DKA?? Advice

jillsymes66

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I have been on keto for 8 weeks and my blood sugar levels have been perfect and ketone sticks say between 1.5 and 4. I have had a cold which had almost gone but last night I began to feel so awful. Vomiting, shivers and a bad headache. My sugar levels are between 7 & 8 but my ketones have shot up to 16 with the stick going dark purple immediately. I can't keep anything down and am taking 1 unit of insulin when my b/m goes over 7.9. I think DKA is with high BM levels too isn't it. Any advice would be good. Thanks
 

diamondnostril

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Hi @jillsymes66 ...

The attached picture is a clipping from "The Ketogenic Diet" by Lyle McDonald. I have used the Keto diet for around 5 years now, and I find this book very useful to refer to.

As you can see, you are not close to DKA by any of the markers that you have mentioned. Remember that DKA can only happen in the absence of Insulin.

If you are injecting Insulin to try to keep your blood-sugar under control, then DKA is not possible. Insulin inhibits the creation of Ketones. If you are injecting enough Insulin to keep your blood-sugar anywhere near normal, then Ketones cannot get out of control.

Sorry that you are feeling so bad. Of course you are doing the right thing by monitoring your blood-sugar and trying to keep it near to normal. The very act of doing that will prevent DKA.

Best Wishes :)
Antony
 

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jillsymes66

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Hi @jillsymes66 ...

The attached picture is a clipping from "The Ketogenic Diet" by Lyle McDonald. I have used the Keto diet for around 5 years now, and I find this book very useful to refer to.

As you can see, you are not close to DKA by any of the markers that you have mentioned. Remember that DKA can only happen in the absence of Insulin.

If you are injecting Insulin to try to keep your blood-sugar under control, then DKA is not possible. Insulin inhibits the creation of Ketones. If you are injecting enough Insulin to keep your blood-sugar anywhere near normal, then Ketones cannot get out of control.

Sorry that you are feeling so bad. Of course you are doing the right thing by monitoring your blood-sugar and trying to keep it near to normal. The very act of doing that will prevent DKA.

Best Wishes :)
Antony
Thank you Antony that has put my mind at rest.
 

Scott-C

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I have been on keto for 8 weeks and my blood sugar levels have been perfect and ketone sticks say between 1.5 and 4. I have had a cold which had almost gone but last night I began to feel so awful. Vomiting, shivers and a bad headache. My sugar levels are between 7 & 8 but my ketones have shot up to 16 with the stick going dark purple immediately. I can't keep anything down and am taking 1 unit of insulin when my b/m goes over 7.9. I think DKA is with high BM levels too isn't it. Any advice would be good. Thanks

I would consult doctors immediately if I were you.

Although dka usually involves both high ketones and high bg, there is also a rarer form called euglycemic dka where, for a variety of reasons a person can be dangerously dka but bg is normal.

The article in the link below explains the reasons why this can come about, but I'd seriously consider leaving reading it till later, after you have obtained advice from doctors first.

www.ncbi.nlm.nih.gov/pmc/articles/PMC4488998/
 

diamondnostril

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Hi @Scott-C ...

I saw on another thread your opinion that I had posted "irresponsibly" on this thread.

Just to be clear, the reassurance that I gave to @jillsymes66 on this thread was not solely "because she didn't have high bg" as you stated.

My reassurance that she does not have DKA was based on the fact that she did not report ANY of the symptoms required for a diagnosis of DKA. She was injecting Insulin, she was keeping blood-sugars near-normal, and crucially her Ketone levels were not high enough for a DKA diagnosis.

When somebody does not show ANY of the symptoms required for a DKA diagnosis, reassuring them that they do not have DKA seems reasonable. Otherwise we all have to spend our entire lives at the hospital, getting checked (and re-checked, and re-checked, and re-checked) for every emergency condition we are not showing symptoms of.

Hopefully that clarifies my position.

