Just what is DKA?

By w8chd Latest Reply 2012-01-09 08:43:15 -0600
Started 2011-12-29 19:03:34 -0600

I've noticed in numerous postings mention of DKA. I know what the letters stand for but that is about it. I've been diabetic for over 10 years and never heard of it till I saw it here on DC. How do you know if you have a problem with it? How is it checked for?

15 replies

w8chd 2012-01-08 12:24:47 -0600 Report

I know I'm going to have to do something different than what I have been doing, which is bascially nothing. Here is some background info… my issue with insulin is the weight gain. I believe for some of us who have weight issues are going to gain when taking meds that have that side effect no matter what we do to try to prevent it. 30 pounds in the first three months of taking insulin starting two years ago. I was taking 100 units Lantus and 200-240 units Humolog 75/25 per day. This along with watching carbs was working. My a1c was below 7. Finally my weight increased to 306 last fall. That was an increase of 56 pounds.

For about a year now I have some issues going on here at home that has my stress levels somewhere up near the moon. And to complicate things more my wife has zero interest in any of my health issues. No support system at home.

My current situation began on July 4 when I started a new job working 11p-7a. I really like the shift but it played havoc with everything till I adjusted to it. My eating and sleeping patterns are completly different than before. without realizing it I had began to go 2-3 days at a time without a bg check or taking insulin. But the weight started coming off. It took over a month before I realized just what was going on. I then checked bg every two or three days. It would be 300-400. But with the weight loss I felt great.

Now 6 months later I am down to 243. That's a loss of 63 pounds. At what cost I wonder? I take 30-40 units of whichever insulin I feel like about twice a week, just enough to keep my bg below the point where the meter will read it. It mostly runs 300-500. I have had two lately my meter wouldn't read. It just said HI. I ws in to see my Doc in late November, (first I had been there since June) she was less than impressed with my new weight loss program. The loss was good but not my method. My a1c was 10.5 then.

Since I have my weight down where I want it I'm going to go back in and see what we can do. My Doc wants me to an Endo. I know I can't continue like this. This is 6 months of bg's of mostly 400+. One may wonder how I'm even walking around. From what I've read about dka I most likely would have it.

I guess I didn't just fall off the wagon, I leaped! Maybe I've gotten a little obssessed about the weight loss.

roshy 2012-01-09 04:36:17 -0600 Report

dude, you need to sort this out the last thing i want to do is add to your stress levels but the long term effects of this behavour are really deadly to your health., no wonder you doc is anxious to send you to an endo. i took part in this increasing epidemic "diabulimia" for a while and paid the consequences. You need to think about the potential nerve damage, the damage it is causing to your eyes and your emotional and psychological health. With blood sugars that high for a long period of time you must feel exausted and drained. Weight gain is terrible for our self esteem but think a few years down the line when you start resenting yourself for allowing this to happen just because you wanted to be thinner. Is putting your organs and eye sight at risk really worth it?
Would your company cover you to see a counsellor to help ease the burden or provide some emotional support that you lack at home? think of other ways to deal with this other then starving your body from insulin.
When i came out of hospital after my DKA the hardest thing to do was dealing with the resent, guilt and trauma i put myself through, knowing how dangerous it was and allowing myself to do it. I also had to deal with putting my family and friends through the whole experience. It as two years ago and it still gets to me.

Again, im not trying to scare or use petty tactics to make you pay attention but i hope even by shinning light on my experience will help you understand what you could potentialy do to yourself.

Best of luck in the future and i hope you gain better control with your diabetes.

w8chd 2012-01-09 08:43:15 -0600 Report

Actually it's the exact opposite. Overall, I feel better than I have for years. It's so much easier to do things since I'm not lugging around all that extra weight. Maybe that is a trick of the mind. But certainly don't feel tired or drained in any way. I don't plan to continue this much longer, I know I can't. Probably will make an appointment next week to see what to do.

jayabee52 2012-01-09 04:45:29 -0600 Report

Thanks for your input Roisen! I didn't know if my example as a T2 spoke to Christian. I just pray he gets a good handle in it quickly!

jayabee52 2012-01-09 02:46:38 -0600 Report

WOW Christian I AM surprised you are still walking around. I think there is a term for this eating disorder, "Diabulimia" You can read about the damage it does here ~ http://www.medicinenet.com/script/main/art.as...

