure they understand the severity of his lack of understanding and hopefully get the help he needs!

many thanks,
Gillian

 

[novorapidboi26]

Spelled correctly.....

Yeah, so the Levemir is long and Novorapid short......if no carbs are being eaten then you can stop the Novorapid but must always take the Levemir as normal.....

A course sounds great.....good luck....

 

[Gill1990]

Hi @Gill1990 welcome to the forum. I’m T2 diet controlled so cannot help or advise you but I’ll tag some T1s who hopefully can such as @therower, @Robinredbreast, @Juicyj, @porl69 and @Jaylee.

thank you so much!

 

[Gill1990]

Spelled correctly.....

Yeah, so the Levemir is long and Novorapid short......if no carbs are being eaten then you can stop the Novorapid but must always take the Levemir as normal.....

A course sounds great.....good luck....

he eats a lot of carbs to be honest because his line of work is so vigorous. He lost 4 stone in weight when diagnosed and whenever he stops working during shut downs his weight drops dramatically it’s so hard to try and balance it but thanks for the advice. This forum is invaluable I read a lot but never really posted

 

[Gill1990]

Hi @Gill1990 and welcome to the forum. WOW, sounds like the pair of you have gone thru the mill with this episode of DKA. As previously said the infection and effects of the DKA couild still be causing your fella problems. Are you and your other half in contact with his diabetic team at all? May be worth giving them a call and let them know what is happening with your fella. Think like a pancreas is a very good book to get as Juicyj has mentioned.
What insulin regime is he on??

Yeah it’s been a total eye opener to say the least! He was struck off for a while because he kept going to work and thinking work is more important but after a stern word and being hospitalised he has had a reality check and thankfully the diabetic nurse in hospital referred him back so we have an app next Monday which I will be in attendance to ensure everything is being taken on board.

I will get that book I love reading, him not so much but I’m the one cooking meals etc so I can relay important points to him to help him understand. The worry I have is we have a 7 year old daughter and we want him to have the best quality of life that he can have but it also comes down to accountability on his part aswell as mine as a support mechanism!
Thank you for taking the time to reply to my post it’s greatly appreciated. X

 

[Robinredbreast]

Hi I’m not sure how to post something on here for help and advice my partner is type 1 Diabetic and was diagnosed 3 years ago. It’s been a big learning curve for us and I meticulously keep reading this forum to see how others cope with the illness so I can try and help him. As you can imagine getting this news in your late 20’s didn’t bode well for him and he rejected the reality of it for a number of months before he would listen to anyone.

2 weeks ago we were all unwell with a viral infection but he was vomiting and couldn’t eat so he didn’t inject his insulin which resulted in him going into ketoacidosis within 3 days, vomit was black couldn’t move so luckily we got an ambulance and he was hospitalised for 4 days with over 14 litres of fluid pushed through him in drips, potassium etc. It was the scariest thing but also a big big reality check in that we need more education on this condition.

The issue is now is that he is signed off work (he works in demolition so burns a lot of energy in one day) and after he came out of hospital he has been very unsteady on his feet, looks like he is drunk although his bloods are hitting around 8.9-13.2 throughout the day. He seems to be high when just waking up but during the night he is staggering around to get to the toilet and is completely unaware he is awake.

I’m asking for advice on if this is normal or not. I understand the severity of DKA now and grateful that is he still alive at this point after our ignorance of diabetes so please be kind with comments as I would appreciate advice on anything I can do to support him.

Hi, so sorry to read of your partner being so poorly. Sometimes it can take awhile for the body to heal, and recover, if it takes weeks and weeks, then so be it.
Just continue to support him and if you or your partner are concerned that things aren't 'right', then get in touch with your GP asap.
I do hope he makes a full recovery very soon.
Take care.

 

[therower]

@Gill1990 . Welcome to the forum.
I can’t really offer much more than all the great posts so far.
I think you and hopefully your partner are now realising how T1 can’t be ignored.
I was 27 when diagnosed, worked in a builders merchants ( very heavy work back then ) and also spent 2/3 hrs a day working out. What I’d give to have that energy nowadays .
Looking back I believe the one thing that got me through everything was the fact that I accepted my diagnosis from day one.
Almost had a sense of pride with being T1 and being able lead the life I was. Wasn’t always plain sailing but fortunately never went DKA but did end up in hospital a few times after hypos.
For me having a positive attitude and embracing being T1 is the only approach to living life as a T1.
“ Get the T- shirt and wear it with pride “ Diabetes thrives in dark places , don’t hide it away.

 

[Daibell]

Hi. A severe DKA can take quite along time to recover from so he will need to take it carefully. Do learn about carb-counting from a course, your consultant or come back here for clarification. Make sure your partner has enough proteins and fats to provide a range of nutrients and some of his glucose needs. If he is having too many carbs his weight will go up so this will be one measure but it sounds like he will need more than many of us due to the type of work.

 

[Mad76]

Hi there,
Just wanted to welcome you and wish you the best of luck.
I'll leave the advice to the more experienced members, I've only been diagnosed a year and had a pretty bad DKA myself too.
Keep asking and reading on here. Advice is great.

100percent never dont take long acting insulin. This is also what I was told upon discharge after my dka