I was having a good sleep till 3 in the morning when my telephone rang.
Sir,there is a patient here with a blood sugar report of 800mg percent. The duty doctor from my hospital was calling me.
How is she now and what is her past history? I asked sleepily.
She is drowsy and breathless. She is a known type 2 diabetic 65 years of age.She stopped her Insulin injections on her own 1 week ago was the reply.
Yes this was a Diabetic emergency. She is having diabetic ketoacidosis.In my mind I cursed her for stopping Insulin,but rapidly fired orders to be executed.She needs intensive care,lot of fluids and lot of Insulin and strict management of her electrolytes.
By mid-day her blood sugar levels came down to 250mg% and she became alert and less breathless.
If managed well Diabetic ketoacidosis [DKA] is a rewarding experience to a doctor. I still remember how I monitored and helped in managing Diabetes patients [mainly type 1]with DKA as an intern in medical college. The principles of management are the same even now though the technology used has improved a lot.
Though my sleep was disturbed, in the end I felt happy and satisfied in managing that patient.
Friday, July 11, 2008
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5 comments:
Wow 800 is very very high, nice job getting it back down, but what happens to her now? Will she be able to get insulin and take it?
Yes she is already shifted from iv insulin to subcutaneous insulin.Now we have to stabilise her blood sugar
Great work Doc!
I have to admit, your comment about managing DKA well is rewarding, through me off a little but I Totally get it!
I like that you added "The principles of management are the same even now though the technology used has improved a lot." I can only imagine. I have not had DKA since I was diagnosed, 23 years without an episode. Glad that you shared this insight with your readers.
And of the course the best part:
"Though my sleep was disturbed, in the end I felt happy and satisfied in managing that patient."
Good work again. Thanks!! ;-)
Idiotic lady! As a type 1 diabetic I know how dangerous it is to fool around with these things.
Yes I also felt like blaming the lady. But on second thoughts I felt ignorance not stupidity may be the reason.We do not get [or you can say find] enough time to educate the patients about the disease,about the importance of taking the treament etc.Usually in small clinics and hopsitals only the doctor is involved in educating the patient.I believe in the West there are an array of para medics to help the patients.
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