High levels sugars and keytones

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Hi my 18 year old daughter has struggling with high sugar levels and very high keytones for about 4 weeks.Been in hospital twice and and still no better and not much help available.really week all the time and being sick.
 
That sounds really bad. Can you tell us a little about your daughter - is she already diagnosed with diabetes, if so is she on injections or a pump, which insulins? Why are they discharging her from hospital in that state, does it improve a little and then get worse again?
 
Hi my 18 year old daughter has struggling with high sugar levels and very high keytones for about 4 weeks.Been in hospital twice and and still no better and not much help available.really week all the time and being sick.
If she has high sugars, high ketones and is being sick then she needs to go to A&E asap. Insist on seeing the diabetes team before discharge.
 
That sounds really bad. Can you tell us a little about your daughter - is she already diagnosed with diabetes, if so is she on injections or a pump, which insulins? Why are they discharging her from hospital in that state, does it improve a little and then get worse again?
Hi she's had diabetes since she was 9 and just over a month ago she came off the pump due to an allergic reaction to it.she is now on phiaza as they took her off nowva rapid two weeks ago when she was last in hospital she is also on levimer at night.They to steady her levels by putting her on a drip then once she's home she's high again.not much help available
 
No Idea what phiaza is, but do have to wonder if A.. she is taking her insulin or B,, the insulin has been compromised in any way i.e., frozen or got to hot.
Sounds as if your daughter needs to be back in hospital again as it sounds as if she has DKA.
 
Is she following sick day rules for ketones? If she can’t control them at home then hospital is absolutely the right place to be.

If she’s been on the pump for a while then her insulin needs may have changed so the ratios she’s been using for meals etc may not cut it. If you add in a new fast insulin and a basal she’s not been on for a while then it can be hard to get the levels right. Fiasp has a similar profile to novorapid but everyone responds differently so the doses may need increasing and her basal probably needs to go up. She needs a consultant or specialist nurse to help her go over her numbers though as we can’t advise on specifics.

Priority is to treat the ketones and then to get some help in adjusting doses to stop her going so high.

It must be very worrying for you all. Much love to you.
 
It sounds like she is only injecting Levemir once a day at night. Usually it is injected twice a day, morning and night., so it may be that she isn't getting enough basal, or perhaps that she is forgetting to take her basal if she has been on a pump for a long time. If she has high ketones and is being sick, she needs to be back in hospital.
 
It turns out my daughter as had an infection for over 6 weeks thats why she's been so poorly with high sugars and high keytones and the hospital have sent her home 4 times without finding out.it took an appointment with our local gp to confirm it.
 
Sorry to hear that. I hope she is getting appropriate treatment now and feels better soon.
I think it is important to know how to manage your BG levels and insulin doses when you are ill/have infections or viruses etc. and I wonder if your daughter has ever been offered an intensive education course like DAFNE or whatever your local equivalent is? Amongst other things like carb counting and managing BG levels with exercise and alcohol use, it also provides a framework and flow chart for increasing insulin doses during times of illness (referred to as "sick day rules") particularly when ketones start to develop. It is really important to know how to adjust your insulin doses to manage these situations, especially with the NHS and hospitals in particular being in the state they are. Knowledge is power with diabetes, so I would encourage your daughter to ask about such an education course. You never know, it could save her life one day!
 
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