At what point do you class DKA

[Jen&Khaleb]

When do you decide that your child is DKA? Khaleb has been sick since Friday night and I think he has an ear infection. I've kept his blood sugar in good order until 4pm this afternoon when in 2 hours he rose 12mmol and now has ketones of 1.4 (blood measured).

Khaleb is not sympomatic of DKA but the level of ketones is heading that direction. I'm planning on waiting a few hours now he's had a big dose of insulin and some paracetemol and retesting him. I'm hoping he will have a good drink for me also but that may be the decider on where we go from here.

Fingers crossed things come back normal. I'm sure kids always get sick on weekends just to make things extra difficult. I'll be happier if I can get him through the night and see a doctor tomorrow.

 

[SophiaW]

I'm not sure of this Jen but I think it's when they're heading to a ketone reading of 3, but really your best bet is to get in touch with your diabetes nurse for advice as here they do recommend contacting the team when ketones reach 1 or higher. It doesn't necessarily mean hospital admission at that point but it's to get advice and make sure it can be handled at home until/if ketones get worse. Has she given you a mobile number for emergencies? Our nurse has done that, we've never needed to phone on a weekend or out of hours but it's reassuring to know it's there if we ever need the advice. I hope Khaleb gets better soon, hugs xx

 

[leggott]

Hi Jen, I think Sophia has given you some good advice. The only other thing I can think of is to keep his water intake up. Hope he feels better soon. Hugs too. leggott

 

[Jen&Khaleb]

I got his ketones back down to 0.1 and his blood sugar stayed under 10 all night and first thing this morning his bg was 4.6. This seemed all positive but the ketone test was 1.6. He is refusing to drink or eat so I have forced him by syringing sugar water down his throat. Seems cruel but I'm sure it is still better than going to hospital and getting the drip. His ketones are back down to 0.6 and I have an appointment to see his GP at 11.30 this morning. I'll syringe some more fluid into him shortly and hopefully some antibiotics will clear up the infection enough to get him happily eating and drinking.

After already having 3 nights without sleep I don't think I could stand a hospital admission so I'm going to try and keep him in safe levels. I don't know what your hospitals are like but hospitals here are pretty horrid for parents. There isn't even a bathroom and they get reallly mad if you use the patient bathroom. I'm feeling kind of rotten myself and think I'd pass out if I had to go there.

I'll do what is necessary but while we are okay at home I'm going to stay here.

I did think DKA was 3. I can contact the hospital staff and diabetic nurse but they only tell you to bring them in so what is the point.

 

[leggott]

Jen, this certainly does not sound cruel. You are an extremely loving and caring mother. You are doing all that you can and it sounds like it's paid off as Khaleb's levels sound good even without taking Into account he's unwell!

Hope you get some sleep tonight. Leggott.

 

[Jen&Khaleb]

Sometimes I get the feeling that there is something else wrong with Khaleb. He's been so sick and his levels are really hard to control still. I'm going to try and get him back to the GP and get his blood tests done early. His thyroid medication was reduced at my last clinic visit and I just feel it is too low now. Khaleb is really tired and generally just a bit weird. It just seems more than just the common cold. I went in to Khaleb at 10pm to find him very sweaty. I'd done his bsl only the hour before and he was 11mmol and on doing another test he was 6.9 so would say a definite "No" to a hypo. I took his temperature and he was only 35 deg. I think this is a part of the thyroid issue.

I'm feeling pretty pleased that we haven't ended up in hospital or needing an ambulance. I hope things improve. It is Khaleb's birthday on Saturday ... He will be 4!

 

[sugar2]

Jenny, sounds like youare doing a super job in controlling his diabetes,...and I am another one who hates doing things like feeding a child who won't drink..but you have to be cruel to be kind...the alternative is worse. Hope teh GP can rush his bloods through...as it does sound like you are dealing with a few thing (diabetes, cold etc etc) all at once. Khaleb is a lucky little boy to have you!