- advertisement -

missed dka diagnosis?

Discussion in 'Parents of Children with Type 1' started by Ti'sMom, Jun 25, 2013.

  1. Ti'sMom

    Ti'sMom Approved members

    Joined:
    Sep 15, 2012
    Messages:
    95
    With all the stories of misdiagnosed dka I've heard, something keeps bothering me. A friend of mine lost her son 4 years ago. It was during the height of the h1n1 virus outbreak. Her son was fine and the next day was having trouble breathing. They took him to the emergency room who said he was having an asthma attack. Gave him breathing txs and sent him home. His dad wasn't comfortable with the diagnosis as he was barely breathing and Brandon was barely conscious at this point, so they went to another hospital. They admitted him into icu and put him on life support to help him breathe. He died the next day. 9 years old, no previous health issues, sudden onset, no particular symptoms other than the respiratory distress. After he passed they said he tested positive for h1n1, even though there were no flu-like symptoms, and so that was what they said was cause of death. I feel like maybe this could've been a case of misdiagnosed dka. I wouldn't bring it up to her, but I can't get it off my mind. Thoughts?
     
  2. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    No I really do not think so, DKA would have shown up in the bloodwork even if they were not looking for it. He would have been vomitting, massive urination, and a sweet smell to his breath that would have been noticed if it were DKA. There is also s type of breathing in DKA.

    The flu is respiratory, so I am not sure what you mean by "flu like symptoms". thousands of people die everyear from the flu.
     
  3. funnygrl

    funnygrl Approved members

    Joined:
    Nov 2, 2005
    Messages:
    2,324
    It would have shown up on blood work. He likely died of influenza, which unfortunately isn't super uncommon. The flu doesn't get the respect is deserves.
     
  4. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    Very very unlikely because a blood sugar is part of the bloodwork that's always done on people admitted to hospitals. It's just standard.
    Also, in severe DKA, there are a number of things that change on labwork and even in breathing. If a person was being treated for breathing issues, there's no way somebody would miss kussmaul respirations. And, because weird breathing can cause respiratory acidosis, he would have been tested for that.
     
  5. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    kussmaul respirations; that is what I was thinking!
     
  6. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    Please put it our of your mind and not dwell on it, I know it is hard to beleive that the flu took a younge healthy child and maybe there was something more to it, but not Type 1 Diabetes.
     
  7. Lee

    Lee Approved members

    Joined:
    Oct 5, 2006
    Messages:
    9,633
    All of my family had swine flu and it was incredibly difficult. Coco had tamiflu, but they would not give it to me or my oldest due to a shortage. Both of us, those without the tamiflu, missed 10 days of work and school and we both now have lingering asthma and lung damage (as shown in xrays).

    Like others have said, DKA would have shown up. And I just use this story to point out how incredibly terrible the swine flu was for some people. To this day, when either me or my oldest gets sick, our lungs are the first and the most affected and experience severe breathing problems.

    And yes, we did get the vaccine - a couple of days before we started showing symptoms...so not soon enough.
     
  8. quiltinmom

    quiltinmom Approved members

    Joined:
    Jun 24, 2010
    Messages:
    1,189
    What he said. Ds was dxed soon after arrival at the hospital because blood sugar readings are standard procedure. It's very unlikely two hospitals would both miss something like that. Try to put it from your mind. It is very sad your friend lost her son. It would be even sadder if it was because of some oversight like that.


    I wonder if most missed diagnoses are at dr offices? a relative took her ds to the pedi who missed it the first time. I don't remember if they went to the hospital or not, but I do remember her saying she went to the dr more than once in he weeks before he was diagnosed. (He was 12 months old at dx.). Just a thought.
     
  9. valerie k

    valerie k Approved members

    Joined:
    Feb 19, 2008
    Messages:
    1,510
    Im sorry for thier loss, my own sister passed due to h1n1 complications. funnygrl is right, it doesnt get the respect it deserves...
     
  10. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    An older statistic that i found is that influenza and pneumonia is the 8th leading cause of deathin the US, we can only imagine that it is much higher else where. In the US ther was over56K deaths in 2008, even prior to H1N1. I wonder what it was that year?
     
  11. missmakaliasmomma

    missmakaliasmomma Approved members

    Joined:
    May 31, 2013
    Messages:
    846
    I just wanted to insert something here. My daughter was dka at the hospital however, she was not throwing up, it didn't sound like she was breathing differently and she didn't have the sweet smell on her breath. Honestly, she didn't even seem that sick. I don't know if this was just her but they definitely said she was in dka. Her sugar was over 700. Maybe these other symptoms are more common in people with even higher blood sugar when they're in dka, I'm not sure. i just wanted to let you guys know that my daughter didn't present in the same way.
     
  12. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    DKA comes in various severitys, my dd was DKA with a bg in the 400.

    I am glad that your dd did not have severe DKA like mine, but in DKA that would cause death I Am most certain that the classic symtoms of ketoacidosis would be present, but the other thing to think about is that we do not know allbthe facts. It is possible that they were receiving meds to lessen symptoms.
     
  13. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Joined:
    Sep 10, 2006
    Messages:
    4,925
    It's the severity of the acidosis that changes the breathing, not the blood sugar. My blood sugar was lower than that (at diagnosis the meter said 425 and on retest said 375; the bloodwork said 453) but I'd been having Kussmaul respirations for weeks when I was diagnosed.
     
  14. missmakaliasmomma

    missmakaliasmomma Approved members

    Joined:
    May 31, 2013
    Messages:
    846
    Since she was over 700, I'm sure her body was pretty acidic
     
  15. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,030
    the BG in itself says nothing about how "acidic' her body would be, it all depends on how well the body is dealing with the elevated BG.


    Like the previous poster stated he was breathing funny for weeks, that breathing funnny was the bodies way of not becoming acidic but eventually his body was not able to keep up.

    Since DX my dd has been in the 600's and not a trace of ketones, yet she has also been in the low 300's and had large ketones above 2.3

    The quesiton about running ketones and becoming acidotic come up here allot and ketones does not equal ketoacidosis just like elevated BG.
     
  16. missmakaliasmomma

    missmakaliasmomma Approved members

    Joined:
    May 31, 2013
    Messages:
    846
    The reason I wrote the response is to show that not everyone presents the same way, just like not everyone presents the same way with diabetes. Everyone's different. That's it. I simply stated that when my daughter was in dka, she did not show the signs that were mentioned earlier in the post.
     
  17. Michelle'sMom

    Michelle'sMom Approved members

    Joined:
    Aug 21, 2009
    Messages:
    1,432
    We were told BG at dx is a measure of hydration more than anything. The more severe the dehydration, the more concentrated blood glucose levels become.

    My dd's BG was 623 at dx, no DKA.
     
  18. Michelle'sMom

    Michelle'sMom Approved members

    Joined:
    Aug 21, 2009
    Messages:
    1,432
    I agree flu doesn't get the respect it deserves. My dad died from flu complications years ago. My dd had H1N1 only a couple of months after T1 dx. It wasn't as bad as some local cases, but it's not something I would want her to experience again.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice