Ketoacidosis SKA/eDKA

[RachelK]

Hello I’m non insulin dependant and take no medication. In the past 10 months I’ve been in ketoacidosis twice.

I was wondering is there anyway to manage mild ketoacidosis at home and if not what do you do in the mean time before you can get to hospital to make yourself feel better when you’re too nauseated to eat/drink yet all you can think about is how thirsty you are and how tiring lifting your head is kind of thing?
I’ve tried taking Ondansetron and domperidone for the nausea but it does nothing


The first time it was clearly starvation ketoacidosis; BGL 1.7 blood ketones 7.2

Just under 2 weeks ago I went into ketoacidosis again.
BGL 3.2 in triage Ketones 3.2
But that time round initially the glucose drip brought my ketones almost to normal levels and started to reduce the acidosis so I felt less nauseated and could eat some of the sandwich and juice they gave me however as I went mildly hyper my ketones went back up to 5.9! So they aren’t sure if it was purely SKA since I was also hyper when I first started producing ketones then since I left it so long I went hypo from not eating from the nausea. I was also incredibly dehydrated to the point my kidneys weren’t producing urine in the ED even after 2+L of aggressive fluid resuscitation.

I think I might be going into ketoacidosis again. At first my BGL was high end of normal when I started producing ketones over 1. Now my ketones are sitting between 5.5-6.5, my BGL 2.5 - 5.2.
I don’t want to go to hospital I feel like I’m wasting their time and since I’m skinny they always think I have an eating disorder (I have gastroparesis that makes me underweight).

Sorry I don’t know where I’m going with this but any advice/experiences with ketoacidosis and making the symptoms less awful is much appreciated.

 

[Dark Horse]

Phone 111 and ask for advice.

 

[EllieM]

Now my ketones are sitting between 5.5-6.5, my BGL 2.5 - 5.2.
I don’t want to go to hospital I feel like I’m wasting their time and since I’m skinny they always think I have an eating disorder (I have gastroparesis that makes me underweight).

It sounds like a very difficult situation. Have you been given instructions on how to avoid and treat this condition at home in the future?
My very limited knowledge suggests that you don't want to mess around with ketones that high. If the nausea is making you unable to eat/drink and your ketones are already that high then you can't manage it at home.

As @Dark Horse suggested, why not ring 111 and see what they say. My (admittedly limited) knowledge suggests that they won't blame you for wasting their time if you go in and it doesn't matter what they think about your weight, what is important is that you don't die of DKA. Do you have someone at home to call 999 if you collapse? (If not, then you might need to bypass 111 and go straight to 999).

Good luck

 

[KK123]

I was wondering is there anyway to manage mild ketoacidosis at home

Hi there, I really do feel for you, it sounds horrible. As for the above question though, NO. There is no such thing as 'mild ketoacidosis', the problem is that when it begins it can progress very rapidly into full blown DKA, literally within hours or sooner. The start of the process is your body shutting down (I know this sounds dramatic but this is how it was explained to me when I was in it but had been feeling absolutely fine in the hours before). The hospital said had the GP waited a moment longer to send me to the hospital or sent me home without doing a ketone test, which she nearly did, then the outcome could have been very different. Do not take the risk. I see your circumstances are different to someone on insulin going into DKA of course, but I really would not sit and wait it out.

 

[MrsA2]

It can change very very quickly.
Call 111 now