My 78 year old dad just went through having diabetic ketoacidosis. They said he blood sugars were 126 mmol/L [2268 mg/dl] and should of been 6.0 mmol/L [108 mg/dl]. Also, his acid level was at 6.14. They said that anything below 7.0 is not compatible with life. My dad is still alive and doesn’t seem to appear to have any brain damage. He was in the hospital for 26 days. How many people have had such high numbers and survived? I am curious about this. I am not sure if you can give me statistics for Canada or for the world. If possible, I would like your comments on his blood sugar numbers and the acid levels.

I am glad your dad is doing better. The units are sometimes a problem as mmol/L is used in Canada and mg/dl is used in the U.S. However, levels above 126 mmol/L are not usually seen because patients are symptomatic a long time before this and either get changes in mental status or severe loss of fluid that cause a decrease in urine output and changes in kidney function. I would be concerned that there was some element of kidney dysfunction as well. Maybe it has resolved with treatment of the high sugar. These very high sugars result in a condition of high osmolarity in the brain with swelling and the potential for seizures or neurologic dysfunction. The fact he is doing better is great. Hopefully, he will not have any permanent problems.

For him to have such a high blood sugar, your dad must have had some other intercurrent illness. The low pH in the blood is an indication of how sick he was. Usually, when the pH gets below 7, we think that it is very severe and can cause heart and pressure failure in the presence of the overwhelming acidosis. Turning around the acidosis, treating the blood sugars, and treating any other aggravating illness are all part of the overall treatment. I can say that the lower the pH, the worse the chances of dying. However, I cannot give you an exact number. Similarly, we intermittently have patients with blood sugars as high as your dad’s were. However, how well they do is a function of what the cause of the underlying illness is. Those with life-threatening problems, such as pneumonia, may do worse than those who just forgot to take their medications and let their sugars get high. Since your dad is 78, he probably had some other illness to get his sugar that high.

JTL