romanian, dr, involved in diabetes care I like to answer people's questions if the topic is familiar to me and I have some knowledge to share about it.
There's this young man, 25, diagnosed with type 1 diabetes 10 days ago, presented with severe ketoacidosis. He was underweight, his BMI was around 16, you could see his bones under his skin. A striking exofthalmia.The ketoacidosis was treated, the first 2 days he couldn't eat much because of the nausea, after that his appetite came back, his hunger has no limits, he often hides and eats so that nurses don't see him.
We increased the insulin dose to cover a higher amount of carbs, given the fact he's malnourished, but we reached almost 3 units/kg body weight and still his glycemias are around 300. Education in his case is hard to do, because of his very low IQ.This boy comes from a very poor family, has a history of child abuse, and a mental retardation. TSH level is very low, we are waiting for the FT4, FT3 results, but he probably has also an autoimmune thyroiditis.
Q: what would you do ?4 AnswersDiabetes1 decade ago