Belfast schoolgirl almost dies of diabetic condition

[Northerner]

The family of a 15-year-old Co Antrim girl who could have died after being stricken by a dangerous diabetic condition are calling for more awareness over the threat posed by the disease.

Alex McKnight's mum Gayle Doherty (36) thought her sporty, otherwise healthy daughter, was simply suffering from a stomach bug when she began drinking large quantities of water and vomiting.

However, on February 16 the Belfast Royal Academy student was rushed to the Royal Victoria Hospital with diabetic ketoacidosis (DKA), a complication faced by diabetics that occurs when the body starts running out of insulin.

The disorder causes harmful substances - ketones - to build up in the body, which can be life-threatening if not spotted and treated quickly.

https://www.belfasttelegraph.co.uk/...most-dies-of-diabetic-condition-36641676.html

DKA is HORRIBLE 😱 I had it at diagnosis, and came close again a few years later Hopefully, this story will raise more awareness.

 

[Matt Cycle]

These stories crop up occasionally. Thankfully in this case the girl is ok but there have been other stories where the child hasn't been so lucky. I had DKA at diagnosis too but as T1 is relatively rare it's not always obvious what is going on leading up to it for the person involved (stupidity and denial in my case 🙄) and as GP's see very little of it they don't always diagnose it straight away. (In this case it appears they had issues with the bg monitor when she first saw them).

 

[Flower]

Thank goodness she got medical help in the nick of time.

It is so alarming how quickly you deteriorate when in DKA, I went from poorly but alert to desperately ill very quickly. Terrifying

 

[Sally71]

When I initially took my daughter to the doctor he didn't think she could have diabetes because she wasn't showing signs of DKA! I knew what the symptoms of diabetes are but still took a while to take her to the doctor because I thought I was being neurotic at first Luckily the doctor did have the sense to agree to send my daughter for tests, unfortunately he thought it had to be a fasting test (correct for diagnosing T2 but not T1) and by the time we'd waited a few days for an available slot first thing in the morning, and then were called back the next day for the result, she was going into DKA and could barely stand up, never mind walk, my hubby had to carry her into the GP surgery and then into hospital. The diabetes consultant said if we'd waited one more day she would have been in a coma, and then in intensive care 😱

The DSN did comment that most GPs only see type 2 as that is far and away the most common type, and may never get to diagnose a new case of type 1, so they tend to base all their diabetes knowledge on type 2. They said they were trying to change things but obviously weren't succeeding. Certainly there should be more awareness of DKA and how quickly it can progress, it really shocked me how quickly my daughter went downhill at the end, you could see her getting sicker almost by the minute. If I'd known more about that at the time I might have stamped my feet a bit at the GPs to get them to deal with it more urgently (and I might also have taken her there sooner in the first place )

 

[Northerner]

The DSN did comment that most GPs only see type 2 as that is far and away the most common type, and may never get to diagnose a new case of type 1, so they tend to base all their diabetes knowledge on type 2.

Nevertheless, if their knowledge is largely based on Type 2 they should be aware that the incidence of Type 2 in children is incredibly rare - at least in this country - that maybe taking the Type 2 route of tests is the wrong route and more investigation (perhaps also a bit of googling?) should be done first. I appreciate Type 1 is relatively rare, but they should be aware it exists and if diabetes is considered a possibility see if the symptoms apply to Type 1. In an adult I would agree that misdiagnosis is far more excusable as it may look like either type in the beginning as onset is slower generally.

 

[Sally71]

He knew it was type 1, my daughter was only just 6 at the time - but didn't seem to realise that the method of confirming the diagnosis might be different. To be fair he did request lots of other tests too, e.g. full blood count, so he was quite thorough, but the only one which came back abnormal was the blood sugar level of 18! When we were called back the next day he looked like he'd had a bigger shock than I had, especially when he saw how far she had deteriorated in the intervening few days. He said he should do another fasting test to confirm the diagnosis (also correct T2 procedure) but luckily he used his common sense and didn't do that, just referred her straight to hospital, as it was glaringly obvious by then that she was very ill indeed.

The DSNs said he should have just done a finger prick at the first appointment and then referred her straight to hospital for further testing if it was anywhere above normal. He did one straight away when we were called back and it was off the scale, just said HI (what a friendly meter!). He had done a urine test at the first appointment which was apparently normal, nobody can believe that because it was only 5 days later that she got a fasting reading of 18 and one more day after that when she got +33 on the finger prick and urine now full of sugar and ketones!

The doctor admitted that he initially thought I was being a neurotic mum, especially when the urine test was apparently normal, and had wanted to just send us home - luckily he realised that he wouldn't be doing his job properly if he didn't check out that particular set of symptoms, but I could tell when he referred us for the blood test that he thought it was a waste of time and that everything would come back normal. When we went back he kept saying "I'm so sorry, I didn't want it to be true" and looked like he was sweating a bit, as if he realised that he had come very close to making a potentially life threatening mistake! So I hope he learnt something at least . But in general I think there should be much more education among both GPs and the general population, about the signs of T1 and the speed at which you can deteriorate once DKA starts, and the fact that it can occur at any age! T1 is also on the increase, nobody knows why

 

[Northerner]

So I hope he learnt something at least

Sounds like he definitely learned a lesson there! I guess it's human nature that doctors can be influenced by what they have observed in others - I have often read the 'just another neurotic mum' statement - but hopefully this will have persuaded him to put those preconceptions aside when assessing patients after this.

I think the awareness of the differences in Type 1 and 2 has been continually undermined by conflating the two into one and making it an issue of bad diet and lack of exercise - this is the only message that is getting through to people in general I can understand that the aim is trying to get people to act to prevent large numbers of them being diagnosed with Type 2, but I often wonder just how successful that message is? Just how many people actually take the message on board and seriously apply themselves, or do the majority of people simply believe it doesn't apply to them and will never happen - until they get a diagnosis?

 

[mikeyB]

I was quite the opposite- my mum was type 1 from when I was four years old, so what I didn’t know about Type 1 was just topped up at med school. I grew up thinking there was only one type.