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From Garland, Texas, USA:

My 13 year old daughter was diagnosed almost 4 years ago. She has been in the hospital twice in the past 3 months with DKA. Both times she got sick, she spent the night away from home. This past time, she was fine on Saturday when we dropped her off her blood sugar readings were stable and she had no ketones. On Sunday morning when we picked her up, she got sick and had a blood sugar reading of 477 and large ketones. She told us she had a horrible time and that her Grandmother was continually yelling at her. Can stressful situations cause her to get DKA within a 24 hour time frame? I have read that when a diabetic gets stressed and if it builds up to much acid that it can happen. Is this true?


It is true that emotional stress can raise the blood sugar, but it is unlikely that arguing with a grandmother could put someone who was in control into ketoacidosis in less than 24 hours.

I would be concerned that your daughter either didn't take her insulin or didn't take the right amount the night she slept at her grandmother's house. It is not uncommon for teenagers to show their parents they either aren't mature enough to control their diabetes away from home on their own, or don't want to stay away from home by not taking the insulin or not taking the right amount.

I suggest you speak to your child's doctor about seeing a therapist with experience treating adolescents with diabetes. Ketoacidosis is very serious and can even be fatal. I suggest you not let your child stay away from home without close supervision by someone knowledgeable in both drawing up and administering insulin until you have this issue under control. If you feel your child may not take her insulin or the correct amount at home when she is upset, you may want to supervise her insulin drawing up and administration at home too. Explain to her you are concerned and that you want to help her so she doesn't get dangerously sick. Even is she doesn't want supervision, most likely in the long run she will appreciate your concern and care. Make sure she actually injects the entire amount drawn up. It is not uncommon for teens to squirt out some insulin before injected, even when supervised.

You will want to of course sort out what the issues are that causes your daughter to get so upset away from home. It is not uncommon for teens to let their diabetes get out of control as a way of letting their parents know they need help.


Original posting 17 Jun 97


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