dka
It all started a week ago Monday…no matter what I did, I could not get my sugars under 300. And I tried everything…first sliding scale w/ my pump every two hours, then with regular injections. I changed my infusion set and my site…nothing. Tuesday I was up over 400, and I took myself to the ER. They wanted to keep me, but I HAD to be at school the next day so I signed out AMA. I dragged myself to school the next day then went directly back to the ER. My sugars were actually better, but I still have some ketones in my blood, so they kept me. Did some tests, no signs of infection anywhere. My best guess is that it was all the stress of the last two weeks of school. The doctor that admitted me (not my own) doesn’t believe that stress alone can cause that kind of trouble. I disagree, and so did the diabetic educator that came to visit me. What do you guys think? I know I’m really brittle and it doesn’t take much for me to be in DKA these days. In my prepump
days I walked around at 300-400 all the time and never developed ketones. Now in no time flat I need to be hospitalized. 
What do you guys think….could stress have been the culprit?
Jenny
–
All who see me jeer at me; they
toss their heads and sneer…
Oh God, my God, why have you
abandonded me?
–Psalm 22
December 15th, 2004 at 2:00 am
yes, stress sucks and can wreak havoc.
Keep in touch and let us know how you are doing.
Thanks for caring and sharing,
Rhonda
Mom to Sydney, 7
type 1 since April 7, 2003
December 15th, 2004 at 10:44 pm
Jenny,
First of all, God has not abandoned you. The ills we face, as far as I am concerned, stem from Eve’s little maneuver of eating the fruit (notice, I say fruit, and not apple. The apple has gotten a bad rap from the whole Adam and Eve thing.) Anyway, He allows some things to happen for His purpose, but we have NO idea what purpose high sugars could have to do with His plan.
Anyway, off the soap box.
I have had sugars like that before, and they were seemingly unattributable to anything. Except stress. Stress causes release of epinephrine and norepinephrine by the little gland on top of our kidneys. These hormones are the ‘fight or flight’ hormones that cause one to be super aggravated when someone cuts us off on the highway, or when the husband is late for dinner, and dinner is a black piece of charcoal in the oven. These hormones trigger the liver to convert glycogen back to glucose, hence the allegedly unexplainable high sugars. I wonder if we were to test our overall body function during our bouts with these unexplained high sugars, there is also an increase in heart rate, respiration, our pupils are more dilated than usual and we urinate less. (These are all part of the fight or flight response.) My nurse practioner said there was no reason but my own gluttony to have such high sugars. Until I read your post, Jenny, I was under the impression I was just a
piggie. Then when I thought of the stress response, it makes sense.
So. What can we do about this? Personally, I think we can only wait it out. Avoiding stress in today’s world is impractical. If our bodies need more sugar due to the hormones, no matter how much insulin we take, our body is going to keep boosting our sugar higher and higher in challenge to the insulin trying to get it lower. It is a catch 22. So, I will just wait until after exams to get my sugar under tight control. ’til then, perhaps some exercise may relieve the stress a bit, and in turn, lower the sugars a bit as well.
By the way, what are you studying? Another by the way, putting you in the hospital is not exactly stress relief.
Best wishes on exams. Mine are Wednesday.
Joan
December 20th, 2004 at 11:42 am
Brian,
It is a result of the body trying to get the energy to cells that it needs, and the body is digesting its own protein, hence the weight loss associated with being newly diagnosed. Unfortunately, some of us slip back into this when we don’t take our insulin as we should, or we eat whatever comes our way. (Not that I would know anything about that…. : O )
I can get my old notes about the krebs cycle in the cells, for the ketones are a result of a problem at the cellular level, but that was 2 years ago, and I don’t remember the exact chemical process.
Joan
June 26th, 2007 at 12:52 pm
Thursday night I went to bed with a blood sugar of 88. Friday morning I woke up in DKA. I knew as soon as I woke up…it is a very distinct feeling, at least for me.
I went to the ER where they ended up putting a central line in cuz my veins are so lousy. It turned out to be a Godsend though…w/ blood draws every two hours they were able to draw off the line instead of poking me.
Nothing seems to have set this off….my infusion set was good….ALL my lab work indicated no infection. I am so frustrated. Feeling very burned out.
Jenny
–
“Do not be afraid to use the
talents you posess. The woods
would be very quiet if the only
birds that sang were the ones that
sang the best.” Unknown
June 26th, 2007 at 11:25 pm
I hope you feel better. I’ve been in DKA before, and it isn’t a pleasant feeling. How long was your site in?
June 27th, 2007 at 7:55 pm
Jenny,
Although you went to bed with an 88, what did you have for dinner/snack that night? I know pasta still is elusive as far as guesimating how much insulin to take, and the morning sugars prove it. I am probably in DKA, but there is no way I am going to the hospital. This Friday I am asking the doc if I can start my own insulin drip when it gets that high. If he says ‘no,’ I will probably try it anyway to see what happens.
Burn out hits us all, Jenny. I understand completely, even though that does not help you one bit. You are not alone. I have found when I am approaching the point of major burnout, I pick on my husband something awful. Poor guy. He will physically sit me down and ask what is my problem, because sometimes I just can pinpoint it. It’s the damn diabetes sometimes.
One of the most frustrating things is there is no escape. I HATE that. I wonder, at times, what it would be like to NOT be diabetic. I get envious, and dislike people who abuse their bodies with cigarettes or drugs when they are otherwise healthy.
I am sorry to ramble, Jenny. Go ahead and vent some more. I would look at something you ate the night before. There are certain foods that get us, and sometimes we aren’t aware of them until something like DKA happens the next day.
There are times, Jenny, that I DO tell God He was mistaken. I CAN’T handle this anymore, no matter what the Bible says about not giving us things we can’t handle.
I’ll be thinking of you,
Joan
June 29th, 2007 at 3:32 pm
Jenny,
This is my biggest fear now that I’m pumping. So far, on the pump, my
highest highs haven’t gone over 300, and those were during the day when I
was testing frequently & could correct quickly. I’m always afraid I’ll end
up pulling my site out when I go to bed and wake up really high. I
seriously doubt I’d go to the ER. As long as I can walk & take care of
myself, I’d try to handle it on my own.
If I use the ketone strips after a high reading, it will often read
“moderate” and that’s while I’m in the low 200’s. I’ve also had to read
moderate in the upper 100’s. But I hate ERs, hospitals and procedures so
much I’d have to be in extremely bad shape to go.
–
Liz
July 1st, 2007 at 12:09 pm
can you tell me how dka feels so I could learn to recognize it in my daughter?
Thanks for caring and sharing,
Hugs, Rhonda
Mom to Sydney, 8
type 1 since April 7, 2003
pump start march 2, 2005
July 10th, 2007 at 5:46 am
I will even register trace/small amounts in the mid-100’s. I generally
don’t check unless I’m close to 200, though. When I first started on the
pump I checked a lot since I was frequently going over 200, and got lots of
Moderate readings. Now that my rates have been changed, my numbers are
better and I haven’t really had to test my urine.
I remember when I had no insurance, I’d sometimes buy the urine strips that
tested glucose & ketones. Those would turn the darkest shade possible (for
both) as soon as they touched the urine. I know I was walking around in
really bad shape for years.
–
Liz