By Steve Edelman, MD on April 8, 2019 / A Dose of Dr. E, DKA, Insulin, Video / 20 Comments Previous Post A Dose of Dr. E: Evidence-Based Hope Next Post What Is the IQ of Your Pen? Smart Insulin Pens Are Available Now!
Hey, thanks. I learned more about ketones from your video than I ever did in 57 years with T1d! I didn’t even know about ketone meters! I thought we were still using strips. ( havent has a strrip in 40 years. ). Only been to ER twice for” flu “. They never said anything about my ketones. Five hours in ER then home.
That was great! Really! I’m going to mention it on Glu. I’m 69, got T1d in 1962. Doing well. I guess old dogs can still learn things!
Glad it was helpful Joan!
Thanks guys! A further question is how DKA differ from the ketosis state that is desired in the “keto diet?”
Ketosis and DKA are all part of a spectrum, with ketosis happening in the beginning. If untreated and ketones get higher in the blood, it turns into DKA.
This was very informative and appreciated that a subset of type 2 can have DKA… its amazing how many people especially health professionals seem to question and doubt that I had it!
I wish there was a bit said about its presentation with type 2 or maybe another article or video about it because obviously type 1 people know about this and experience it quite easily and the focus of TCOYD in general which I do understand being a autoimmune disease…
The one thing I learned and was very helpful is the Euglycemia DKA … probably jacked up that spelling but that’s what happened in my case and it’s that it was figured out…
I had been feeling sicker then usual but due to multiple comorbidities and other autoimmune diseases I have, I assumed it was status quo but accidentally took a double dose of blood pressure medicine not realizing it and became very dizzy and my moms voice sounded like she was in a tunnel… it’s fortunate I was laying in her bed to chat with her and ironically she didn’t really want me to but just gave in …. otherwise, I would have been in bed in my room….
She called 911 and my BP was soo low, the EMTs didn’t believe it and kept rechecking it so of course I was whisked off to scripps memorial and this really tenacious smart doctor who I’ve had ER Care with before and always treated me with respect had my case ..
He latter told me that I just seemed sicker then low blood pressure and not like I normally was in previous encounters. My blood glucose wasn’t reallly that high considering… maybe 300 but I also often need steroids so even with both insulin therapies, it is sometimes difficult to counter cover. Anyways, he continued to dig into the issues he saw and didn’t just look at the surface and discharge me as I suspect other ER docs would have done especially since the presentation was so unclear and based on a personal hunch.
I’ remember the doctor telling me I’m in DKA and I had never heard of it before. He ordered a CT scan which really blew up the significance of this and of course I was already being given fluids and other stuff. For admitted for a week and CDE Came through to give me information and answer questions.
I had just started going to scripps and this was before Epic so I guess that’s why my current doctors there don’t have this record online as the epic records only go a couple of years back….
It was quite a learning experience and I took my diabetes a bit more serious after this happened….
It’s just annoying that when asked if I had DKA before or if I offer it, it’s often met with doubt and even in my health appointment summary, one recent Endocronologist I had a special consultation with as he subspeciallizes in obesity medicine… asked me if I had DKA but when I said I did, he was not only surprised but asked me if I was sure and when it happened. On his summary note, he stated he could not find it and wasn’t sure if this was a accurate thing!
Now I’m not like your average patient…. I was educated at UCSD where I majored in human development and neuroscience. Even before that, I have been and still am a avid reader and devour books. I know about my diseases , my medications even the doses and IV infusion ones etc. yet, it seems like these things are often discounted and even using medical terminology brings surprise yet I’m still not believed lol
Anyways, I think more needs to be said about the more obscure effects with type 2 as well since most of us aren’t on pumps that dislodge or even can get a CGM so the more we are likely to be in the dark…
It is very rare in people with type 2 which is why we didn’t focus as much on it for this particular video, but we’re glad you found the information helpful.
Hi Dr. E.
I was diagnosed as a type 2 dibetic and had DKA twice, once when I was firs diagnosed with diabetes and years later when my insulin was changed.
Thank You for the information. Sometimes we think we are just not feeling well when there is actually something else we should be aware of. A good reminder for a diabetic.
Thank you Linda! We’re glad it was helpful.
Very helpful. I am going to purchase a Keytone meter and follow your instructions.
I am a brittle diabetic with fluctuations high and low. Not sure if you have any advice for me.
There are a ton of reasons why people bounce around all over the place, so having the best insulin regimen with CGM and working with your healthcare provider is first step.
Thanks a million guys. Unfortunately after 55 years, I spent 3.5 days in ICU and 3 days on the the regular floor. I’ve never been in DKA. With the admission was severe dehydration, Acute Renal Failure, heart attack. Working hard to never go through this again! Miss You! Keep up the great job!
Thanks for the note and we hope you’re feeling better!
can you go into DKA from too much exercise? recently on a bike trip and I smelled very sweet! No ketone strips or meter to check with and blood sugar was higher than normal but could bring it down with insulin, water, small amount of food and walking around.
was I in danger with “exercise” DKA?
Exercise does not cause DKA…the only way you could go into DKA during exercise is when you lose access to insulin.
After hearing this, is a keto diet not good for a Type 2 diabetic?
Check out this video Dr. Edelman made on the keto diet, along with one of our nutritionist partners. I think it will be very helpful for you!
Am a new patient of type 2 but my ketone was trace level wat does ..is there a posibility that am prediabetic or….because the doctor told me I was on a boarderline after diagnosis. ..my levels are now noraml I don’t take medicine just make exercise
I appreciate your website in so many ways. I am a CDCES and I often will use this website, not only for a resource for my patients, but also for myself. I can appreciate the way you both present information, not only from your knowledge professionally, but also personally.
Thanks Karessa, that’s very kind of you. Glad to be a resource for you and your patients!