Regards :)
Antony
 
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KK123

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I really do not know how ANYONE on a social media site can give someone reassurance that they are ok and not ill or even dangerously ill based on a snap shot of a post. It's one thing on advising to eat bacon instead of bread for example but when someone is telling us they have ketones of 16????? You might not be showing any other symptoms at the time of posting but DKA can develop very, very quickly. 5 minutes later you might well be getting other symptoms. Same with anything, eg blood poisoning, you can appear fine one minute and near death the next. I know this post is old btw. Seeing a Doctor is also about them then being able to monitor you, whether in a hospital or not. When I was pregnant I had symptoms that COULD have turned into pre eclampsia, they never did but they kept me in the hospital to monitor and to be able to act swiftly if need be.
 

Scott-C

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Hi @Scott-C ...

I saw on another thread your opinion that I had posted "irresponsibly" on this thread.

Just to be clear, the reassurance that I gave to @jillsymes66 on this thread was not solely "because she didn't have high bg" as you stated.

My reassurance that she does not have DKA was based on the fact that she did not report ANY of the symptoms required for a diagnosis of DKA. She was injecting Insulin, she was keeping blood-sugars near-normal, and crucially her Ketone levels were not high enough for a DKA diagnosis.

When somebody does not show ANY of the symptoms required for a DKA diagnosis, reassuring them that they do not have DKA seems reasonable. Otherwise we all have to spend our entire lives at the hospital, getting checked (and re-checked, and re-checked, and re-checked) for every emergency condition we are not showing symptoms of.

Hopefully that clarifies my position.

Regards :)
Antony


In fairness, the OP at post #1 reported, "vomiting, shivers".

That caught my eye as the notes about Case 1 in the linked article mentions, "Her symptoms were associated with chills, nausea, and just one episode of emesis."

So, vomiting, chills, shivers, continuing to take insulin, they had that in common, which, taken together with the fasting, and a substantial increase in ketones by a factor of 4 from 1.5/ 4 to 16 had alarm bells ringing. There was just so many parallels that I felt more caution was required.
 

jillsymes66

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Update:. Turns out I had a kidney infection and after a few days of IV antibiotics and fluids I am fine. Thanks for all your advice everyone.
 

diamondnostril

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I really do not know how ANYONE on a social media site can give someone reassurance that they are ok and not ill or even dangerously ill based on a snap shot of a post. It's one thing on advising to eat bacon instead of bread for example but when someone is telling us they have ketones of 16????? You might not be showing any other symptoms at the time of posting but DKA can develop very, very quickly. 5 minutes later you might well be getting other symptoms. Same with anything, eg blood poisoning, you can appear fine one minute and near death the next. I know this post is old btw. Seeing a Doctor is also about them then being able to monitor you, whether in a hospital or not. When I was pregnant I had symptoms that COULD have turned into pre eclampsia, they never did but they kept me in the hospital to monitor and to be able to act swiftly if need be.
In fairness, the OP at post #1 reported, "vomiting, shivers".

That caught my eye as the notes about Case 1 in the linked article mentions, "Her symptoms were associated with chills, nausea, and just one episode of emesis."

So, vomiting, chills, shivers, continuing to take insulin, they had that in common, which, taken together with the fasting, and a substantial increase in ketones by a factor of 4 from 1.5/ 4 to 16 had alarm bells ringing. There was just so many parallels that I felt more caution was required.

Lesson humbly learned ... Apologies to all ... :sorry:

Regards :)
Antony
 

Scott-C

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Messages
2,474
Type of diabetes
Type 1
Lesson humbly learned ... Apologies to all ... :sorry:

Regards :)
Antony

It's all good, Antony. To be honest, I'd never heard of edka until about six months ago. I don't think a lot of doctors know about it either. Heck, some don't even know that much about dka! I was taken to hospital many years ago with all the classic pre-dx T1 symptoms (t'were no internet back then so couldn't google them), doc in A&E dx'd "exam stress" and sent me home! Got taken back the next day unconscious which kinda convinced them... The junior doc apparently got an absolute b*llocking from the consultant.