Diabetic Ketoacidosis Insulin Treatment

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What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin. Depending on the severity, insulin may be given intravenously or by injection under the skin. Usually potassium is also needed to prevent the development of low blood potassium. Throughout treatment blood sugar and potassium levels should be regularly checked. Antibiotics may be required in those with an underlying infection. In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended. Rates of DKA vary around the world. About 4% of people with type 1 diabetes in United Kingdom develop DKA a year, while in Malaysia the condition affects about 25% a year. DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost universally fatal. The risk of death with adequate and timely treatment is currently around 1–4%. Up to 1% of children with DKA develop a complication known as cerebral edema. The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. Those who measure their glucose levels themselves may notice hyperglycemia (high blood sugar levels). In severe DKA, breathing becomes labored and of a deep, gasping character (a state referred to as "Kussmaul respiration"). The abdomen may be tender to the point that an acute abdomen may be suspected, such as acute pancreatitis, appendicitis or gastrointestinal perforation. Coffee ground vomiting (vomiting of altered blood) occurs in a minority of people; this tends to originate from erosion of the esophagus. In severe DKA, there may be confusion, lethargy, stupor or even coma (a marked decrease in the level of consciousness). On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, tachycardia (a fast heart rate) and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity", often compared to the smell of pear drops whose scent is a ketone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.....

Low-dose Insulin Infusion In The Treatment Of Diabetic Ketoacidosis: Bolus Versus No Bolus

The effects of an initial iv bolus of insulin upon plasma glucose, blood gases, and electrolytes were assessed in 19 children with 20 episodes of diabetic ketoacidosis treated by a continuous low-dose insulin infusion of 0.1 unit/kg/hour. An iv bolus of insulin administered prior to low-dose insulin infusion accelerated the decline of plasma glucose concentration during the first hour of treatment, but differences in decline of mean plasma glucose concentration were not apparent thereafter. The mean time required for attaining “normoglycemia” (250 mg/dl) was similar, whether or not the initial bolus of insulin was given, with a smooth and predictable correction of initial hyperglycemia in the majority of children. However, an accelerated response was more frequent in those patients with compensated metabolic acidosis, who received an initial iv bolus of insulin; those with more severe metabolic acidosis took longer to recover. The data suggest that an initial iv bolus of insulin may not be required nor desirable in the majority of children with diabetic ketoacidosis treated by a standard low-dose infusion regimen. To access this article, please choose from the options below Continue reading >>

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  1. dolby

    Dealing with Chronic Constipation

    Perhaps this thread belongs to the Food & Diet section but I've been told that constipation may be related to longstanding (and perhaps untreated) T2 diabetes (and perhaps gastroparesis?). Anyway, no diagnosis was made whether I suffer from IBS. I would not be surprised, though, if I have IBS since I have experienced frequent gastrointestinal distress (not necessarily constipation) in the past due to my unhealthy eating habits (binge eating, large meals close to bedtime, etc.).
    I've been experiencing clear constipation, however, since late Fall 2008, even before my official T2 diagnosis 6 months ago. It came and went but never completely went away. When I started eating low carb to control my BG, constipation became much more severe. (I eat about 50% fat, 25% carbs, 25% proteins. About 1500-1700 calories and 90-110 carbs per day). At this point, I seem to have hemorrhoids.
    I tried Citrucel (a Metamucil equivalent) and lots of water but that made it worse. My endo told me that I should try Colace, a stool softener, rather than fiber since fiber could irritate my bowel. Tried both MiraLax and Colace but they didn't really help. Tried milk of magnesia, which is helping. I did not try Mineral Oil since the label says it may dilute any medication you may be taking (should someone on Metformin/Lisinopril/Statin take mineral oil)?
    But you are not supposed to use softeners or milk of magnesia regularly; you can do that with fiber and Metamucil, I presume. So if you suffer from chronic constipation, how have you been dealing with it? I know that it is a common occurrence among those starting Atkins-type diet plans. Did it eventually go away? My internist recommends a colonoscopy to get to the bottom of this but I think it's a bit too extreme at this stage. I mean, for example, did you have to do a colonoscopy to diagnose the Irritable Bowel Syndrome?

  2. jwags

    I would definitely listen to your doctor and have the colonoscopy. I do a very low carb diet and never have had problem with constipation. I try to eat 40+ g of fiber. Every meal or snack I try to incorperate at least 5-10 or more of fiber. I also use those low carb, high fiber energy bars like Atkins. Foods like raspberies, blueberries work well for me. Can you eat nuts ? I munch on almonds and cashews but I know they cause some people discomfort. Have you tried a high fiber powder called Inulin. Sometimes I will add that to foods to boost fiber.

