Type 1 Diabetes and Ketoacidosis

Question

“I have a young male family member who has Type 1 diabetes. He has had many times that he has been in ketoacidosis and hospitalized. I don’t know much about this except its not good. Is there anything we can do to help him with this?”

Answer

It is possible that your concern for your family member’s health is greater than his own. You would think that one bout of ketoacidosis ought to be enough to get anyone’s attention. But let’s give him the benefit of the doubt. He probably just doesn’t understand. Let me explain what’s going on and then we can consider if helping is possible.

Your body gets the energy it needs from food through a process called metabolism. There are two major hormones involved, insulin and glucagon, both made in the pancreas. These two, in combination, help meet all of the energy requirements of your body while keeping your blood sugar in balance.

On average your body requires about 5 grams (a teaspoon) of glucose in the blood to assure a continuous flow of energy when you aren’t eating. The operative word in that last sentence is requires.

When Working Correctly

When working correctly, your body and all bodies release insulin immediately when food of any kind arrives in your mouth. Once that food is broken down, insulin’s job is to put the nutrients into storage someplace. That storage might be directly into muscle cells, liver glucose storage, or body fat.

Diabetes reflects when too much glucose stays in the blood instead of properly storing. Ultimately the storage of last resort is body fat.

However, your body doesn’t know how much or what kind of food you are ultimately going to shove in your mouth. Is this going to be a feast or a snack? Too much insulin will cause blood sugar to dip too low. So in the face of this uncertainty, as a counterbalance, the pancreas releases glucagon.

Glucagon signals the liver to release some sugar from its storage, just in case, to assure that blood sugar doesn’t go too low. Too low, in and of itself, can be deadly.

So, in the grand scheme of things, it’s a balancing act that really goes awry with diabetes. This is enormously critical, potentially fatal, for your Type 1 diabetic family member.

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease that destroys the pancreatic cells that make insulin. However, the cells that make glucagon remain intact and glucose release will be signaled. Why is that important?

Blood glucose is generated by the food you ate plus the glucose being released by the liver, all without the insulin required to store the glucose anywhere. Water, water everywhere and not a drop to drink.

A common signal of Type 1 diabetes is weight loss. Why is that?

Back to normal for just a minute. When there is not enough glucose available for energy, your system begins using body fat. Plan B, if you will. A perfectly normal process, the fat is converted by your liver into ketones which are used for energy. This is how a person loses weight.

However, in the absence of insulin, a Type 1 diabetic isn’t storing body fat. So slowly but surely any body fat available will be converted to ketones. Which is why a a strong indicator of Type 1 diabetes (and cancer) is unexplained weight loss. No matter what or how much you eat.

Ketoacidosis

This brings us to ketoacidosis, a combination of high blood sugar and high ketone production generating a high acid (ph) level in the blood. Untreated ketoacidosis can be immediately deadly. It is fortunate that your family member gets to the hospital quickly, albeit often.

The damage from high blood sugar and the absence of insulin in every organ in his body is beyond description here. Your question is, how can you help?

How to Help

Type 1 diabetes is very inconvenient, especially for a young person who wants to eat, drink, and be merry along with their more normal friends. Many a female type 1 diabetic teen won’t use her insulin in the interest of being skinny. Many an adult Type 1 diabetic errs on the other side, eating whatever they want and covering it with insulin.

As you have already learned here, no insulin can take a person out pretty quickly. Too much insulin takes longer and comes with a lot of extra body fat. Consequences both ways.

Parental knowledge and willingness to train and develop a child’s judgement is required. And sometimes that will fail as well. But we are giving your family member the benefit of the doubt here. Helping certainly has to start with at least an opportunity to understand the consequences.

Maybe a copy of this article would be a start. And I definitely recommend this book, Dr. Bernstein’s Diabetes Solution, for any diabetic but especially a Type 1. Another excellent book is Think Like a Pancreas. Also there is a Facebook group of parents with Type 1 diabetic children called Typeonegrit that parents may find helpful. ===================================================

Pat Smith is the author of “It’s All about the Food,” a book that guides nutritious food choices as the way to avoid illness and maintain a healthy weight. Proceeds from her book benefit the Montgomery County Food Pantry. Her book is available on Amazon and at Bob’s Food City, Mount Ida Pharmacy, and Turtle Cove Spa. Her website is http://www.allaboutthefood.org/ She can be contacted at patsmith2@live.com, 501-605-3902. Her Facebook page is www.facebook.com/patsmithbooks.