What Does Ketoacidosis Feel Like

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Jamie On Diabetic Ketoacidosis

We lost our dear and gentle Jamie in 2009 to cancer and diabetes. Jamie and her cat Boots were long-time friends on the Feline Diabetes Message Board. Jamie will live forever in our hearts. I am copying here what she wrote about her own DKA episode. Thank you, Jamie, for one of your many legacies. What does DKA Feel Like? WARNING: Reading this story may be upsetting. The physical manifestations (and, to a lesser extent, the mental manifestations) of Diabetic Ketoacidosis, or DKA, as I have experienced and thus described, can be summed up very simply: suffering. Reading this story is reading about suffering. It's not all graphic; the bad bit begins and ends at the asterisks (***). You may want to just skip over this if you're not in a good place at the moment. "Not in a good place" might include: your kitty is newly diagnosed with feline diabetes and you are feeling overwhelmed; you have a kitty who is currently experiencing ketosis or DKA; you have lost a kitty to DKA, especially if you've lost your kitty recently; your kitty's diabetes is not under good control, and you're stressing. Please understand that in posting this story, I am not trying to cause or exacerbate pain, grief, Continue reading >>

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  1. elbruce

    Stages of DKA/Any Personal Experiences?

    After 19.5 years of Type 1 diabetes I should probably know everything about DKA but thankfully up to this point I have avoided any hint of DKA so out of sight, out of mind! I of course know the basics, the danger signs, symptoms etc. but the basic info does not tell you a lot about the progression, stages, etc. so in my mind my takeaways were "don't stay high too long, take your insulin, if you are high stay hydrated,"....good to go right?
    So yesterday around 4 AM my blood sugar started to rocket up after being normal for most of the night. Took a bolus to bring it down and when I woke around 6 my CGM said 250 but tested my blood sugar, it was 190. A little annoyed as my bolus should have brought this down but good enough to continue with my plan so I went for a 30 min run. After exercise it came down to about 150, I was happy so I did not think too much of it.
    Got it the car, ate two pieces of toast, and on my drive to work (45 minutes) my blood sugar started to rocket up! Gave myself a large bolus to bring it down and by the time I got to work it still was climbing higher and higher (over 400). Changed my infusion site (it was leaking so I probably was getting very little insulin), gave myself a bolus with a needle, drank a lot of water and just tried to focus on work. Started to come down very slowly but it was coming down and around 1230 I was down to about 150 around the same time I started feeling physically ill (lots of nausea, threw up once, lethargic) and that is when it hit me, could it be DKA? Since my blood sugar was not too bad I did not feel I was in immediate danger but I read that DKA can change your blood chemistry so I was a little worried about any cascading effects. My body felt awful, I just threw up, my stomach was upset, I didn't feel like eating. I forced myself to eat my modest lunch and closely monitored but still didn't feel good for most of the day and I left work about an hour early.
    I rode it out and I was fine but the experience just got me thinking. Has anyone ever experienced DKA? How fast did it come on? Any noticeable stages? Just curious about any personal experiences. Read that DKA can happen fast but when you are possibly experiencing it, it still surprised me at the speed of it. Don't know if I was actually experiencing DKA but it certainly seems plausible! Thoughts?

  2. Nicoletti

    Sorry, no personal experience here, but vomiting can be an early sign. And yes, DKA will change your blood chemistry to the point of metabolic acidosis. Too much acidosis is not compatible with life -- very serious stuff!
    Do you have urine keto strips? You can check ketones with them if your blood sugar is high.

  3. coravh

    I've been on the verge twice in my 50 years of D. The first time was when I was about 16 or so and I'd had the flu. One of those horrible ones making the rounds that was killing some of the elderly that caught it. I was vomiting for 3 days and on day 3 it started getting worse, rather than better (keep in mind that this was in the 70s, so horrible insulins and no home testing) so my Mom took me to the hospital. They said my blood chemistry was just starting to go "off". The second time was when I had peritonitis (so got really sick, really fast) and went to hospital in the morning. Again, this was in the days before lantus. I took my morning shot of N, and went to the ER. By midnight they had given me no insulin, hadn't tested my blood sugar in 6 hours (the nurse was refusing to) and so I called home to get my insulin. The next morning a young resident cheerfully told me that I had "been on the verge of DKA, but we saved you!!!!". I informed her that they were the ones that had pushed me there.
    As far as for myself, I know coming close I have always been pretty ill before I got close to the edge. So if you are taking a reasonable amount of insulin and still feel ok, I suspect that DKA is the last thing you need to worry about. Especially if you can keep fluids down along with your bg.
    I really doubt if you were experiencing DKA. Don't forget, the K stands for Keto (acidosis). So you have to have rampaging ketones that acidify your blood. It's not a single day process, especially with insulin on board.

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