  3. leFleur

    I know this will sound crazy, but I will put it out there anyway. I am on a lot of pain meds which can cause severe constipation. I use this and it works after two or three days. I can stomach this even though metformin has kept me from eating other nuts.
    Try slowly eating 6 or 7 unsalted brazil nuts after supper or as a bed time snack. Brazil nuts are high in selenium and that helps get things moving so to speak. Do this every evening.
    Let us know if it helps.

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DKA diabetic ketoacidosis nursing management pathophysiology & treatment. DKA is a complication of diabetes mellitus and mainly affects type 1 diabetics. DKA management includes controlling hyperglycemia, ketosis, and acdidosis. Signs & Symptoms include polyuria, polydipsia, hyperglycemia greater than 300 mg/dL, Kussmaul breathing, acetone breath, and ketones in the urine. Typically DKA treatment includes: intravenous fluids, insulin therapy (IV regular insulin), and electrolyte replacement. This video details what the nurse needs to know for the NCLEX exam about diabetic ketoacidosis. I also touch on DKA vs HHS (diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome (please see the other video for more details). Quiz on DKA: http://www.registerednursern.com/diab... Lecture Notes for this video: http://www.registerednursern.com/diab... Diabetes NCLEX Review Videos: https://www.youtube.com/playlist?list... Subscribe: http://www.youtube.com/subscription_c... Nursing School Supplies: http://www.registerednursern.com/the-... Nursing Job Search: http://www.registerednursern.com/nurs... Visit our website RegisteredNurseRN.com for free quizzes, nursing care plans, salary information, job search, and much more: http://www.registerednursern.com Check out other Videos: https://www.youtube.com/user/Register... Popular Playlists: "NCLEX Study Strategies": https://www.youtube.com/playlist?list... "Fluid & Electrolytes Made So Easy": https://www.youtube.com/playlist?list... "Nursing Skills Videos": https://www.youtube.com/playlist?list... "Nursing School Study Tips": https://www.youtube.com/playlist?list... "Nursing School Tips & Questions": https://www.youtube.com/playlist?list... "Teaching Tutorials": https://www.youtube.com/playlist?list... "Types of Nursing Specialties": https://www.youtube.com/playlist?list... "Healthcare Salary Information": https://www.youtube.com/playlist?list... "New Nurse Tips": https://www.youtube.com/playlist?list... "Nursing Career Help": https://www.youtube.com/playlist?list... "EKG Teaching Tutorials": https://www.youtube.com/playlist?list... "Personality Types": https://www.youtube.com/playlist?list... "Dosage & Calculations for Nurses": https://www.youtube.com/playlist?list... "Diabetes Health Managment": https://www.youtube.com/playlist?list...

What Is Dka?

One of the many complications of diabetes is something called diabetic ketoacidosis (DKA). It most commonly occurs with Type 1 diabetes and is often the first symptom of Type 1 diabetes. DKA is caused when the body has little or no insulin to use and, as a result, blood sugars rise to dangerous levels and the blood becomes acidic. How Does This Occur? Insulin is a hormone that helps transport sugar or glucose into the body's cells so that it can be used for energy. When you have no insulin, sugar remains in the blood and blood sugar rises to dangerous levels. It causes severe hyperglycemica (high blood sugar), resulting in an emergency situation. As the blood glucose continues to increase, the body goes into an "energy crisis" and starts to break down stored fat as an alternate energy source. When fat is used for energy, ketones are produced and as the ketone levels rise, the blood becomes more and more acidic. High blood sugars can progress to ketosis (build-up of ketones) in the body. Ketosis can lead to acidosis, which is a condition in which the blood has too much acid. When this happens it is known as diabetic ketoacidosis. This is a medical emergency and must be treated immed Continue reading >>

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  1. kitkat1

    Did metformin cause you reflux?

    I am just wondering if it if it went away after a while or did you have to quit taking it because it got too bad.
    Currently trying a very bland diet of no fats/oils and just some foods documented to be ok to eat. Metformin has done wonders with my numbers and curbing my appetite. Yesterday was the first day in years I actually went 5 hours or so without eating so I am sure it is metformin doing its job and I just do not want to stop taking it.
    Currently taking 1000 mgs of regular metformin since I've already tried the ER and I didn't find it to be as good for my numbers and I still had the same amount of reflux. so just curious if others had this problem but really I don't know what it is from but thinking metformin though I've taken it a year or so ago with no problem. thanks for any input.

