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Re: [IP] 1st DKA on pump

This is not really DKA, but an impending DKA could occur if
troubleshooting and action does not happen. Your rising BG
trend was a clue that something was wrong,  and checking for
ketones with a BG >240mg/dl was the right thing to do. True
DKA would have to be diagnosed by a physician based on signs
and symptoms and lab work indicating electrolyte imbalance,
dehydration, and hyperglycemia.. You didn't note any
symptoms of thirst, increased urination, nausea/vomiting,
abdominal discomfort, rapid or difficult breathing.
I think you caught the problem in time and took the correct
action. It isn't always easy to make a rational decision
when sleepy. Of course, sleepiness and lethargy are also
symptoms of DKA.

I trust you increased your oral fluid intake to flush the
ketones out of your system. They usually lag behind the BG
by several hours. You might have a normal BG level now, but
still show urine ketones. The ketones should be decreasing
toward the moderate -> minimal -> negative. If not going in
that direction, check with MD.

Barbara A. Bradley, MS, RN, CDE
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