Ketones

This past Memorial weekend my husband and I stayed home. The weekend was fantastic and we had a great time celebrating the holiday and my mother-in-law and brother-in-law’s birthdays. Monday night I got to bed on time to prepare for work the next day. My BG readings just before bed were at 147. Around 5:00 in the morning I was awakened by nauseous. I tried to put it out of my mind and go back to sleep, but I couldn’t. The taste in my mouth reminded me of pencillin or some kind of medicinal residue that gets left behind on your tongue. On top of the disgusting taste that filled my tastebuds, my mouth was incredibly dry. I drank some water and fell back asleep.

Within an hour of falling asleep I was immediately awakened by the sudden urge to vomit and that is just what I did. However, all that came up was water and bile. I knew it couldn’t be food poisoning because there was no food in my vomit. Once I was done I felt better, but I checked my BG as a precaution. Sure enough my readings were at 318. I turned on a temporary basal of 130% and I bolused to correct myself thinking this might help fix the problem.  Unfortunately it did not and I was awakened yet again with the sudden urge to vomit more bile and water.  Since I had just bolused and turned on my temporary basal I figured it would be a little bit till I felt better. I called out of work and stayed in bed.

Around 9 am I woke up not feeling nauseous, but fatigued and sore. My lower back had been sore all day which I read is a result of the dehydration caused by my kidneys being overworked from the vomit and high blood sugars. I checked my BG’s hoping to see some improvement, but I was still only at 276. I checked my pumps settings to make sure it was not malfunctioning, and everything was okay. I checked the expiration date on my insulin and it was fine too. I then replaced my infusion set and cranked up my Temporary Basale to 150% . I had a small breakfast which I bolused for accordingly. I decided to check my ketone levels, but I was not sure on how accurate the reading was since they were expired. According to my ketostix I had a high level of ketones in my system, which could explain this sudden onset of symptoms.

I decided to go into work since the nauseous had subsided, but to be safe I  stopped off at the pharmacy and got some new ketostix  and some glucose tablets to prepare for what I thought would be a rapid decline in my BG’s throughout the day. I have not eaten much today and I have had a ton of water. I have checked my ketones throughout the day and they have gone from moderate to trace/small amounts. It is now 6 p.m. and unfortunately my BG’s are still over 200. My latest reading was at 238.  My temporary basal is now at 170% and I have no desire to do anything but lay on the couch and drink water. My lower back hurts like hell and I feel like I was mugged. My mouth no longer tastes medicinal, but I have to pee every hour and I have an unquenchable thirst. I am going to have protein with very low amounts of carbs for dinner and see what happens. If I am not better by tomorrow I am going to call my endo and see if she can help me out.

I have had ketones in my system before but the onset only lasted a few hours and I was able to get it under control quickly. This is the first time I have experienced something like this. I am fearful of getting DKA. For anyone that does not know what DKA is it’s:

“Ketoacidosis (key-toe-ass-i-DOE-sis) is a serious condition that can lead to diabetic coma (passing out for a long time) or even death. When your cells don’t get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are acids that build up in the blood and appear in the urine when your body doesn’t have enough insulin. They are a warning sign that your diabetes is out of control or that you are getting sick. High levels of ketones can poison the body. When levels get too high, you can develop diabetic ketoacidosis, or DKA.”

http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html

Wish me luck because I am sure tonight will be a long night filled with drinking tons of water and checking my BG every few hours.

Alcohol and Phish food

It’s hard not to succumb to the pressures of social drinking when your in your 20′s, but if you want to maintain a social life and decent blood sugars it is a constant balancing act. This has been one of the hardest things I am learning to balance because alcohol and diabetes do not mix. A few weeks back I went out on the town with my best girlfriends. We started the night off with dinner at Bj’s restaurant. I split a Mediterranean mini pizza with one of my friends and one glass of Jameson and Diet with a side of water. Blood sugars at that time were right where I wanted them. After dinner I prepared for some higher BG’s by adding a temporary basal, because lately when I go out on the town my excitement/adrenaline causes my BG to run higher than normal.

After dinner we made our way to downtown Pasadena where we spent the night bar hopping. Typically I have  pretty decent blood sugars  provided I stick  to my trusty Jameson and Diet with a glass of water between drinks. I check consistently throught out the night to make sure I am balanced. If I stick to that routine I tend to be okay. However, once I introduce other cocktails, beers, or shots I start to throw my body into complete disarray. Most of the time I am responsible and careful. Every once in awhile I knowingly disregard what I should or shouldn’t be doing. I do so in an attempt to feel “normal” or like everyone else my age who is living a carefree 20 something year old life. This particular evening I decided to have a few shots, cocktails and beers. (Mixing is not good for anyone, but especially not good for diabetics.)  Initially my blood sugars ran higher as I expected, but once the sugars had burned off and all that was left in my system was the alcohol my BG’s crashed. I turned off my temporary basal once I noticed the trend heading downward.

I am not sure if anyone else has ever gone through this, but people that don’t know that I am diabetic try to peer pressure me into taking a shot of some sweet looking concoction that I am sure is liquid sugar. More often that not if I decline I am bombarded with comments like “Wuss, Chicken, so on and so forth.”  Most of the time I will just say “No Thanks!” However, every once in awhile I decide to be dumb and take one of those shots.  I find myself sometimes embarrassed to tell these people “sorry I can’t because I am diabetic!” In the past when I have they either ridicule me for drinking at all, or they want to go into deep conversation about my condition.

This particular evening ended with cold sweats, shaking, ringing in my ears and a very scary low BG.  The only thing I had to bring my blood sugars back to normal was my sister in law’s Ben & Jerry’s Phish food Ice cream that she left in my freezer. The sugar in the ice cream absorbed slower than I would have liked and as a result I was up for an hour trying to correct my blood sugars. I am learning more and more that in order to lead a healthy diabetic life I need to reconsider certain social habits and stick with my comfort zone. The only person that is going to take care of me and keep me safe from my diabetes is myself. Slacking off for just a night could have potentially dangerous consequences.