DKA Type 2?

[Deleted member 391597]

Hi,

I just wanted to know if it was possible to go in to DKA with Type 2 diabetes and if anybody had ever experienced it?

I am being treated as Type 1 at the moment after going in to DKA but I'm still waiting for the antibodies test so was wondering if it could still be possible that I'm Type 2 instead?

 

[Jamesuk9]

Hi Hollie, it's rare in T2 but not impossible....

 

[AndBreathe]

Hi,

I just wanted to know if it was possible to go in to DKA with Type 2 diabetes and if anybody had ever experienced it?

I am being treated as Type 1 at the moment after going in to DKA but I'm still waiting for the antibodies test so was wondering if it could still be possible that I'm Type 2 instead?

It's really unusual for T2 to experience DKA, unless they are taking drugs from the group containing Canagliflozin, dapagliflozin, and empagliflozin, and even then it's a rare complication.

If your bloods were high, and you had significant ketones in your blood, it's more likely you are T1. The result of the antibodies test will help clarify things.

 

[Sarah69]

Im type 2 and have had DKA.

 

[LittleGreyCat]

I think some T2s who "crash and burn" before diagnosis have DKA.

The ones who end up in hospital and go straight onto insulin once stabilised.

DKA is a consequence of a serious failure in BG control and severe hyperglycemia so it isn't dependent on type.

Having said that, it is far more common in T1s.

 

[azure]

Your profile and diagnosis does fit Type 1 @Hollieo4 The antibodies will give you a definite answer and none of us are medically qualified, but I want to say that it's normal to question a Type 1 diagnosis because it seems to come out of nowhere.

I didn't have DKA luckily, and I did wonder many times if I'd been misdiagnosed. I even wondered if I was diabetic at all. But I'm Type 1 and now just get on with things - while looking forward to a cure

 

[ickihun]

I agree with @azure. DKA in a type2 is normally over a period of time. Warning signs for months. Canagliflozin etc meds catch you out like a type1 too thou.
DKA happens in type2s who burn out their beta cells. That's when a specialist will know its happened. Type2s arnt routinely tested for c-peptide levels.

 

[Deleted member 391597]

Thank you all so much for your replies. I've been told mixed things by different doctors, consultants, diabetic nurses etc about DKA in Type 1 and 2 diabetics so wondered if it was possible at all! So my understanding is that to get DKA as a Type 2, you'd pretty much have to run high blood sugars for a while and be symptomatic as a result?

 

[Deleted member 391597]

Im type 2 and have had DKA.

Sorry that you went through this too! It's a horrible experience. Do you mind sharing how this happened to you?

 

[Sarah69]

Not at all. It was several years ago now that it happened. One day I had completely lost my appetite so didnt eat for 3 days. During this time I didnt inject any insulin as my DSN had said if you doent eat you dont need to inject. So I didnt and I didnt have my evening insulin either. Day 3 I started being sick, every half an hour, went to the drs in the afternoon, they thought I had picked up a bug. By about 11/12pm I felt like I couldnt breathe so my son called an ambulance, they came apparantly I was having a painc attack. They managed to calm me down and left. An on call doctor was called to see me who came in the early hours and requested an ambulance to take me to hospital. It wasnt till the next day they confirmed I had DKA, it was due to not having any insulin. I had never heard of it until then. I was in and out of hospital for 2 weeks and it took me 4/6 weeks to get over it.

 

[ickihun]

Not at all. It was several years ago now that it happened. One day I had completely lost my appetite so didnt eat for 3 days. During this time I didnt inject any insulin as my DSN had said if you doent eat you dont need to inject. So I didnt and I didnt have my evening insulin either. Day 3 I started being sick, every half an hour, went to the drs in the afternoon, they thought I had picked up a bug. By about 11/12pm I felt like I couldnt breathe so my son called an ambulance, they came apparantly I was having a painc attack. They managed to calm me down and left. An on call doctor was called to see me who came in the early hours and requested an ambulance to take me to hospital. It wasnt till the next day they confirmed I had DKA, it was due to not having any insulin. I had never heard of it until then. I was in and out of hospital for 2 weeks and it took me 4/6 weeks to get over it.

Are you on a different insulin regime now?

 

[Deleted member 391597]

@Sarah69 so it can happen with Type 2 too then! It's an awful thing to go through, I started panicing when I was struggling to breathe too - that's when my husband took me straight over to a&e. Do you know how high your blood sugars/ketones were? Thanks for sharing!

 

[h884]

Certainly sounds like a very unpleasant experience. I have just been started on canaglifoxin and have been warned about DKA in particular that with this drug it is not always assoc with high blood sugars

 

[donnellysdogs]

Depends if prior to DKA On your foods and lifestyle.
If your diet had beeen jyst full coke and choc and cake for 6 months or even 6 days, then a t2 could easily go dka..

 

[Sarah69]

Are you on a different insulin regime now?

I was on novarapid and lantus, I'm now on Byetta and Lantus.

 

[tim2000s]

In discussion with some of the senior bods of the NHS, one of the things that has changed in the last few years is the number of Type2 patients displaying DKA on admission has been increasing. So yes, it's possible, but I'm not sure of the reasons for the phenomenon, nor have I seen any research into it.

 

[TorqPenderloin]

Not at all. It was several years ago now that it happened. One day I had completely lost my appetite so didnt eat for 3 days. During this time I didnt inject any insulin as my DSN had said if you doent eat you dont need to inject. So I didnt and I didnt have my evening insulin either. Day 3 I started being sick, every half an hour, went to the drs in the afternoon, they thought I had picked up a bug. By about 11/12pm I felt like I couldnt breathe so my son called an ambulance, they came apparantly I was having a painc attack. They managed to calm me down and left. An on call doctor was called to see me who came in the early hours and requested an ambulance to take me to hospital. It wasnt till the next day they confirmed I had DKA, it was due to not having any insulin. I had never heard of it until then. I was in and out of hospital for 2 weeks and it took me 4/6 weeks to get over it.

Do you know if they ever actually measured your ketone levels?

These reason I ask is because there is a condition very similar to DKA with the main difference being the absence of high ketone levels. I've seen it referred to many things, but the term I've always used is "HONK" which I believe stands for Hyper osmolar non-ketotic. It generally affects people who are sick and have an extreme level of insulin resistance (particularly older individuals). In some cases, blood glucose can reach 100 mmol/l (not a typo).

My cousin is an emergency room doctor here in the USA and she said it's extremely common to see people admitted who have it.

 

[Judgeloki]

Yes, I did it,

That's how I found out I had diabetes, my pancreas stopped working and they diagnosed me T1, but after more tests, I am in fact T2.

 

[Deleted member 391597]

Thanks for your reply @Judgeloki. I'm still waiting for an appointment with my consultant and to have blood work done but so far my DSN is assuming I am Type 1 based on DKA and normal bmi...

 

[Mep]

I haven't had DKA but I'm at risk of having DKA as I'm insulin deficient. If I don't take insulin then my sugars will go high. The only time I came close was when I was in hospital with an infection and they found I had high ketones. And yes I agree @ickihun that c-peptide test should really be done more as routine for type 2's as things change. I think it should be done at least every 3 years minimum (I say that as that is how quick I think things changed for me at one point). I've had 3 of the tests since diagnosis.... although I'm sure I had a couple of years where I should've been on insulin when I wasn't. If they're not done, then people could be wasting time on the wrong treatment.... not only that it would be damaging the body.