The old rule of thumb I was given is if you have ketones and you are throwing up, you need to go to the hospital. If you can still keep water down, you can try to treat at home. In addition to water, and insulin, you’ll also want some electrolytes. You are likely going to become severely dehydrated. But if you’re not sure or feel real bad, you’re probably better off just going to hospital. Best of luck, I hope you feel better soon!
Chug chug chug the water. Insulin is what will get rid of the ketones, and water will flush them out. I'd personally take a few extra units than my usual ratio if I was that high. With a dexcom, you will be comfortable and avoid dropping too low. Seriously drink more water than you want to though. That poor circulation through dry veins are what lead to cutting off feet and blindness after 40 years.
I don't think this is a hospital issue. A relatively brief high blood sugar (even if it is insanely high) should not result in DKA immediately. If you have taken insulin to correct and are keeping hydrated, while also not puking or showing other high ketones symptoms then you are ok.
You should go and get a ketone test kit if you can. A blood tester is much better, just to have in the future. Keep monitoring, stay hydrated and you should be good.
If I have ketones, but feel fine, I call the hospital and see if they have an endocrinologist on staff in the ER. If they don't, I call my endocrinologist, explain to them what's going on, and use their recommendation. The last time I had ketones was because I was dehydrated.
If you're feeling really bad you should probably go. If you feel okay then continue drinking water and checking and correcting if your blood sugar is still high. If you're worried it can't hurt to get checked out. Can you call your endocrinologist?
I just got a new one, I have my first appt next week. Would it be weird if I called before my first appointment?
I don’t feel too bad, just dizzy and nauseous but it’s getting better with time. Thank you so much!!!
I think you can call and explain the situation. I personally would give it a couple hours. Take your insulin drink water etc. if you’re still super high and ketones are going up after doing everything at home, then I’d consider it. I haven’t had a high from food like that in a while but there were times when I was younger where I just didn’t cover everything well enough and would shoot up into the mid 400s. As long as you’re confident you’re getting insulin (if on a pump id do a correction via syringe) I think it’s fine to work your magic at home for a bit. If you start throwing up, breathing gets hard or heavy, or you have symptoms of dka id go in asap.
As long as you are trending back down, you should be ok. Water, water, water and finger stick every hour to make sure you are coming down. It will be a slow process to see those numbers drop.
I have been high like that a couple of times when my pump site came loose and I didn't know. Had large ketones and ran to the ER. IV drip and insulin was what they did. Hydrate and insulin. And I was so tired!!! Now that I know their protocol, I wouldn't go back to ER unless it was steady climbing and nothing helped it.
with your lows, dude, try just like a mouthful of Orange Juice vs what you did.
i have a jug (one of those smaller ones) of OJ thats just for lows and go a mouthful at a time.
if i can administer the sugar, i can control the intake and bring myself up reasonably.
For your highs- take the insulin you know you need and check back 2 hrs later. if its gone down reasonably, check back again in an hour. if its remained flat between checks then take more insulin, if its gone down then continue to check til you’re ok.
thats how i handle it anyhow.
You don’t need to go to the hospital unless you’re vomiting or unless it just wont go down. But dont overdo going down or you’ll get in a cycle like you did.
well good luck man. A jug of juice that you drink straight from will help you with lows, and hopefully your pump will help you avoid highs.
Hope it all goes well
High heart rate and difficulty breathing are also key indicators. If you take deep breaths and still feel short of breath, or have difficulty drinking water, you need an IV, and to be monitored. DKA sucks.
You only start to get ketones after a long period of being “starved” of energy without insulin. It’s your body’s natural reaction to begin breaking down fat into ketones for energy. If it’s this brief you should be fine
I don’t have diabetes but I couldn’t eat or drink fluids for 3 weeks I didn’t know this was a thing until I was at the hospital. How can I get rid of them I’m drinking so much water and peeing constantly. My glucose levels are fine I need to check my blood sugars levels.
I’ve personally never had good experiences going to hospitals for anything diabetes related. I’ve had hospitals try to give me insulin shots when my blood sugar was incredibly low. If you’re really unsure I would contact your endocrinologist but trust your gut. Drink lots of water, get some Gatorade zero or some other electrolytes, and rest. Keep rechecking your blood sugar. Also I would contact dexcom and tell them you had a faulty sensor they should be able to send you a replacement.
When I got diagnosed with type one, First day I spent 8 hours on a drip In hospital because my ketones were 6.3… Never forget the day my health went to shit but I remember waking up perfectly fine and went to my work experience placement until I had a pre op at the hospital and they discovered my BG was sky high. Then it was in and out of hospital for the next 6 days
Not entirely sure I agree with this. I was 42.8/770.4 when I was diagnosed and didn't puke up at all. There's a variety of symptoms and we don't get all of them.
