DKA Doesn’t Wait: Gibran & Trinity’s Stories Show Why Ketone Checks Matter

When Gibran Juarez and Trinity Lindblade were diagnosed with type 1 diabetes, their lives changed instantly. A few years later, they each faced a life-or-death moment when they were rushed to the hospital with diabetic ketoacidosis (DKA).

Today, by actively monitoring their ketone levels, they now work diligently to prevent DKA episodes—allowing them to stay healthy and inspire others.

What is diabetic ketoacidosis (DKA)?

DKA can strike at any age in people with any type of diabetes and it is the leading cause of death for people with type 1 diabetes.

It can occur when the body lacks insulin and burns fat for energy, producing ketones. Too many ketones make the blood dangerously acidic.

The time between initial symptoms and acute DKA presentation can range from a few days to as rapidly as a few hours.

Symptoms and consequences of DKA include:

• Severe thirst
• Nausea
• Vomiting
• Confusion
• Coma 
• Death

Euglycemic DKA (Eu-DKA) is a rare DKA type where blood sugar stays normal (under 200 mg/dL), making it harder to spot if someone is only monitoring glucose levels.

Eu-DKA can happen due to:

• Dehydration
• Not eating enough
• Pregnancy
• Alcohol
• Some diabetes meds like SGLT-2 inhibitors, or
• Illnesses

Eu-DKA treatment includes rapid fluid replacement, insulin and correction of electrolyte imbalances. 

It’s important to note that DKA can also affect people with type 2 diabetes who are on intensive insulin therapy or medications like SGLT2 inhibitors.

Trinity’s basketball dream

Trinity emphasizes the importance of knowing when to check your ketones to stay safe and decrease the risk of DKA.

Living with diabetes, she excels in basketball, demonstrating exceptional commitment and skill.

Trinity’s relentless dedication secured her a spot on a collegiate Division III women’s basketball team.

“A lesson that I have learned from type 1 diabetes that has made me a better basketball player would be resilience,” Trinity shares. “Some days, you’re going to try your hardest and still not get the results you want. You have to keep pushing. Every day is a new day, and you should not give up because of a bad day.”

Whenever she realizes she might have rising ketones, Trinity tells her parents, checks her ketones and hydrates.

Gibran Juarez’s mission

Diagnosed at nine years old with diabetes, Gibran Juarez experienced his first DKA episode at age 13 during a soccer tournament.

“My parents saw that I was not looking okay,” he recalls, “and my breath was a bit funky. I also had to use the restroom every five minutes, so that’s when they took me to the hospital, and that’s where I learned about DKA.” 

Attending a diabetes camp was the turning point that transformed Gibran from a shy, self-conscious child into a confident advocate for others living with diabetes.

Now, as a teacher and coach in North Texas, Gibran helps young people reach their fullest potential while showing them a diabetes diagnosis does not define their future.

Knowing the signs: Taking action early

Both Trinity and Gibran have faced DKA multiple times.

Studies on children with type 1 diabetes and DKA have shown that experiencing DKA once increases the likelihood of it happening again. Even years later, those who have had DKA require additional care to prevent future episodes.

Through their respective experiences, Trinity and Gibran have learned to recognize DKA warning signs. 

Trinity’s advice for someone who doesn’t check their ketones or know when to check their ketones? Learn to listen to your body.

“If you aren’t checking regularly, you need to know what signs your body is giving you that tell you they could be out of control,” she says. “It is also scary to see the amount of ketones you have if you do not check them regularly, so don’t panic. Do what your doctors tell you to do and keep on pushing. Diabetes does not define who you are.” 

Initially, Gibran overlooked symptoms like frequent urination and fatigue. Now, he actively monitors ketones and manages his glucose levels.

“If for whatever reason, I need to test, I use ketone strips, and I know to take action by drinking plenty of water and making sure I take the proper insulin dosage.” 

How to test for ketones

The American Diabetes Association (ADA) recommends testing for ketones in the following situations:

• When your blood glucose levels are consistently above 240 mg/dL.
• If you are feeling ill, such as having a cold or the flu, you should test for ketones every 4 to 6 hours.
• If you show symptoms of DKA (e.g., nausea, vomiting, abdominal pain, fruity-smelling breath, or trouble breathing).

Despite being potentially life-threatening, DKA risk can be reduced with proper preparation.

• Consult your healthcare provider to create a personalized ketone monitoring plan.
• Spot symptoms like excessive thirst, nausea and rapid breathing early.
• Know your risk, as medications like SGLT-2 inhibitors and conditions like illness or pump failure can raise it.
• Keep unexpired urine and blood ketone test strips ready for regular checks.
  • Urine strips change color based on a range of ketone levels. 
  • Blood ketone meters provide a precise reading.
• Follow product instructions and seek medical advice if ketones appear, as they may require urgent care.

Trinity and Gibran’s inspiring fight against DKA 

Resilient and united by diabetes, Trinity Lindblade and Gibran Juarez have transformed their challenges into strengths.

With help from their families, they work to lower the risk of DKA. They do this by making sure they use the right amount of insulin, knowing the warning signs of rising ketones, talking often with their doctor, and sticking to a plan to manage their insulin.

Through advocacy, sports and perseverance, they inspire others to take proactive steps in diabetes care.

Their journey proves that while diabetes is demanding, it doesn’t define them.

This content was made possible by Abbott Diabetes Care, an active partner of Beyond Type 1. Beyond Type 1 maintains editorial control over its content.

DISCLAIMER: The interviewees are members of Abbott’s FreeStyle Libre Champions Program, a community of people across the U.S. who volunteer to share their diabetes management experiences. For more information, email [email protected].