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Question:

From United Kingdom:

I am 15 and have had diabetes for five and a half years. I am very recently just out of a three week stay in hospital due to ketoacidosis. I had been unwell for quite some time before this and eventually I was brought into hospital. My A1c was 11.9 and the doctors couldn't figure out why. They thought I just wasn't taking my insulin, but my family and I know I always take my insulin. While I was in hospital, I wondered if my age or puberty could have any effect on my blood sugars. When I asked the doctors this, they just completely shifted the subject. All I want to know is if my age could have had anything to do with my high bloods.

Answer:

Age is not a factor although the hormones of puberty can make taking care of diabetes more difficult. An A1c of almost 12% is enormously high so that you have frequently very high blood glucose readings. DKA happens when one runs out of insulin, does not take insulin or an illness blocks how insulin works. We think that virtually all cases of DKA are preventable with proper sick day rules, ketone testing (blood or urine), extra insulin when ill, etc. So, the questions I have revolve around all these issues: why are you so out of control all the time; what caused the DKA if you were not omitting insulin; or, is it possible that you always take too little insulin and then got ill and did not take enough extra insulin as a second factor?

I would encourage you to go back to your diabetes team and ask to problem solve with them. Listen to what they recommend: perhaps more daily monitoring, perhaps more insulin injections or a different regimen, or a change in meal planning or carbohydrate counting review. Your first goal should be no more DKA. Your second goal should be moving the A1c downward. (We would say an A1c goal should be less than 7% and without excessive/severe hypoglycemia, for instance). Go for it.

SB

DTQ-20080310163659
Original posting 18 Mar 2008
Posted to Hyperglycemia and DKA and Puberty

  
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Last Updated: Tuesday April 06, 2010 15:10:16
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