Oldvatr
Expert
- Messages
- 8,453
- Type of diabetes
- Type 2
- Treatment type
- Tablets (oral)
This study discusses other triggers that may be relevant. we must take on board that SGLT-2 medications are now being prescribed as a prophylactic to those at higher risk of cardio event, and this may include T1D in the future. There is also the possibility that weight loss injections may also trigger these events because they also increase glucagon levels and have reported occurrences of gastroparesis. I note that bariatric surgery is also a risk factor.As a T1 I've ;always been told that DKA was caused by insufficient insulin and that high bgs and ketones were a marker. (Admittedly, my consultant was horrified when I told her a few years ago that I'd never really tested for ketones, and promptly gave me a glucometer that could test for them. (And I haven't had a DKA in 53 years of T1, don't know if that is luck or not).
So, assuming no other meds than insulin, is a T1 actually more likely to go into euDKA than a non diabetic? (Assuming that a T1 is injecting insulin to maintain their bgs and therefore presumably not low on the stuff)
Non-medication causes of euDKA appear to be starvation, pregnancy or a weird metabolosm.. I'm not sure whether a T1 is more likely to have any of those than a non diabetic?
So, users of low carb / keto diets who are insulin dependant should also be aware of possibility of euDKA , but I doubt if that message is being dispensed. It seems it is not.
The SGLT-2 experience in T2D shows that controlling to a low level of bgl can allow gluconeogenesis from ketones to reach euDKA levels and not the higher DKA levels but enough to turn the blood acidic. This same mechanism could apply to T1D. I have seen warnings from an SGLT-2 study on euDKA from it that they suggest that controlling below 7 mmol.l does increase the risk of euDKA, which is why Low Carb is contraindicated for those meds.