In 23ish years of life with type 1 diabetes, I’ve never really experienced DKA…and I feel wildly fortunate to have avoided it.
But the other day, I came extremely close to it, and it’s something I won’t soon forget.
Here’s what happened: It was the wee hours of a Sunday morning. I woke up because I had to use the bathroom. My pod was on my thigh. I was due to change it that Sunday evening. I noticed that the pod’s adhesive folded up in the exact wrong way (it was crinkled up by the cannula), causing the cannula to bend and dislodge itself from my body…
…except I didn’t make that super-important observation until around 11 A.M., after several hours of tossing and turning in bed, unable to sleep because I was battling both a headache and stomachache.
What’s more is that around 10 A.M., I noticed that my CGM had been reporting a high blood sugar since about 5 A.M., and I simply hadn’t heard it alarming. When I saw that I was high, I took a bolus, but I didn’t bother checking on my pod because to my knowledge at that point, there was nothing wrong with it. Fast-forward to one hour later to when I did discover the dislodged cannula and I was feeling downright terrible: My stomachache turned into full-blown nausea, my head was pounding, my throat was drier than the Sahara, I couldn’t unfold myself out of the fetal position, AND I was feeling incredibly stupid for 1) missing my CGM’s blood sugar alerts and 2) not checking my pod to make sure it was secure to my body.
Fortunately, I did have a back-up pod and insulin with me, so I went about activating the new pod as quickly as possible. I felt a fleeting sense of relief when it was on me, but that relief turned into panic when I felt a swooping sensation in my stomach that indicated I was about to be sick. I ran to the bathroom and retched once, grateful that nothing actually came up, then sank down on the floor in shame, wondering how I could let myself get to this point of obvious borderline DKA.
The next few hours passed in a blur as I crumbled back into bed. I drank as much water as I could stomach, gave myself bolus after bolus, increased my basal rate, and tried to settle into a comfy position. I was extremely lucky that I wasn’t alone during this whole ordeal: My significant other was very concerned and doing everything he possibly could to help me. I was and am still so grateful for his care and attention. I didn’t admit it to him, but I was a little freaked out by the whole experience, but I took consolation over the fact that it didn’t come down to him having to bring me to the hospital.
By 4 o’clock that afternoon, my blood sugar was finally below 180 again and I was able to eat a little food, though I wasn’t overly hungry. I spent the remainder of the day beating myself up for letting this happen, but I guess that if I learned anything from it, it’s that I need to remember to 1) keep the volume turned up on my CGM so I can hear the alarms going off overnight, 2) check my pod immediately after hearing a high alarm so I can rule out any obvious pod issues, and 3) bring a syringe with me wherever I go so I can inject myself with insulin/get it in my system faster than a pod would be able to.
The experience also taught me a couple of other things…DKA is very real, very dangerous, and should be taken very seriously. The fact that I just barely dodged it is a jarring reminder that I should never underestimate it. On a much lighter note, though, I also proved to myself that I’m able to take control of a situation like that the moment I become aware of what’s going on. Thank goodness I was at least prepared enough that I had an extra pod and insulin on hand. I hope there isn’t a next time, but if there is, I know exactly what to do in order to take care of it as quickly as possible, thanks to this icky experience.