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.