Returning Veteran

[Patrick1969]

Hi All,

I've been a T2 diabetic for 21 years and am often amazed that I'm still mostly functioning after such a long time - my health is generally above average for my age. I've also been a member of the forum for many years too, but fell out of posting a long time ago as life tends to do its thing.

The reason I'm back is because I recently ended up in hospital for a week with DKA. It was my first real reminder that diabetes is a very serious condition that long term veterans like myself can become quite complacent with as we get used to living with the condition. Apart from the obvious horrible physical issues that DKA caused, the psychological impact for me is that I was doing everything right but still became very ill. I was taking my medication, eating at appropriate times, limiting alcohol and 'treats' and even weight training at the gym in an effort to improve my overall strength and fitness. I'm even back to mountain walking, something that life events and work responsibilities had mostly ended.

With DKA, diabetes gave me no warning and showed no mercy. Thankfully, intensive care in hospital and an additional three weeks off work have meant a pretty good recovery.

I'm back in the forum to stay in touch, to find out more, and to share my own knowledge and experience.

Have any of you experienced this traumatic condition (DKA)?

Best wishes,
Patrick.

 

[EllieM]

Hi @Patrick1969 and welcome back. It's quite common for T1s (often occurs at diagnosis) but I was diagnosed very early by a T1 mum (who had DKA on her diagnosis) so haven't (yet) had it, though as I'm now on an insulin pump I'm now more at risk. But as a T1 I've always been aware of DKA as a potential issue and get prescribed ketone testing strips so I can easily check for it if my bg goes high. (And I do recognise the symptoms).

My understanding is that DKA is caused by lack of insulin, so tends to be less of an issue for newish T2s because they produce plenty of insulin. Can I ask whether you were already on insulin before you got the DKA? I'd naively hope that all insulin users got given ketone testing strips but realise that that may be optimistic.

I am glad you are feeling better now and agree that it is worth making other T2s aware of the issue.

 

[Patrick1969]

Hi @Patrick1969 and welcome back. It's quite common for T1s (often occurs at diagnosis) but I was diagnosed very early by a T1 mum (who had DKA on her diagnosis) so haven't (yet) had it, though as I'm now on an insulin pump I'm now more at risk. But as a T1 I've always been aware of DKA as a potential issue and get prescribed ketone testing strips so I can easily check for it if my bg goes high. (And I do recognise the symptoms).

My understanding is that DKA is caused by lack of insulin, so tends to be less of an issue for newish T2s because they produce plenty of insulin. Can I ask whether you were already on insulin before you got the DKA? I'd naively hope that all insulin users got given ketone testing strips but realise that that may be optimistic.

I am glad you are feeling better now and agree that it is worth making other T2s aware of the issue.

Hi Ellie,

I've had a very tough time getting consistent care which means my history of treatment is quite complex. Too many NHS departments meddling, no regular GP contact meaning that I often have to re-tell my history to new specialists that I meet. Until last year I'd been on insulin having worked my way over the years through pretty much all of the available medications (all of which caused me side-effects or hypos). I managed on insulin for a good few years with the help of Libre monitors, but had difficulties getting doses right. In May this year I was admitted to hospital due to high blood pressure (still an issue) and the diabetes consultant decided to put me on Semaglutide and Dapagliflozin, instead of insulin as my control was random at best. I initially welcomed the decision thinking that a return to tablets would be easier but straight away I started to have quite extreme reactions to Semaglutide - this drug played a big part in my DKA experience, effectively causing gastritis on top of everything else. Now I'm back on insulin and have been ultra-disciplined with my dosages and timings, and I feel pretty good physically though tiredness is a real issue presumably due to the physical shock. I also now have ketone strips so I can test if my levels skyrocket for any reason. I've definitley started to make other T2's I know aware of the potential risk. It was a big shock for me and a recognition that none of us are indestructible.

 

[septua]

Euglycaemic DKA can occur with normal or only slightly raised blood glucose levels when taking dapagliflozin. Hopefully you are aware that a very low carb diet is inadvisable on this drug.

 

[Patrick1969]

Euglycaemic DKA can occur with normal or only slightly raised blood glucose levels when taking dapagliflozin. Hopefully you are aware that a very low carb diet is inadvisable on this drug.

Thankfully I'm only on insulin and statins again. I can't cope with fancy drugs, they always seem to break me in some way. Could have been an issue though, as I was focussed on protein based meals after vigorous exercise the day before, and I most certainly didn't have a carb heavy meal the day I became ill. Appreciate your feedback.