  2. VeeJay

    Did you not get the answers you wanted on this other thread of yours?
    SERIOUSLY need reflux relief/help

  3. Roxanne0312

    Could Metformin cause Acid reflux (Gastroesophageal reflux disease) - eHealthMe.com

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What is INSULIN SHOCK THERAPY? What does INSULIN SHOCK THERAPY mean? INSULIN SHOCK THERAPY meaning - INSULIN SHOCK THERAPY definition - INSULIN SHOCK THERAPY explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Insulin shock therapy or insulin coma therapy (ICT) was a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks. It was introduced in 1927 by Austrian-American psychiatrist Manfred Sakel and used extensively in the 1940s and 1950s, mainly for schizophrenia, before falling out of favour and being replaced by neuroleptic drugs in the 1960s. It was one of a number of physical treatments introduced into psychiatry in the first four decades of the twentieth century. These included the convulsive therapies (cardiazol/metrazol therapy and electroconvulsive therapy), deep sleep therapy and psychosurgery. Insulin coma therapy and the convulsive therapies are collectively known as the shock therapies. Insulin coma therapy was a labour-intensive treatment that required trained staff and a special unit. Patients, who were almost invariably diagnosed with schizophrenia, were selected on the basis of having a good prognosis and the physical strength to withstand an arduous treatment. There were no standard guidelines for treatment; different hospitals and psychiatrists developed their own protocols. Typically, injections were administered six days a week for about two months. The daily insulin dose was gradually increased to 100150 units until comas were produced, at which point the dose would be levelled out. Occasionally doses of up to 450 units were used. After about 50 or 60 comas, or earlier if the psychiatrist thought that maximum benefit had been achieved, the dose of insulin was rapidly reduced before treatment was stopped. Courses of up to 2 years have been documented. After the insulin injection patients would experience various symptoms of decreased blood glucose: flushing, pallor, perspiration, salivation, drowsiness or restlessness. Sopor and comaif the dose was high enoughwould follow. Each coma would last for up to an hour and be terminated by intravenous glucose. Seizures sometimes occurred before or during the coma. Many would be tossing, rolling, moaning, twitching, spasming or thrashing around. Some psychiatrists regarded seizures as therapeutic and patients were sometimes also given electroconvulsive therapy or cardiazol/metrazol convulsive therapy during the coma, or on the day of the week when they didnt have insulin treatment. When they were not in a coma, insulin coma patients were kept together in a group and given special treatment and attention; one handbook for psychiatric nurses, written by British psychiatrist Eric Cunningham Dax, instructs nurses to take their insulin patients out walking and occupy them with games and competitions, flower-picking and map-reading, etc. Patients required continuous supervision as there was a danger of hypoglycemic aftershocks after the coma. In "modified insulin therapy", used in the treatment of neurosis, patients were given lower (sub-coma) doses of insulin. A few psychiatrists (including Sakel) claimed success rates for insulin coma therapy of over 80 percent in the treatment of schizophrenia; a few others argued that it merely sped up remission in those patients who would undergo remission anyway. The consensus at the time was somewhere in between - claiming a success rate of about 50 percent in patients who had been ill for less than a year (about double the spontaneous remission rate) with no influence on relapse. Sakel suggested the therapy worked by "causing an intensification of the tonus of the parasympathetic end of the autonomic nervous system, by blockading the nerve cell, and by strengthening the anabolic force which induces the restoration of the normal function of the nerve cell and the recovery of the patient." The shock therapies in general had developed on the erroneous premise that epilepsy and schizophrenia rarely occurred in the same patient. Another theory was that patients were somehow "jolted" out of their mental illness.

The Efficacy Of Low-dose Versus Conventional Therapy Of Insulin For Treatment Of Diabetic Ketoacidosis

The effect of low-dose intramuscular insulin therapy was compared with that of high-dose insulin therapy by intravenous and subcutaneous routes in 48 patients with diabetic ketoacidosis. A simplified protocol was devised to compare efficacy of the two methods of therapy in a randomized manner. Plasma glucose dropped to less than 250 mg/dl in the low-dose group in 6.7 ± 0.8 h and in the high-dose group in 4.5 ± 0.8 h (P = not significant). The amount of insulin necessary to lower plasma glucose to 250 mg/dl was 263 ± 45 U in the high-dose group and 46 ± 5 U in the low-dose group. Twenty five percent in the high-dose group and none in the low-dose group developed hypoglycemia. Other biochemical and clinical variables in the two groups were comparable. No treatment complications were noted in the low-dose group. Our studies suggest that low-dose intramuscular insulin therapy is simple and as effective as high-dose therapy in the treatment of diabetic ketoacidosis without the risk of hypoglycemia and with a diminished incidence of hypokalemia. Furthermore, the favorable response of these patients to low-dose insulin therapy suggests the absence of insulin resistance in diabetic ket Continue reading >>

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  1. DeeF

    I have really bad leg~foot cramps that wake me up frequently. I usually have to soak them in hot water for any relief. Thanks for the ideas!

  2. Madman

    I was having horrible leg/foot cramps for several months prior to diagnosis.

  3. ckdsite

    do you have examinations such as blood suger, glycosylated hemoglobin?

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