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Re: [IP] DKA and Ketones

I did -- as a kid!  Much too much.  Water, water, water!  Have him sip
continuously in tiny tiny sips if he is too naseous.  Serious dehydration can
occur in as little as an hour or two if you BG keeps going up and if you aren't
absorbing insulin.  I'm very serious about this -- I spent several weekends as
a teen in the ER as a result of DKA (2x even after I had started on an
Autosyringe Pump (the old kind).

Bob Burnett wrote:

> Katie asked:
> >Outside of additional insulin and drinking plenty of water . . . what else
> can be done to prevent DKA? And isn't >DKA actually ketones present in the
> urine? Actually being one in the same?
> I pulled my book from MiniMed - "The Insulin Pump Therapy Book - Insights
> >From the Experts" to answer this one. There are a number of notations re:
> DKA, but the following quotation from chapter 11 may answer it best:
> "Glucose derived from carbohydrate is the body's first choice as an energy
> source. Without insulin, cells cannot utilize glucose and the body shifts
> from metabolizing carbohydrates to fat for energy. This shift is
> accompanied by elevated blood glucose levels (hyperglycemia) and the
> appearance of normal, acidic by-products of fat metabolism known as
> ketones. When fats are the main source of energy, ketones accumulate and
> are detectable in the blood and urine. The accumulation of ketones moves
> the body's electrolyte balance to the acidic range, contributing to
> diuresis (excessive urination) and dehydration as the body tries to
> reestablish its acid-base balance by excreting the ketones. This
> life-threatening condition is known as diabetic ketoacidosis (DKA)."
> There is a further notation in this chapter that the researchers "observed
> that the most common triggering event for DKA in all treatment protocols is
> failure to respond to elevated blood glucose readings immediately and
> appropriately".
> "Pumping Insulin" and the MiniMed book indicate that it may be necessary to
> increase insulin by as much as 50% to 100% to bring the BGs back into
> target range when ketones are present in the urine.
> Most recommendations re: prevention of DKA are centered around *prompt
> action* when BGs get above 240, remain there and ketones are present.
> Injection by syringe of fast acting regular, changing the infusion set,
> tubing, reservoir / cartridge are also recommended. "Copious amounts of
> fluid" are recommended, but can be a challenge, since "impending DKA" may
> make the pumper nauseous.
> I've never suffered from DKA. I do remember vividly the tales my CDE told
> me when I started pumping, so I tend to be a bit cautious with high BGs.
> Bob Burnett
> mailto:email @ redacted
> Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/

Insulin-Pumpers website   http://www.bizsystems.com/Diabetes/