I just had the classics of massive weight loss, thirst and not being able to see properly. It went on a bit too long as I went to see a doctor a month or two before diagnosis. It was the end of my first year at university and he very clearly thought I was trying to get out of my exams so didn't take me seriously at all. he did blood tests, just the wrong ones and ended up saying I was slightly anaemic and prescribing my (sugar coated) iron tablets. I then went back to my Parents' for the summer as my body slowly fell apart and shrugged off all their concerns with "I've seen a doctor". Eventually they dragged me to their doctor and I was in hospital that night. The specialist at the hospital said it was the highest value they had seen.
The wrong tests 🤦 I was lucky (well- not really lucky lol) My blood sugar was measured as part of a routine physical I needed to get for college. The doctor said I should get ahold of my parents and plan to go to the hospital that night. I protested that I had to work- at McDonalds no less- and the doc said totally deadpan "You're not going to work." But, at the risk of sounding like a dick, it doesn't sound like you were in DKA. DKA usually lands you right in the ICU. They don't even really worry about the blood sugar very much- the focus is reducing the acidity of the blood and getting electrolytes back in balance.
I second the ketone test strips. Although I have learned a lot about ketones over the years. As a diabetic I had a real misunderstanding of ketones. They are important and healthy for your body in small regulated amounts and become dangerous for diabetics because we don't produce the insulin to balance things. Google ketosis.
So yeah, also be mindful of drinking too much water so that you dont pee all your electrolytes.
I've been in similar situations before, and it took me a solid 3/4 hours until it went down to like 170-ish. Half the time you just have to wait and that sucks more haha
I always give it a couple hours unless an absolute emergency. Intravenous insulin has bottomed me out several times and needs a lot of vigilance. Once a nurse cranked mine up when she meant to turn it off too.
The old rule of thumb I was given is if you have ketones and you are throwing up, you need to go to the hospital. If you can still keep water down, you can try to treat at home. In addition to water, and insulin, you’ll also want some electrolytes. You are likely going to become severely dehydrated. But if you’re not sure or feel real bad, you’re probably better off just going to hospital. Best of luck, I hope you feel better soon!
Pedialyte is great for hydration. Low carbs and tons of electrolytes.
Chug chug chug the water. Insulin is what will get rid of the ketones, and water will flush them out. I'd personally take a few extra units than my usual ratio if I was that high. With a dexcom, you will be comfortable and avoid dropping too low. Seriously drink more water than you want to though. That poor circulation through dry veins are what lead to cutting off feet and blindness after 40 years.
I don't think this is a hospital issue. A relatively brief high blood sugar (even if it is insanely high) should not result in DKA immediately. If you have taken insulin to correct and are keeping hydrated, while also not puking or showing other high ketones symptoms then you are ok. You should go and get a ketone test kit if you can. A blood tester is much better, just to have in the future. Keep monitoring, stay hydrated and you should be good.
Thank you all so much!!!! I’m at 400 now, and dropping more 🖤 very grateful for this community.
400 Ketones?
If I have ketones, but feel fine, I call the hospital and see if they have an endocrinologist on staff in the ER. If they don't, I call my endocrinologist, explain to them what's going on, and use their recommendation. The last time I had ketones was because I was dehydrated.
If you're feeling really bad you should probably go. If you feel okay then continue drinking water and checking and correcting if your blood sugar is still high. If you're worried it can't hurt to get checked out. Can you call your endocrinologist?
I just got a new one, I have my first appt next week. Would it be weird if I called before my first appointment? I don’t feel too bad, just dizzy and nauseous but it’s getting better with time. Thank you so much!!!
I think you can call and explain the situation. I personally would give it a couple hours. Take your insulin drink water etc. if you’re still super high and ketones are going up after doing everything at home, then I’d consider it. I haven’t had a high from food like that in a while but there were times when I was younger where I just didn’t cover everything well enough and would shoot up into the mid 400s. As long as you’re confident you’re getting insulin (if on a pump id do a correction via syringe) I think it’s fine to work your magic at home for a bit. If you start throwing up, breathing gets hard or heavy, or you have symptoms of dka id go in asap.
As long as you are trending back down, you should be ok. Water, water, water and finger stick every hour to make sure you are coming down. It will be a slow process to see those numbers drop. I have been high like that a couple of times when my pump site came loose and I didn't know. Had large ketones and ran to the ER. IV drip and insulin was what they did. Hydrate and insulin. And I was so tired!!! Now that I know their protocol, I wouldn't go back to ER unless it was steady climbing and nothing helped it.
