High Blood Glucose and DKA?

[Midori1999]

I am not diabetic but have a condition that causes hypos/highs and when I posted in here before I got really useful advice, so I find myself here again. I hope no one minds.

I am on high dose steroids, which started Monday and have been having high blood sugars since then in hospital and was discharged today, with instructions to present at A&E immediately if I feel I need re admission.

Normally my blood sugars have dropped a bit after a meal and then find up again afterwards and then fallen more overnight. However, they've been highish all day today with no post meal fall below that. (18-20 mmol) the consultant wants me to check for keytones and had said hourly in hospital, but that seems excessive to me. I haven't had keytones so far and am wondering if my blood sugars would really need to be persistently high for much longer to cause a problem?

Thankyou.

Hi,

I am a type 1 diabetic and I always test for ketones when my BS stays as persistently high as yours has. Sometimes I have ketones with it sometimes not. I use dipsticks to check my urine. You can easily do this hourly.

Has your consultant given you advice on what to do if you do find ketones?

No one will want to advise you here as we don't know anything about your condition

Forgot to say I hope you get this sorted, although I don't know about your condition I do know that you can feel pretty rubbish with BS levels like the on's you are experiencing.

How are you now?

Hospital admission is not over the top in this situation. If you are in the process of developing ketoacidocis you need careful monitoring as people can suffer serious and fatal deterioration in a few hours. It really can happen that fast (not saying it's likely but there is a risk).

You need monitored until the situation is under control - possibly regardless of your health status before, you may actually be diabetic now?

Hi op, just noticed this thread is from a week ago ... Hope you are feeling ok.

Thank you. The condition I have is called Insulin Antibody Syndrome and and very rare, so even the hospital (or the specialists they are consulting with) don't have that much experience of it or treatment of it. It's basically where my body is producing antibodies, which bind to the insulin I produce and stop it working, but then randomly release it and cause hypos. It means there are massive amounts of insulin in my blood which can be made available at any time.

My steroid dose reduce on Monday and will reduce again tomorrow, so I'm hoping that will help. My blood sugars have still been mostly high, but for me it's more important to just avoid lows for now, as things can be so unpredictable and my blood glucose can drop really quickly. They're nowhere near as high as they have been and have been rising after meals and then falling again, so I think that's better and less risk of DKA from what the consultant had said. I have checked for keystones, but have never had above 0.2, which is insignificant as I understand it?

Wow that's bizarre (and difficult to deal with I'm sure)!

Is there any evidence/theory on what triggers the cycle of binding up the insulin or dumping it? I'm not a medical professional, just a nosy cow !

Thanks. The hardest thing is so few people having it tbh, as even the specialists have only treated ten cases worldwide, so all treatment is very experimental. Also, as I am fine most of the time then it's hard for peopl to understand how potentially dangerous it is, much like Diabetes I suppose. I've only been allowed out of hospital with an alarmed CGM.

As far as I know they really don't know very much about the condition at all. Most cases are apparently in Japanese people and they think that is due to some genetic predisposition. I did have insulin dependent gestational diabetes in two pregnancies and they aren't sure if giving myself insulin then (which I obviously needed) may have been some sort of trigger. I've had blood etc taken for medical research, as well as weekly bloods being taken and sent to the specialists, so hopefully that will help them find out more about it. Some cases are quite mild and resolve themselves quite quickly, whereas my blood insulin levels are apparently one of the highest they've seen and my symptoms very apparent (I was having around 8-10 hypos a day under 2.2 before I started the steroids) so hopefully that means they can get a lot of information from me.

It's obviously horrid being ill, but it's all been quite interesting.

That really is very interesting! I suppose it doesn't help you right now but it sounds like the severity of your condition might help with research breakthroughs in the future... Fingers crossed .

I know this thread is old but wanted to come back to you to send you my best wishes. Your condition sounds really challenging to handle so I hope you get some help with it.

Sugars rising high after meals is quite common, I can get spikes as high as yours depending on what I have eaten, usually drops as the food is processed. Ketones of 0.2 is fine. Mine are often like that but less than 0.5 and I feel comfortable.

Hypos of 2.2 10 times a day -poor you-you have had a lot to cope with.
As for 1of 10 cases worldwide-wow!

Have you looked at the Diabetes UK website? I seem to remember reading on there about someone (in this case with type 1diabetes)developed antibodies to insulin. Worth a look anyway.