illness when in remission

Status
Not open for further replies.
R

rayswife

Member
Relationship to Diabetes
Carer/Partner
My husband was diagnosed a while ago as diabetic when was taken ill with dka out of the blue. He was on insulin in hospital for a week then sent home with pills and with careful diet in Feb this year was given the all clear to come off the meds as his HbA1c was good. We continued to test his blood sugars and he was generally below 9. sometimes a bit too low and needed a bit of food to bring it up;

then 3 weeks ago he was being violently vomiting ill and rushed into hospital- again dka + this time pneumonia , sky high blood sugar and ketones. It was bad, he was on a ventilator for 4 days and was on insulin again, everything trying to fail. The medical team have pulled him back and he is now perky on a medical ward - weak but doing well. But his HbA1c test they did was only 42 so how on Earth did he go from all happy happy to DKA? oh and his blood sugar now is hovering around 22 now they have removed the insulin.

Can anyone make sense of this? Due to covid I am not allowed into hospital to visit him and not getting much oppertunity to talk to his care team. How can someone marked as doesn't need treatment as bloods all good suddenly go into full blown DKA?
 
Hello @rayswife

I am so sorry to hear about your husband, and it certainly sounds very unusual.

Do you know if he was tested for Covid19? I am aware from some HCPs I am connected to on Twitter that there have been cases of people with T1 with relatively low BG rapidly experiencing high ketone levels and DKA.

I am slightly at a loss as to why your husband’s insulin keeps getting stopped. My understanding was that for DKA to develop you needed elevated ketones with low levels of insulin. It is much more common in T1 and LADA than T2.

Does your husband have a diagnosis of type, or are there complicating factors which mean he is not so easily classified?

Were you regularly checking your husband‘s BG levels before his most recent DKA admission? What sorts of levels were you seeing?

It almost sounds like his insulin production is stopping and starting from day to day and week to week?!
 
Thank you for your reply. It is weird. They had thought type 2 after first DKA. (his hba1 test on that occassion was high) He has been tested for covid pretty much daily while in hospital too. All negative. I took his blood sugar when he first started vomiting and it was only 6.8!!! but he had been off colour for a few days and had barely eaten anything so I was suprised was that high . admit I didn't take ketone reading but they had told me only to that if blood sugar high.
They are now watching him in hospital to see if blood sugar lowers on its own now the pneumonia has cleared but I am frankly terrified. He came close to death, his ketones /blood sugar went insane within a couple of hours of vomiting starting and his kidneys temporarily stopped working. Apparently they had him on massive doses of insulin until a few days ago.

They seem to be at a loss as to what has gone on and that freaks me too because how do we stop it happening again? He went from well controlled to near death in blink of an eye.

oh meds wise after first DKA he was on gliclazide for a few months which he was happy with as no side effects then they insisted he go over to metformin which he was not happy on-kept getting bad night sweats and feeling generally unwell which was why he was keen to go med free which because his hba1 test at the time was good they were happy for him to do)
 
Last edited:
If he hadn’t been eating anything, and his body had been burning fat for fuel that would have given rise to ketones (sometimes called starvation ketones).

But these are not usually of concern if there is sufficient circulating insulin.

Has he had a cPeptide test to check how much insulin he is producing?

I can see how worrying this must be for you :(
 
@rayswife How terrifying! I haven’t heard anything similar so it’s hard to know what to suggest. I agree that a C Peptide test sounds sensible and also the antibody tests to check for Type 1 diabetes.

I’d be getting them to do every test they could including other hormones. You said his blood sugar without meds sometimes went too low. I think there are conditions that can contribute to that so I’d want those ruled out.

Mainly, I hope he feels better very soon. A horrible experience for you both.
 
He is being allowed home! Just spoken to his nurse- they are sending him out on gliclazide which he did well on before. I am so relieved.
 
rayswife said:
He is being allowed home! Just spoken to his nurse- they are sending him out on gliclazide which he did well on before. I am so relieved.
Click to expand...

Ah that‘s great news @rayswife - thank goodness!

Hope he bounces back, and you get some clarity and answers about what might have been happening.
 
Status
Not open for further replies.
Back
Top