DKA

[PhilBrown]

Hi

I have type 1 diabetes and was diagnosed 5 years ago. My nurse has been teaching me about blood ketone testing. I'm used to glucose testing but this is new to me. She tells me I am at particular risk of something called DKA when I am ill or if I have not taken my insulin. Frankly it sounds a bit worrying, she assured me that as long as I test if I'm ill and call if I have a certain level than everything will be fine. Has anyone any experience of DKA??

 

[Sarah69]

I have had dka , I can tell you it's the worst thing I've ever experienced in my life. I was non stop throwing up for almost 12 hours. I was in and out of hospital for 2 week and it took about a month after that to get back to nomal!

 

[SophiaW]

DKA or Diabetic Ketoacidosis can be life threatening and must be taken very seriously. The way to know if you're at risk of developing ketoacidosis is by testing the levels of ketones in your blood. Usually if your blood glucose is well controlled and you are well you shouldn't have any problems with ketones and don't need to check. If you become unwell you may start to get ketones in your blood and as the level of ketones increase you start to run the risk of ketoacidosis developing. Ketones usually start to accumulate in the blood when you are unwell and are running high blood glucose levels. The general rule is if you're unwell, check for ketones until you are feeling better and your blood glucose has returned to normal levels. My daughter has been unwell a number of times and even survived swine flu without developing ketoacidosis so try not to worry about it too much, but it is important to test regularly for ketones in you're unwell so that you can get help if ketone levels start to rise too high.

Here is some more information: http://www.dmforum.org.uk/DMF/PDF/blood ... ing_A4.pdf

 

[partlyfallen]

My bf has had it twice now. Both times from not taking insulin when ill. No one explained how to manage illness, so he thought if he wasn't eating he should't take insulin. Glad to hear you've been educated. If you make sure you test regularly you should be able to avoid/detect any problems arising.

 

[Sarah69]

That's how I got dka I lost my appetite didn't eat so I didn't inject I'd never do that now!

 

[TheSparkyPony]

I had DKA 7 times (yes, you read that correctly, 7!!!) last year due to a number of different factors. To be fair, 2 of those were repeated in hospital due to negligent doctors not prescribing me any insulin :shock: but that's another tale!

Experiences I never want to repeat again, really. It leaves you weak and not feeling right for quite a while after the initial occurance. Never mind the abdominal pain, vomiting, dry mouth, dizzy spells, acetone breath etc

SophiaW has written out some fantastic information, and the link is well worth a read. Give DKA a search on here, there are some great threads with advice and resources available for your personal education

 

[Philbrown1]

Thank you very much for your help and advice on DKA, all scary stuff!

 

[jopar]

I'm surprised that it's taken you DSN 5 years to tell you about DKA, how to check and hopefully how to combat it...

And if you were very poorly etc when you were first DX'd then it's probably you were suffering from DKA...

Simple measures such a maitaining good control and reacting quickly with implement sick day rules will help to prevent going into full blown DKA... Once experienced once you are in no rush to experience for a second time..

If you Bg hits 14mmol/l then check for ketones, if you find none then do your normal correction procedure.. How ever if you find some, doesn't matter whether it's on a trace you need to be taking some measure to combat them..

Which is many drink plenty of fluid to keep yourself hydrated and flush out the ketones, with a correction dose to lower you BG, recheck state of play at two hours BG and ketones... Repeat a correction dose if still high.. And you basically keep checking every two hours until they flushed out, if you find your BG is normal but still have traces of ketones, then re check after an hour to ensure that BG's aren't going to go back up..

Problem is with ketones is that we all have different tollerance levels to when they start to kick in, some diaebtic find they start getting them at 14mol/l others will have a much higher tollerance level..

I haven't had DKA since I spent most of my pregnancy in and out of hospital with it several weeks stay at a time, that was 20 years ago and since then I've had a couple of bouts of norvacs virus, flu and Glandler Fever apart from having to implement sick day rules to prevent my BG rocketing out of control, I didn't have any signs of ketones phew. But I will always check and monitor if for any reason my BG hits over 14mmol/l