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June 28, 2006

Hyperglycemia and DKA

Question from Athens, Georgia, USA:

How long does it take for someone to go into DKA? I went for about four days without any insulin. I just felt REALLY tired, thirsty, and was going to the bathroom a lot. I was doing it to lose weight. And I did. I was just wondering because I've heard it could happen within 18 to 24 hours. I'm so surprised. DKA doesn't scare me, although I know it should. I just have this mindset that nothing will happen to me. I've done this multiple times before. I've never had DKA though. Do you think you could possibly tell me why?

Answer:

What you are doing is extremely dangerous. You have what we call “DIABULIMIA.” This is a type of eating disorder like anorexia or bulimia. You are correct that you can lose weight, but in an extremely dangerous fashion since omitting insulin raises your blood glucose levels. This causes you to urinate excessively. Exactly how long any individual person can go without insulin when they make no insulin of their own is not known. Some would get extremely dry, dehydrate, become acidotic, go into a coma and die within several hours, while others could go for several days. Some wouldn’t die, but would only have the equivalent of a stroke and end up paralyzed or severely brain damaged. Also, it would depend on what and how much liquid intake you had to balance the dehydration, how low your blood pressure would drop, how much of such dangerous stress your brain and heart and kidneys would tolerate. There are people who can help you to consider alternatives for weight control and others who can help you if you have been physically or sexually abused, are depressed, are angry, etc. Why not talk this over with your diabetes team and see if they might assist?

SB

[Editor’s comment: It is important that you seek help before you do end up in DKA. Ask your diabetes team to help you find a counselor or therapist. And, even if it is difficult, please tell your parents or guardians about this and ask them to help you as well.

BH]