Ketones. The word has a lyrical sound.....It makes me think of a music flowing pleasantly from appealing chords to melody, or of soft palettes of colour for creative expression. Ketones are not benevolent or pleasant though. At least not for people with type 1 diabetes. (There are some pancreatic-enabled people who choose a ketogenic diet of low or no carbs and high fat.as a weight control method)
Essentially ketones are toxic acids. Glucose is our usual source of energy, but if that glucose can't be used in the blood (that's the role of insulin), the body looks for an alternative source of fuel - fat. The liver processes fat into ketones and sends them into the bloodstream. People without diabetes can handle this acid in the blood, but for people with Type 1, the acidic build up together with high glucose that can't be processed, is a life threatening situation. It leads to DKA - diabetic ketoacidosis. DKA can cause damage to the lungs, brain and kidneys. It is to be avoided at all costs - it can be deadly and requires hospitalization.
TD's glucose levels have been on the high side for the last while. At the end of the year we met with the endocrinologist who thought TD was doing a good job of handling the stress of a pandemic, exams and diabetes. 2021 has not been the new start so many were hoping for, it seems to be a continuation of the 2020 mess with the promise of some light at the end of the tunnel. TD's glucose numbers started to rise ....and rise... until last Saturday she was feeling lethargic, tired and couldn't bring down the glucose from 20s. We needed to test for ketones.
TD's glucose meter has the facility to test for ketones using a different test strip. These strips are fairly expensive, and not covered by medical aid, so we don't keep too many in the house. As luck would have it, the few we did have had expired, so TD (exhausted and dejected) and I (anxious and flustered) went in search of more. (I could not leave her at home in case she deteriorated and needed help). The first pharmacy offered to order some in, and I could fetch them in a few days time. The next had a ticket queue of at least 90 minutes wait. It was quicker to drive the 15 minutes to a pharmacy that I know stocks them on the open shelf.
 |
| A safe ketone reading! |
Long story short, there were only trace ketones in TD's blood and we could relax a bit. Getting the glucose down took a lot of patience, jugs of water and more insulin than she would usually inject in 2 days.
But it worked, eventually, and the lethargy, dizziness, anxiety and fatigue subsided, and TD could carry on with her weekend. This will always be a part of TD's life. She will always have to keep control of her glucose, and avoid the highs as much as the lows.
I wish type 1 diabetes were preventable, but it is not.
I wish avoiding it were as easy as obeying a few rules, like wearing a mask, washing your hands and social distancing, but it is not.
. Life throws us so many things we are completely unable to control. So when we are given a challenge (like covid) that allows some measure of being able to keep ourselves safe, grab the opportunity to stay healthy with both hands. Please.
TD was in DKA at diagnosis.The build up of ketones and glucose was so high that she was in critical danger. She survived because a dedicated pathologist ran her tests at night and phoned me at 2am to urge me to rush her to Emergency. She is alive because the insulin that was dripped into her saved her life. The kindness of the doctors and nurses surrounded us when we were overwhelmed and bewildered.
It is our turn to show that same dedication and responsibility towards the medical community. Most of them are feeling overwhelmed and bewildered at the sheer number of people who need their care, and of the loss of life they see daily. Keep being aware of the dangers of covid. Keep the preventative measures as daily habits. Keep safe. Please.
