Diabetes Crisis Can Look Like a Hangover
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When you have diabetes, you always have in the back of your mind a
list of "what ifs".  What if I go into diabetic coma? What if I pass out in
the street and no one knows I am a diabetic?  Now, to this list of "what
ifs", you can add another, more troubling one --what if I have diabetic
ketoacidodis, get to the emergency room, but the doctors let me die
because they think I am drunk?

Recently, a young 26 year old woman in the UK, 26-year-old Phillippa
Odlin, died from diabetic ketoacidosis at London's North Middlesex
Hospital when doctors mistakenly thought she had a hangover,

Diabetic ketoacidosis affects over 2.2% of al diabetics according to the
Centers for Disease Control, meaning it could potentially affect up to
581,000 of the 29.1 million people in the US with diabetes. Diabetic
ketoacidosis can affect both Type 1 and Type 2 diabetics.

Diabetic Ketoacidosis Is a Deadly Condition

With diabetic ketoacidosis, you develop extremely high levels of acid
compounds called ketones.  One unalterable truth is that your body has
a constant need for energy. You have to breathe and that requires
energy. Your heart beats and that requires energy. Your brain thinks
and that requires energy.  

To meet this constant need for energy, your body draws down on both
sugar (glucose) and fat sources.  If your body is unable to metabolize
sugar to use an energy, it draws down on the fat sources. Burning fat
produces ketones.

Too much fat-burning without some sugar burning produces excessive
levels of ketones. If you took a blood test, you would find evidence of
ketoacidosis by measuring the levels of bicarbonate in your blood. The
test will show that your blood is too acidic.

Ketoacidosis is indicated when the level of bicarbonate in your blood is
lower than 15 mEq per L. Some sources such as the American Academy
of Family Physicians starts the target at 18 mEq per Lmmol.

You would also have an extremely high blood sugar level, since your
body would not have burned any of the sugar and it would therefore
have hung around in your blood stream.

Dangers of Diabetic Ketoacidosis

Ketoacidosis can cause a hemorrhage in your brain, called a cerebral

Other dangers, according to the American Association of Family
Physicians, include low blood sugar (hypoglycemia), low potassium
levels (hypokalemia), kidney failure (acute renal failure), and shock.

Other problems you may develop include blood clots (thrombosis),
death of muscle fibers including the muscle fibers of your heart
(rhabdomyolysis), memory loss and stroke.

What Are the Symptoms of Diabetic Ketoacidosis?

The most common symptoms of diabetic ketoacidosis are

  • having a breath that smells like fruit

  • feeling tired all the time

  • feeling confused

  • vomiting

  • feeling thirsty

  • having difficulty breathing

  • having dry mouth

  • passing out

  • excessive urination

As you can see, many of these symptoms mimic drunkenness. Imagine
having these symptoms and being unable to tell a doctor that you are
not in fact drunk?  That's a nightmare.

These are symptoms listed by the American Diabetes Association and by
various studies of the condition.

What Puts Me at Risk for Diabetic Ketoacidosis?

Of course, the biggest risk for this condition is simply being diabetic, a
condition which men for various reasons find it even harder to control
than women.

If you have diabetes, your are at a higher risk for ketoacidosis if

  • you skip meals

  • you don't monitor your blood sugar often

  • you don't get enough insulin

  • you are sick, such as from a cold or flu or other condition, and
    therefore you don't eat enough

It's also possible to experience a spike in ketone levels even while you
are asleep.

In addition to monitoring yourself to avoid each of these risk factors --
don't skip meals, check your blood sugar and insulin intake -- you
should also have your doctor check you for diabetic ketoacidosis
whenever your blood sugar levels are at or exceed 240 mg/dL.

Moreover, the London Hospital in which the young woman died from
diabetic ketoacidosis strongly recommends that you avoid drinking too
much alcohol especially if you are diabetic because of the risk of
confusing the two conditions. Uh, we can mark that down as the most
obvious warning of the decade.

Diabetic Ketoacidosis Needn't Be Deadly If Treated Right Away

The Mayo Clinic says that treatment for diabetic ketoacidosis include

  • giving you water to replace the fluids you have lost

  • giving you electrolytes to replace the electrolyte imbalance caused
    by to little insulin

  • giving you enough insulin to bring your blood sugar levels below
    240 mg/dL.

Usually after your blood sugar levels fall below 240 mg/dL, you are
able to resume your insulin regime.

A Common Sense Precaution to Take

The danger is that you will pass out and be unable to tell doctors of
your condition. Every second counts.  

If you are diabetic, you should wear a bracelet or necklace to let
doctors know that you are diabetic. This bracelet or necklace can speak
fro you when you can't if you happen to pass out.  You may also wear
something that says "I am not drunk, check for diabetic ketoacidosis!"

An underwear T-shirt with this message, a bracelet or a necklace may
help to save you from a  brain edema or stroke or worse yet, a death,
caused by diabetic ketoacidosis.

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Diabetic ketoacidosis symptoms can
resemble drunkenness.