Friday, 31 July 2009

The Ketone Cops

There are two main types of diabetes – Type 1 and Type 2. Type 2 is something that normally develops slowly, and is largely due to ‘insulin resistance’. This is where the person is still producing their own insulin, quite possibly in large amounts, but the person’s body is not able to use it efficiently. Type 1 tends to be far more dramatic in its development, as it is caused by the failure of the beta cells in the pancreas to produce insulin, and this total lack of insulin can lead to a life-threatening condition called Diabetic Ketoacidosis (DKA). With no insulin available, the cells in the body are unable to use the glucose in the blood and will turn to using the energy stored in fat instead. A by-product of this process are something called ‘ketones’, which can alter the ph value of the blood and turn it acidic.

In order to process the ketones you need insulin, and since this is absent then the ketones will build up to dangerous levels. Ketones are produced in non-diabetic people through a process called ‘ketosis’, and this is the basis for diets such as Atkins, which ‘force’ the body to use fat stores by depriving it of carbohydrates, resulting in weight loss – however, non-diabetics are able to process these ‘starvation’ ketones as they have a healthy supply of insulin.

I was admitted to hospital with DKA when my pancreas failed. I lost 17 pounds in weight in three days and could not eat or drink without being sick, although I was going to the toilet regularly, despite not being able to hold any liquids down. This was because my body was trying to flush the ketones out through my urine. My breath smelt of pear drops, or acetone, as this was another way that my body was trying to expel the ketones, and caused rapid breathing. I was exhausted because my cells were not getting any energy, and the glucose levels were building higher and higher all the time.

Thankfully, I called the emergency services and after some tests in hospital it was confirmed that I had diabetes. My blood sugar was at 37 – normally it would not go above 7 in a non-diabetic person. Immediately, I was placed on an insulin drip, and within 24 hours I no longer felt sick, had boundless energy and a ravenous appetite! I learned an awful lot about the workings of the human body that week and in the weeks and months that followed. I never want to experience DKA again – it is the worst I have ever felt in my life! The one danger that remains is that, should I get ill, with flu for example, my insulin requirement will increase. I would need to increase my doses in order to prevent ketones from developing, and this is an uncertain science. For this reason, people with diabetes need to take very special care when they get ill, and regularly check for ketones using either urine or blood ketone testing strips.

Send officers quickly, there’s been a calamity!
I’m beginning to think that I’m losing my sanity!
I’ve lost so much weight that I’m light as a feather,
And I’m sweating profusely, though it’s hardly hot weather!

I keep throwing up, with an insatiable thirst –
Do you know what it is? You can tell me the worst!
I haven’t stopped p’ing from dawn until dusk,
And soon I’ll be looking like an old dried out husk!

My breath smells of pear drops – that acetone smell,
Oh please come and help me, you can tell I’m not well!
I’m panting and wheezing and my heart’s fit to burst,
I feel helpless and dizzy and wretched and cursed!

Don’t worry, stay with us, for help’s on its way!
We’re thinking that maybe you have DKA…
We’ll get you some insulin and you’ll be right as rain,
And tell you how to make sure it won’t happen again.

If your blood sugar’s high and your insulin’s low,
It’s likely that ketones will soon start to show.
You need to be vigilant – keep them on the hop,
And we’ll make you an honorary Ketone Cop!

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