T Nation

Diabetic Keto Acidosis


#1

Anyone familiar with this? I googled it and got the standard websites. I wanted to see if someone with a medical background could give me a little more insight.


#2

DKA occurs in type I diabetics when too-low insulin levels result in very high blood glucose levels. It causes dehydration, acidosis and electrolyte abnormalities. It is potentially fatal.

Not sure how much detail you’re looking for, but I’d be happy to take a shot at any specific questions you might have.


#3

My stepdaughter passed away a little over 6 months ago and we just received the autopsy results. It stated the cause of death as Diabetic Keto acidosis. She was 38 years old and had no previous history of diabetes. I was wondering if there was any type of test that would have caught this.


#4

I’m so sorry for your loss.

What you describe (a 38 y.o. with no known history of diabetes succumbing to DKA) is very puzzling. Perhaps a physician familiar with the specifics of her case can shed some light on exactly what transpired. Again, my sympathies.


#5

You can test a patent’s blood glucose level at any given time and also test HGB A1C which to put a simply reflection of a patient’s average blood glucose level over a period of time. Elevations in these can have one to suspect someone has diabetes. If there’s no symptoms or complaints from a patient, these tests may not be carried out in a routine test. If she had any routine bloodwork done, her blood glucose levels may have been normal at the time and therefore diabetes may have gone on undetected.

My condolences for your loss and hope you find the answers you’re looking for.


#6

She didn’t have a regular physician, but she was admitted to a hospital back in January for low potassium. I wondering if the should have caught it then.


#7

Thanks for the kind words guys. I have dealt with it but my wife is having difficult time considering it is the holidays. I did leave out one fact. She was also a functional alcoholic. I was thinking this might have been one reason she went undiagnosed.


#8

[quote]Ironmantrw wrote:
Thanks for the kind words guys. I have dealt with it but my wife is having difficult time considering it is the holidays. I did leave out one fact. She was also a functional alcoholic. I was thinking this might have been one reason she went undiagnosed.[/quote]

There is a related condition called ‘alcoholic ketoacidosis’ (AKA) which results in death in a small percentage of cases. Is it possible the report referred to AKA, not DKA?


#9

No it has Diabetic Ketoacidosis listed as the cause of death.


#10

I have seen patients with no history of diabetes present to where I work with symptoms such as nausea and vomiting and found to be in DKA. Not all diabetics get diagnosed this way, but I have seen it enough to not find it surprising.


#11

Sorry for your loss, the human body is an amazing animal and will withstand a heavy punishment for a long time. I had a friend of mine who was a Respiratory Therapist recently married to a Pediatrician and was expecting his first child. He was a lifter for most of his life, and died of DKA at age 33, unknown diabetic.

I also now run an Occupational Medicine clinic where I do pre-screening physicals for guys going to work at places like Exxon. I find guys every day who are new onset diabetics who had now clue. If she was having issues with alcohol, she was probably fearful of reporting this problem to a Dr.


#12

My son, 16 at the time, was diagnosed with Type 1 in August of this year. The only reason we had him checked was because I worked the second shift and noticed that he was suddenly getting up every night around 3:00 to urinate.
If someone doesn’t report their symptoms to a health care provider, no one will test for diabetes.
On that note, the nurses said that we caught my son’s condition very early and that other patients basically were hospitalized due to complications from their diabetes and that’s how they were diagnosed.
I once knew a Navy veteran who was also a drinker and ignored his symptoms until the bottoms of his feet turned black and he ended up being diagnosed with diabetes and was bed ridden for a month until his feet healed.
The human ability to endure and deny is incredible.


#13

I appreciate the condolences. Hopefully this will help someone out there get checked for diabetes and get the help they need before it happens to them. If one life is saved because of this then her death will not have been in vain.


#14

I am not yet a medical professional (by far!!) so don’t try and read any medical advice from whatever I post.

Type 1 diabetes (henceforth abbreviated T1DM) typically has a pretty sudden onset in terms of symptoms (like over a couple of months) and often people don’t think to associate the symptoms with T1DM. Some people also have a much milder experience and may not be concerned at all. Also, some of the symptoms are rather vague and, especially if there’s poor communication between doctor and patient, may lead to incorrect conclusions. For example, if the patient complains of fatigue and weight loss, a doctor might lean toward more common illnesses like cancer or depression, especially if the doctor doesn’t question much further.

Largely the problem is that we don’t really have a good way of screening for T1DM, so it can be pretty difficult if the patient doesn’t complain about “classic” T1DM symptoms like increased thirst/urination beforehand. As a result, a very large proportion of T1DM patients are diagnosed when they are hospitalized for DKA. My guess is that she had developed T1DM but was unaware.

I’m sorry for your loss.