I had heard something about this effect of losing weight by going into DKA. I had just been divorced and wanted to lose weight I ate a lot of things which were not good for me and I didn't take my met. Since I was T2 I was not successful at losing much weight, but I believe that many of my complications were from that time. I didn't know about the other things which can come from it. Frightening!

roshy 2012-01-07 11:53:54 -0600 Report

i had a very bad experience two years ago and i have definitly learned from it!! i was sick for a very long time. i got to the stage where i was falling asleep and couldnt wake myself up. I had shortness of breath, vomitiing episodes, no appitite and through this i lost a lot of weight. I was basiclay a walking zombie for ages until i eventualy went into hospital. Diagnosis was DKA.
I spent 5 days in icu to get everything back on track. I had tubes wires coming from every where, a catider was nessessary because i couldnt leave the bed at all.
It extremely unpleasant trauma that you should try and avoid the best you can. Lesson learned : always take your medication!!!

maclover1524 2011-12-30 16:05:34 -0600 Report

DKA or Diabetic KetoAcidosis is an extremely dangerous albeit atypical condition for reasons which I will mention later. The liver keeps a small supply of glucose on hand just in case - called glycogen. The muscles do as the same. The beta cells of the pancreas are signaled by the liver to produce insulin when carbohydrates enter the digestive system. When insulin is produced by either the pancreas or by injection , glucose levels subside. When there is no insulin being produced but the diabetic is eating carbohydrates, there is basically no way for the body to recognize that carbohydrates aka glucose is coming into the body.

The body reacts because it knows it needs glucose to sustain life. The liver calls upon it's store of glycogen to be released into the body. Because the body can not recognize glucose without insulin, the glycogen is not recognized — so the body goes into attack mode and begins to call upon it's stores of glycogen in the muscle and other tissues.

Blood sugars rise exponentially. The body believes it has no glucose when in fact it has extremely high glucose levels.

The blood turns acidic from all the glucose. The diabetic will usually go into a coma at this point and very likely die unless they get to a hospital quickly.

This is why it is so very important for diabetic's especially diabetics on insulin to wear a medic alert bracelet or chain. The symptoms of diabetic ketoacidosis mimic the symptoms of a person who is fall down drunk - even to the smell on their breath. Once you are unconscious, you run the risk of being thrown in jail instead of being taken to a hospital. Wear the daggone bracelet or chain - it could save your life!

Once in the ER, insulin is typically administered IV to bring the glucose levels back into balance. This must be done as quickly as possible to prevent extreme complications.

Type 1 diabetics are most at risk for DKA. Next in line are type 2 diabetics who are taking insulin injections because they have burned out their beta cells.

So, the absence of insulin or a very, very low production of insulin plus lots of carbohydrates plus ketones in the blood can cause DKA.

Ketones in and of themselves are not dangerous. Ketones in the blood of a person who is not on insulin injections are simply a by-product of fat being metabolized. As long as there is a sufficient amount of insulin in the body, DKA will not happen.

jayabee52 2011-12-29 19:54:52 -0600 Report

Howdy Christian

I understand that we who have been Dx'd and on DC for a bit of time have a tendency to sling around acronyms with wild abandon (well, a bit of over exaggeration)
DKA = Diabetic KetoAcidosis. (of course you knew that already — for those who read this later and don't know).
It happens most commonly to T1s but it CAN happen to T2s under certain conditions.

Here is what the ADA website has to say about DKAs ~ http://www.diabetes.org/living-with-diabetes/... This article stresses the importance and serious nature of DKAs while being able to be understood. DKAs are serious business! You can fall into a coma from a DKA, and perhaps even die because of it. Please note the early symptoms which include the following:

•Thirst or a very dry mouth
•Frequent urination
•High blood glucose (sugar) levels
•High levels of ketones in the urine

(Not much here to signal anything other than diabetes — with the exception of the high level of ketones in the urine —- you can find testing Ketostix for urine in the diabetes section of most pharmacies)

Then, other symptoms appear:

•Constantly feeling tired
•Dry or flushed skin
•Nausea, vomiting, or abdominal pain
(Vomiting can be caused by many illnesses, not just ketoacidosis. If vomiting continues for more than 2 hours, contact your health care provider.)
•A hard time breathing (short, deep breaths)
•Fruity odor on breath
•A hard time paying attention, or confusion

When you reach this point you may want to have someone take you to the ER. (For your safety Do NOT drive yourself! You may at any time get confused very easily or pass out and end up in a motor vehicle accident)

Before I knew how dangerous DKA really was, I actually TRIED to get Ketoadidosis, as I heard that it might be an easy way to lose weight.

I was newly divorced at the time and thought it would be nice to lose a few lbs so I'd be more attractive to prospective mates. It wasn't worth it in the long run. I didn't lose all that much weight and I believe many of my diabetes complications come from that time of ultra high BG levels. And I really didn't know the dangers of the game I was playing with my body.

If you are a T2 you may want to use a Ketostix when you are sick or when some of those "other symptoms" (above) appear.

I pray that this helps you.

Blessings to you and yours, Christian


Caroltoo 2011-12-29 19:48:16 -0600 Report

In non-medical terms (since I'm not a doctor), it's when your body can't use the glucose in your blood because you are so insulin resistant that it can't into your cells to act as fuel. Since the cells have to have nurishment, the body begins to break some cells down to scavenge for food for others. Your BG is very high and this is usually determined in Emergency because you are that sick. It's an extreme form of hyperglycemia with all the usual hyperglycemia symptoms in real intensity. I think there is a discussion on DKA that you might want to look for also.