Am I in DKA?

[Nic71]

Hi all and a HNY

I’ve had diabetes type 2 for about a decade now and my hba1c has fluctuated between 48 and somewhere in the 90s. I’ve regularly taken metformin to hopefully manage this. Mid 2023 it had shot up to 68 so I was put on Jardiance then in September I was out on a bike ride and collapsed after only doing 35 miles. Before this point I’d regularly cycled at least 50 miles on a weekly basis. I was taken to A&E with spiked blood sugar levels, low blood pressure and a high heart rate. These eased off after a few hours but ever since that day I’ve not been able to do any form of exercise without getting really breathless and light headed. Could I potentially have developed Ketoacidosis?

 

[EllieM]

Hi @HNY and welcome to a new year and the DCUK forums.

Diabetic ketoacidosis is a potential side effect of jardiance (empagliflozin). Are you asking whether you had DKA when you were taken to hospital? I would have hoped that the hospital would have diagnosed it if this is the case. Or are you wondering if you go into DKA whenever you exercise???

My understanding is that DKA isn't a chronic condition, it's an acute one, which needs treatment by insulin and intravenous fluids in a hospital unless it's caught very early at home, so it's not a long term condition that you have like diabetes or arthritis. But if you are worried about it you could test your urine or blood for ketones. Here are some links

Diabetic ketoacidosis

Find out about diabetic ketoacidosis (DKA), including what the symptoms are, when to get medical help and how to prevent it.

www.nhs.uk

is the NHS info on DKA.

and this one talks about jardiance and DKA

Side effects of empagliflozin

NHS medicines information on side effects of empagliflozin and what you can do to cope.

www.nhs.uk

Once more, welcome

 

[EllieM]

Oh, and just a heads up that we aren't allowed to diagnose on the forums. We can give you information and personal experiences but if you want an actual diagnosis you need to consult a doctor.

 

[Nic71]

Thank you. Yes, I’m wondering if I do go into DKA when I exercise and do appreciate that this isn’t the forum for any medical diagnosis

 

[AndBreathe]

@Nic71 - what sorts of tests did they do when you were taken to hospital? That would be really useful to know.

Sounds like, if you don't already, perhaps investing in a Freestyle Libre, or such like, could be worthwhile, as that would show what was happening of a full time basis, rather than the snapshots we get from finger prick testing.

In the meantime, if you feel significantly unwell, or unsafe, please call 111 or 999, depending how you are feeling. Better safe than sorry.

 

[Nic71]

@AndBreathe, they did an ecg test as well as constantly monitoring blood pressure and heart beat. They also did a couple of blood tests to check for sugar levels. Don’t know if they checked ketone levels. That was back in September ‘23. Since then I’ve had further blood tests done to check for any deficiencies, blood pressure tested regularly as well as a 24 hour ecg. Also had a lung capacity test done. No issues found in heart or lungs, no deficiencies and not suffering from asthma. Not sure if ketones were checked in A&E but will be contacting my doctor this week to see about getting a ketone check done. I’m also waiting on an appointment with a respiratory specialist as this breathlessness is a daily occurrence

 

[LittleGreyCat]

I would suggest that you get at least some ketone wee sticks to check for excess ketones.
They are cheap and easy to use, if not 100% accurate.
However you are after an indication of too many ketones in your body.

A Freestyle Libre (or other glucose monitor) would be useful to check what your BG is doing when you have these symptoms.
As far as I know DKA is when you have both high BG and high ketones.
However Jardiance can mask the high BG due to the excess glucose being passed in the urine.
This doesn't (as far as I know) cause DKA but it can mask the symptoms i.e. high BG and high ketones at the same time.

Finally, you could just be allergic to the medication.
Has that been considered?

 

[Nic71]

I do occasionally check BG and a fasted reading can be anywhere from 7.5 up to 9.5 so this might imply that my body’s BG isn’t high but then again like you said it could be masked by a high glucose level in the urine

An allergy to jardiance hasn’t been considered though but worth checking

 

[AndBreathe]

@AndBreathe, they did an ecg test as well as constantly monitoring blood pressure and heart beat. They also did a couple of blood tests to check for sugar levels. Don’t know if they checked ketone levels. That was back in September ‘23. Since then I’ve had further blood tests done to check for any deficiencies, blood pressure tested regularly as well as a 24 hour ecg. Also had a lung capacity test done. No issues found in heart or lungs, no deficiencies and not suffering from asthma. Not sure if ketones were checked in A&E but will be contacting my doctor this week to see about getting a ketone check done. I’m also waiting on an appointment with a respiratory specialist as this breathlessness is a daily occurrence

What is your oxygen saturation when you are breathless? What did the blood sugar levels show in hospital?

Whilst DKA is a definite thing, please don't latch onto it too firmly. Please keep an open mind.

 

[Nic71]

Unfortunately I don’t have a wearable sensor that checks oxygen saturation and I can’t remember what blood sugar levels were when I was released from hospital but it was below 10.

Definitely not latching on to DKA but just needing to rule it out

Thanks

 

[KennyA]

This link will take you an NHS page about diabetic ketoacidosis.

Diabetic ketoacidosis

Find out about diabetic ketoacidosis (DKA), including what the symptoms are, when to get medical help and how to prevent it.

www.nhs.uk

 

[jonathan183]

Mid 2023 it had shot up to 68 so I was put on Jardiance then in September I was out on a bike ride and collapsed after only doing 35 miles. Before this point I’d regularly cycled at least 50 miles on a weekly basis. I was taken to A&E with spiked blood sugar levels, low blood pressure and a high heart rate. These eased off after a few hours but ever since that day I’ve not been able to do any form of exercise without getting really breathless and light headed. Could I potentially have developed Ketoacidosis?

dehydration ?

 

[Nic71]

dehydration ?

I drink 1 to 1.5 litres of no added sugar squash each day along with no sugar or milk in my coffee so wouldn’t have thought it was that but it’s possible