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My 16-year old daughter almost died this past winter from ketoacidosis, the primary cause of death in children and adolescents with type-1 diabetes. Diabetics cannot make their own insulin, a hormone that allows cells to absorb glucose, and this cellular fuel simply accumulates, unused in the blood. She manages two daily insulin regimens – one injection that covers base metabolic demands for glucose and injections in response to carbohydrate intake. These ‘carbs’ contain sugars, largely glucose.
She had the flu and was unable to hold anything down and because she was so sick, we did not keep track of her basal insulin. As blood glucose levels rose, her liver responded by breaking down stored glucose. Her body tried to remove the excess glucose through urination. She became dangerously dehydrated, which was exacerbated by her inability to keep even water down. Simultaneously, her body sought energy stores by breaking down fat, which created an acidic by product called ketones. Blood ketone levels climbed and the acidification of her blood overwhelmed her natural buffering system – her body could no longer remove CO2 efficiently from her blood. She became short of breath, hyperventilating to get rid of the excess carbon dioxide that prevented full oxygen absorption.
I carried her to the car, since she didn’t have the strength to walk, and drove to the local hospital. In the emergency room and during the following 3-day hospital stay, she was treated with intravenous fluid replacement, electrolytes, and highly titrated insulin. The experience scared us all. She doesn’t appear to have any long-term side effects and is back to herself. I am left feeling amazed at how easily life unravels once a key system malfunctions and at just how tough she is. She handled the whole experience with grace beyond her years and never complained about ‘why me’. She’s my hero.