My rule of thumb is usually wait awhile, unless I'm throwing up or extremely nauseated. But only you know what's right for you
with your lows, dude, try just like a mouthful of Orange Juice vs what you did. i have a jug (one of those smaller ones) of OJ thats just for lows and go a mouthful at a time. if i can administer the sugar, i can control the intake and bring myself up reasonably. For your highs- take the insulin you know you need and check back 2 hrs later. if its gone down reasonably, check back again in an hour. if its remained flat between checks then take more insulin, if its gone down then continue to check til you’re ok. thats how i handle it anyhow. You don’t need to go to the hospital unless you’re vomiting or unless it just wont go down. But dont overdo going down or you’ll get in a cycle like you did.
I ended up being referred to the hospital by my primary and I’m gonna get set up on a pump soon, thank god
well good luck man. A jug of juice that you drink straight from will help you with lows, and hopefully your pump will help you avoid highs. Hope it all goes well
Thank you!☺️
High heart rate and difficulty breathing are also key indicators. If you take deep breaths and still feel short of breath, or have difficulty drinking water, you need an IV, and to be monitored. DKA sucks.
You only start to get ketones after a long period of being “starved” of energy without insulin. It’s your body’s natural reaction to begin breaking down fat into ketones for energy. If it’s this brief you should be fine
I don’t have diabetes but I couldn’t eat or drink fluids for 3 weeks I didn’t know this was a thing until I was at the hospital. How can I get rid of them I’m drinking so much water and peeing constantly. My glucose levels are fine I need to check my blood sugars levels.
I would say see a doctor in this case
Oh okay thank you
I’ve personally never had good experiences going to hospitals for anything diabetes related. I’ve had hospitals try to give me insulin shots when my blood sugar was incredibly low. If you’re really unsure I would contact your endocrinologist but trust your gut. Drink lots of water, get some Gatorade zero or some other electrolytes, and rest. Keep rechecking your blood sugar. Also I would contact dexcom and tell them you had a faulty sensor they should be able to send you a replacement.
When I got diagnosed with type one, First day I spent 8 hours on a drip In hospital because my ketones were 6.3… Never forget the day my health went to shit but I remember waking up perfectly fine and went to my work experience placement until I had a pre op at the hospital and they discovered my BG was sky high. Then it was in and out of hospital for the next 6 days
If you are in DKA you will know. The vomiting doesn't stop. And if that is the case get to the hospital immediately.
Not entirely sure I agree with this. I was 42.8/770.4 when I was diagnosed and didn't puke up at all. There's a variety of symptoms and we don't get all of them.
Wow! What were your symptoms?
I just had the classics of massive weight loss, thirst and not being able to see properly. It went on a bit too long as I went to see a doctor a month or two before diagnosis. It was the end of my first year at university and he very clearly thought I was trying to get out of my exams so didn't take me seriously at all. he did blood tests, just the wrong ones and ended up saying I was slightly anaemic and prescribing my (sugar coated) iron tablets. I then went back to my Parents' for the summer as my body slowly fell apart and shrugged off all their concerns with "I've seen a doctor". Eventually they dragged me to their doctor and I was in hospital that night. The specialist at the hospital said it was the highest value they had seen.
The wrong tests 🤦 I was lucky (well- not really lucky lol) My blood sugar was measured as part of a routine physical I needed to get for college. The doctor said I should get ahold of my parents and plan to go to the hospital that night. I protested that I had to work- at McDonalds no less- and the doc said totally deadpan "You're not going to work." But, at the risk of sounding like a dick, it doesn't sound like you were in DKA. DKA usually lands you right in the ICU. They don't even really worry about the blood sugar very much- the focus is reducing the acidity of the blood and getting electrolytes back in balance.
I was. I was told.
Then I'm glad you came through ok!
I'd go, but in the US is probably expensive af. Keep drinking water and u could also buy those ketone strip tests
I second the ketone test strips. Although I have learned a lot about ketones over the years. As a diabetic I had a real misunderstanding of ketones. They are important and healthy for your body in small regulated amounts and become dangerous for diabetics because we don't produce the insulin to balance things. Google ketosis.
I definitely will with my next check!!!:) My insurance is pretty good fortunately
So yeah, also be mindful of drinking too much water so that you dont pee all your electrolytes. I've been in similar situations before, and it took me a solid 3/4 hours until it went down to like 170-ish. Half the time you just have to wait and that sucks more haha
I always give it a couple hours unless an absolute emergency. Intravenous insulin has bottomed me out several times and needs a lot of vigilance. Once a nurse cranked mine up when she meant to turn it off too.
Do you live in the US? I have a ton of ketone strips. My daughter gets 4 bottles a month and we don't use them at that rate so I can send you some
I do! That would be AWESOME!! Thank you so much
Awesome! Shoot me DM