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Diabetic Ketoacidosis Pathophysiology

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Pathophysiology Of Diabetic Ketoacidosis

Diabetic ketoacidosis is one of the potentially life-threatening acute complications of diabetes mellitus. In the past, diabetic ketoacidosis was considered as the hallmark of Type I diabetes, but current data show that it can be also diagnosed in patients with type II diabetes mellitus. It is often seen among patients who are poorly compliant to insulin administration during an acute illness. It is commonly precipitated by an acute stressful event such as the development of infection leading to overt sepsis, organ infarction such as stroke and heart attack, burns, pregnancy or intake of drugs that affect carbohydrate metabolism such as corticosteroids, anti-hypertensives, loop diuretics, alcohol, cocaine, and ecstasy. The presence of these stressful conditions incite the release of counter-regulatory hormones such as glucagon, catecholamines and growth hormone. These hormones induce the mobilization of energy stores of fat, glycogen and protein. The net effect of which is the production of glucose. As a result of absent or deficient insulin release, diabetic ketoacidosis present with the following metabolic derangements: profound hyperglycemia, hyperketonemiaand metabolic acidosis Continue reading >>

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Popular Questions

  1. Nanarocksween

    I am on two 500 mg. Metformin twice a day. I'm unsure of when to take them, as I've read so many different things. Some people take them before eating, some after.
    The thing that most concerns me is what time of day should I be taking them? My bottle just says two twice day. Is it best to take them with breakfast early in the a.m. (I eat at 7:00 a.m.) and then wait until dinner (which varies for me--I don't eat "dinner" at a set time, but it is usually around 4 p.m. or so). When do YOU take Metforming (if that is the drug you are using).
    Thanks for any advice you can give. I've been taking Metformin earlier in the day (around 3 p.m.) and I eat snacks before bed (low carb), and also oftentimes take p.m. pain meds. I have found that my morning glucose reading is often too high (137-140). I can't sleep if my stomach is growling, so I have to eat something before I can sleep!

  2. davef

    It actually becomes a fairly personal thing as to when it suits you best to take your Metformin and depends on a few things. Some people experience gastric side effects for the first few weeks of taking Metformin, this can range from cramps, wind to diarrhea - for people who experience this, often the advice is to eat something before take the Metformin - the instruction from the Doctor can be "Take with food", which can be translated as don't take it on an empty stomach. I personally was very lucky and had no issues and so that didn't apply to me (I'm on the same dose as you). I generally don't eat breakfast, but take my Metformin just before leaving the house for work in the morning, or at weekends when I get up.
    The evening dose, is also something that varies, generally people are told to take it with their evening meal. I did that at the start but was finding that my fasting readings in the morning were running a little high. So, after consulting my doctor, I switched to taking it later at night, I found that around 11pm works well for me in keeping my morning numbers lower. If you are having a snack at night to go with your Metformin, perhaps try something like cheese, cold cuts of meat as these are lower carb foods and so less likely to cause a rise in your BG.
    Hope that helps,

  3. sodajerk

    I take 750 ER twice a day. At breakfast 6:00 AM and Dinner 6:00 PM. It took several weeks to get over the issues with running to the outhouse. I started with the plain (not ER). The ER is better. Test and see what works best for you.

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