DKA help

[morethanmutts]

Hi I’ve been diabetic for 22 years and I’ve never had DKA . I’ve got bad flu at the minute and my blood sugar s are all over the place jut done my ketones and they are a 3 and I fill like **** not sure if it the flu or something else

 

[glavesr]

Try searching online for the diabetic sick day rules or DAFNE sick day rules that will explain better then I could I had my fair share of DKA and these have always helped and they what my dsn always tell me to do

 

[Juicyj]

Hi I’ve been diabetic for 22 years and I’ve never had DKA . I’ve got bad flu at the minute and my blood sugar s are all over the place jut done my ketones and they are a 3 and I fill like **** not sure if it the flu or something else

What your BG levels like ?

 

[morethanmutts]

What your BG levels like ?

18 at the min

 

[TheBigNewt]

See if you can get a serum chemistry panel done (Chem 14) and see what the serum bicarbonate is. In DKA it's pretty low.

 

[Juicyj]

18 at the min

OK DAFNE sick day rules are:

If bg is over 13mmol/l and ketones are “moderate” or “large”
Calculate the total insulin (basal and bolus) in the previous 24 hours, calculate 20 per cent of that.
Bolus: take equivalent of 20 per cent of that daily total every 2 hours
Plus normal bolus ratio for anything you eat.
Maintain usual basal doses
Monitor bg and ketones 2 hourly.
Have 100ml of sugar-free liquids per hour.

When bg drops below 10mmol/l AND ketones are negative or trace:
Eat/drink 10-20g carb
Use normal bolus ratios
Use normal basal dose.
Monitor bg and ketones 2-4 hourly.

General notes:
During illness, if you are vomiting you don’t need to eat until you feel well enough to do so, but try to keep sipping fluids.

If you continue to vomit, cannot keep fluids down and/or cannot reduce your blood glucose or ketone levels (or if you are unsure what to do) call your GP, diabetes team or hospital as an emergency.