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Re: [IP] unexpected highs/rapid drops

This is what our endo has told us as well, and that a drop of
75-100mg/dL is fine for regular high bgs.

For DKA, they like to bring the bgs down slowly. Once the bgs
come down to ~200mg/dL they add a dextrose IV drip to keep the
bgs from dropping too rapidly.

As far as the fluid shifts in the brain (in DKA) goes, my
understanding is that it has to do with fluids and electrolytes
shifting from within/without the cells, swelling them, and
changing the plasma osmolarity. "They" don't know exactly WHY
this happens when treating DKA though, and why it doesn't happen
with everyone (it is seen more often when severe dehydration is
present). Here is a webpage with some explanations of what is
going on, with some theories:
Other references for cerebral edema in DKA:
>From what I understand, the cerebral swelling is only an issue
with DKA, not regular high bgs, and an issue for children in DKA,
not adults.

As for getting a headache with a high bg without DKA, one source
I read said that insulin pushes potassium (and with it water)
into the cells. That might cause a headache for some when those
cells "fluff" up. Heck, I get headaches just from drinking too
much water all at once and/or too often. ;)

This is an interesting thread!

Take care, Kerri, mom of Shannon-12.5, dx'd 11/96, pumping 11/99
"Hold on to what is good even if it is a handful of earth.
Hold on to what you believe even if it is a tree which stands by
Hold on to what you must do even if it is a long way from here.
Hold on to life even when it is easier letting go.
Hold on to my hand even when I have gone away from you." ~ Pueblo

Barb said:
I will leave it to Barbara B. to put this fluid shift into
layman's terms.
But you can read about it in medical terms in any description of
DKA.  My 8 year old drops extremely fast from correction boluses
(most of the
time) and knowing that this was a problem in DKA, I specifically
asked an
Endo whether it was a problem when bgs were quite high but not
DKA.  Endo
said that a rapid drop was not a problem at all, at least not for
my child.

Wayne said:
There are lots of reasons why one might get a headache without
Fluid shifts suggest vascular leakage, and this seems rather
unlikely.   I'm wondering if you know of any reference that
demonstrates this might be due to fluid shifts in the brain.
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