DKA...

[riche1972]

hi everyone, my husband is type 2 and insulin dependent, however he's presenting with type 1.
On fri morning, he became really ill, he had diabetic ketoacidosis, his ketones were registering at 6.2, has anyone else got any experience of this, any ideas of recovering times etc would be really appreciated

 

[SB2015]

There are a number of people on here who, because they are adults, are assumed to be T2 but were in fact T1. However there are also a number of that were diagnosed with T1 as adults in my case at 53.

DKA would indicate that T1 is more likely. Is he in hospital? Is he under the care of the hospital team. Keep asking about T1. It is very possible. If he is at home and has ketones of that level, go to the hospital now.

 

[Northerner]

hi everyone, my husband is type 2 and insulin dependent, however he's presenting with type 1.
On fri morning, he became really ill, he had diabetic ketoacidosis, his ketones were registering at 6.2, has anyone else got any experience of this, any ideas of recovering times etc would be really appreciated

Hi riche1972, very sorry to hear this, DKA is truly awful How long has he been diagnosed, is it a recent diagnosis, and therefore possibly a misdiagnosis initially, or is he a TYpe 2 who has progressed on to insulin? DKA is normally the result of insufficient insulin circulating - what insulin is he on and how long has he been on it?

I had DKA when diagnosed. It actually didn't take that long to recover from the DKA itself - as soon as my body had sufficient insulin I felt much, much better - I stopped being sick and was able to eat again. Insulin plus a ready source of energy from carbohydrates reduced the ketones that are responsible for DKA within a matter of days, if not hours.

I hope he feels much better very soon 🙂 Please let us know if you have any other questions 🙂

 

[grovesy]

Welcome.

 

[riche1972]

Thanks for the replies, he's in hospital, on endocrine ward, levels are below 2 today, he's on no food so not impressed lol.
He's been diabetic for 12 years and in the last few years his levels have been up and down, he has never really grasped the serious of his condition, I think he has now!
I knew nothing about DKA, and was horrified at how ill he became so quickly, not sure how he's still alive,
He lost his job in October and being stressed hasn't helped and he is rubbish and taking his insulin.
Also I find he never receives consistent advice, he was feeling ill on tues then vomited weds, he's always been told to not take insulin if he's being sick!
I was furious with his consultant yesterday and he said yes you should take your insulin if sick if levels are high, he said testing him again as type 1.

 

[Northerner]

It's ESSENTIAL to keep taking your insulin when poorly, so that was indeed very poor and dangerous advice DKA does strike very rapidly. What happens is that the body can't process the glucose being supplied from food properly so it turns to burning body fat and tissue. Ketones (the 'K' in DKA) are a by-product of burning this fat, and without sufficient insulin they build up in the bloodstream turning it acidic (the 'A' in DKA) and causing all the problems He should get a blood glucose monitor that can also monitor for blood ketones - you can use pee sticks, but these are very unreliable and only show the situation from a couple of hours earlier - blood ketones test strips will show the levels as they are now. The Freestyle Optium from Abbott takes blood ketone strips as well as blood glucose strips (there are other meters, but can't remember them offhand).

You might like to read Type 2 Sick Day Rules to give you a better idea what to do if he is ill again. He should, however, speak to his nurse or doctor about the insulin he uses and how he should adjust it if poorly - people can have very different requirements, so the doses suggested on that page may not be suitable for him.

He is still Type 2, but because he is on insulin he is still prone to DKA - a Type 2 who is not on insulin will be less likely to suffer from it as they still have some insulin production of their own. Hope he is home soon and feeling much better. When he is better, give him a good talking to about taking his insulin 😉 I also hope he is able to find another job very soon 🙂 Let us know how he goes on, or if you have any other questions 🙂

 

[trophywench]

Urgghh - what lousy advice he was given to not take insulin when sick - people generally don't understand we all need insulin every second of our lives, to merely stay alive! but I'm appalled really that a medical professional might give that info, without any caveats.

You both know better now and I'm very glad he's still here to tell the tale! Hope he goes on OK from here and in future continues to get the proper advice from his team.

 

[sparklestar]

I was originally diagnosed type 2 and 3 years later ended up in hospital for 4 days with DKA and started on insulin during my stay. I had been vomitting for a week and not eaten at all in that time when I was admitted (had seen GP who signed me off with gastroenteritis), my glucose was 30-something on admission. I was told I was actually a type 1.5 who 'would eventually become type 1'!?

The DKA was nasty but recovery was fairly quick and I was back at work within a week.

I hope your husband feels better really soon.

Claire x