My diagnosis story: DKA with 625 mg/dL

I’m Finn. I got my Type 1 LADA diagnosis on Friday the 13th (of August 2021) with a blood sugar level of 625 mg/dL - DKA was a pretty clear cut diagnosis.

I’d been losing a lot of weight the few weeks (or maybe months, I wasn’t weighing myself regularly) before going to the hospital, but I’d also had my first Covid vaccine when I started to notice the weight loss and the weight loss accelerated three weeks later after getting my second shot. In the week before I went to the hospital, I lost 4kg/8.8lbs in one week.

We (including my doctor) initially waved it off as just a bad reaction to the vaccine, but eventually realised we needed to call an ambulance. Afterwards, we were able to look back and recognise the symptoms of DKA - tired, not hungry, throwing up, fruity-smelling breath, having to pee a lot, very dry mouth, fast breathing. Since I wasn’t able to keep food down in the final few days before calling the ambulance, I was drinking hot water with honey in it and eating applesauce - both of which we realised after the fact didn’t help my situation at all, but we had no way to know that at the time.

I spent 3 days in intensive care and then another 11 days in the ‘normal’ ward. Once I got my appetite back, I can honestly say the hospital food was delicious. It probably helped that I hadn’t eaten a full meal in over a week.

In the past 8 months post-hospital, I’ve brought my HbA1c down from 11.4 to 6.5 and I’m pretty happy about that. I feel back to normal… if you ignore the 5 daily injections and the pockets full of glucose tabs.

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Welcome @Finn! Sounds l like you are doing really good!

One of these days you might consider an insulin pump, you just hit a button and can give more accurate doses and smaller doses easier when needed. No more shots lol. But the very best thing, if you don’t have one, is a CGM! It lets you track your BG level 24/7 so you can make adjustments and know what you are trending.

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Thanks Marie.

I’m on MDI right now and have FreeStyle Libre 2 (but recently learned they’re migrating all of us to FSL 3 later this year). I’m doing pretty well with MDI at the moment and the CGM has made a big difference.

I did ask about a pump at one of my first post-hospital appointments (out of curiosity, not as a request), but was told pens are fine for me at this stage. I’m ok with that, although maybe I’d think differently after trying out a pump. :laughing:

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The biggest reasons my son went with the pump after 8 months of MDI was the ability “graze” eat instead of deciding what to eat then dosing, then eating. When he decides he is still hungry at the end of the meal, he just dials in the dose on the pump and proceeds to eat. The second was the ability to help manage his blood sugar during competitive sports. The eating was definitely the most freeing part for him.

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I can definitely see the benefits of a pump, but at the moment I’m enjoy a break from the temptations of grazing. :sweat_smile: I’ve been losing weight steadily since my diagnosis and one of the big changes has been no snacks between meals (unless I’m actually hungry, or have low blood sugar, then I eat). I’ve worked from home for the last 8 years and have gotten in some not so good eating habits. :shushing_face: MDI is at least helping me get in better habits. :grin:

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Sorry about your diagnosis, but fortunately there’s never been a better time to have diabetes with all the available insulins and technology.

CGM is a game changer.

Welcome!!

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I used MDI for 8 years before switching to a pump. MDI is simpler, but the pump enables me to adjust the basal rate for different times of day, even on the spur of the moment. And wearing a pump, I always have insulin easily available for corrections or unanticipated eating. With a pump, dosing insulin is much more discreet. (Have you had the experience of a horrified restaurant employee rushing over to you, “I,m sorry sir, but we can’t allow any drug use in our establishment” as you take out a syringe…) But for me the CGM is the essential tool, both for safety and so that I can learn cause-and-effect while easily steering my BG in a good direction.

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i agree with jim26, and feel the cgm is a lot more important than the pump. knowing your insulin to carb ratios, and knowing how activities affect your bg levels takes a little time, and for now, pens are probably fine. i also had a lot of luck with tresiba, and found it to be the only basal insulin that did not feel like nph peaking every 6 hours. im on the omnipod now, but i was on a 15 year pump break with mdi and dexcom, eversense, libre, then now back to dexcom…only because both the omnipod and dexcom are through my pharmacy benefit, and it costs me the same money if i choose pen needles and test strips, or the omnipod dash and dexcom…maybe a little more for the dexcom since the transmitter and sensors are separate copays…by the time you are ready for the pump, the omnipod 5 will probably work and be released, just make sure to have all the prior authorisations lined up correctly and double check with your insurance company 1st

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Thanks Roger.

I’ve got Freestyle Libre 2 now and learned I’ll be migrated to FSL 3 later this year.

I’m currently on Humalog and Abasaglar (I think that’s just Basaglar in the US). I recently decided to try splitting my basal and it’s let me reduce my bolus by 80%. I’m excited to share the success with my diabetes team at my next appointment! Wins like this are a major confidence booster, especially this early on in my diabetes journey.

I agree - CGM is a game changer. I had about two months post-diagnosis with finger pricks and some rough lows before getting my CGM. The low alarms are great and seeing how I’m trending is so helpful when we go for walks.

I’m in Germany, so my insurance situation is pretty different than those in the US.

Prescriptions here are just €5-10, so each pen costs me €1-2 (depending on whether I get a box of 10 or a box of 5) and each sensor is €5. Test strips are free (even though I’ve got a CGM), although I don’t go through strips nearly as quickly now that I’ve got a CGM.

I’m not sure what the costs are for pumps here, but I imagine it’s not too bad.

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in Germany, you are actually protected by the eu data protection directive… not sure if you are already using xdrip to see your libre2 on a watch, but its certainly a possibility, just needs a little computer research…sorry about the prescription babbling, i often assume everyone here is in the u.s.a. although i would imagine the omnipod might be a little cheaper there, or will be soon

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Thanks. I’m actually American, but live in Germany, so you’re assumption was half correct. :smile:

While the scanning is annoying at times, I’ll be getting the FreeStyle Libre 3 later this year so then everything will be sent straight to my phone. Apparently they’re coming our with a reader too for the FSL 3, but I can’t find what that will look like and how it will work.

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you should be able to use the libre2 and xdrip+ with an Android phone and wearos watch, having a watchface with your glucose and bg directional arrows is my favorite setup so far…might take a little while to figure out, but it will be worth it…there are a few videos out there showing the libre3 without watch interoperability, so im not impressed with the libre3 at all…especially since xdrip and wearos watches have been working fine for about 6 years now…possibly 7, but i started with the dexcom g4 in 2016

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