Don't understand DKA.

[Riverside]

As you can see from the list of questions below, I don't have a clue

To begin:

# Is it possible to get DKA when my number is ok?
# What is the difference between having Ketones from not eating (dietary?) and DKA?
# How do I know my Ketones are bad ones related to my T1D and not just normal ones occuring from low food intake?
# How do I know whether i'm feeling the symptons of DKA or just plain ILL?
# What on earth are 'sick day rules'?

Riv

Note - my control is mighty so what i'm mainly keen to learn about is if it's possible to get DKA in spite of a good number and, DKA during sickness.

 

[phoenix]

# Is it possible to get DKA when my number is ok?
rare but it is possible if you are vomitting and/or have diarrhoea
# What is the difference between having Ketones from not eating (dietary?) and DKA?
there is fundamentally no difference but if you have insufficient insulin (perhaps because of an infection etc) the ketones can develop quickly. Small ketones are not a problem, larger ones are.
# How do I know my Ketones are bad ones related to my T1D and not just normal ones occuring from low food intake?
If your blood glucose is over 14mmol/l or if you are ill, test for ketones
You test using either a ketone urine strip or if you have an Optimum exceed monitor you can test for them in your blood.If ketones in urine are negative or small then drink water and take a correction dose if necessary, as advised by your medical team
If ketones are moderate to large, drink lots of water and contact your team for advice, taking extra rapid insulin as advised ( or better still ask them what to do in advance[/)
Continue to check glucose every 2 hours.
# How do I know whether i'm feeling the symptons of DKA or just plain ILL?
symptoms are like those you may have experienced before diagnosis
steadily rising blood sugars (usually over a 24–48-hour period)
thirst
passing large amounts of urine
tiredness and weakness
nausea and vomiting
abdominal pain
blurred vision
laboured breathing
# What on earth are 'sick day rules'?
Basically keep taking the basal insulin,
Check glucose frequently.
drink plenty of fluids
if you can't eat replace solid food with alternatives such as soup, cereals, milk, ice cream, jelly or yoghurt, use rapid insulin for carbs as necessary
if your glucose levels are falling sip sugary drinks
if they are rising test for ketones as above and give approriate correction doses.

Riv

Note - my control is mighty so what i'm mainly keen to learn about is if it's possible to get DKA in spite of a good number and, DKA during sickness
Unfortunately yes, infections, illnesses can raise the need for insulin, ketones develop quickly when there is insufficient circulating insulin in the body.
Having said that knowing what to do can go a long way to prevent it, particularly in adults (ketones develop even more rapidly in children)

 

[Riverside]

Thanks Phoenix, very good of you.

My mind's a lot more at ease now regarding this.

 

[AndyS]

Hi Phoenix,

Just wanted to say that was an excellent post

Thanks

Andy