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Dka Management Flowchart

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Diabetic Ketoacidosis

Initial Evaluation Initial evaluation of patients with DKA includes diagnosis and treatment of precipitating factors (Table 14–18). The most common precipitating factor is infection, followed by noncompliance with insulin therapy.3 While insulin pump therapy has been implicated as a risk factor for DKA in the past, most recent studies show that with proper education and practice using the pump, the frequency of DKA is the same for patients on pump and injection therapy.19 Common causes by frequency Other causes Selected drugs that may contribute to diabetic ketoacidosis Infection, particularly pneumonia, urinary tract infection, and sepsis4 Inadequate insulin treatment or noncompliance4 New-onset diabetes4 Cardiovascular disease, particularly myocardial infarction5 Acanthosis nigricans6 Acromegaly7 Arterial thrombosis, including mesenteric and iliac5 Cerebrovascular accident5 Hemochromatosis8 Hyperthyroidism9 Pancreatitis10 Pregnancy11 Atypical antipsychotic agents12 Corticosteroids13 FK50614 Glucagon15 Interferon16 Sympathomimetic agents including albuterol (Ventolin), dopamine (Intropin), dobutamine (Dobutrex), terbutaline (Bricanyl),17 and ritodrine (Yutopar)18 DIFFERENTIAL DI Continue reading >>

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Popular Questions

  1. sebastian16

    D-Ribose and Keto

    There is no shortage of advocates for D-Ribose in the alt. health community.
    It's good for sports man and women.
    It's good for circulatory and heart conditions.
    It seems to give extra energy and ummmpf to virtually everyone.
    But D-Ribose is a carb (not an amino acid, as some commentators have erroneously stated)
    My presumption is that D-Ribose should be treated as if it were any other carb.
    So.. for example, if you aim to keep carbs down to 50 grams per day and you
    take 5 grams of d-Ribose with your breakfast, then that leaves you with room
    for only 45 grams of carbs the rest of the day.
    BUT.... d-Ribose comes as a pure, refined powder.
    Probably... eating a gram of d-Ribose is going to pack more carbo punch
    than eating a gram of carrot or a gram of rice.
    Perhaps... eating a gram of d-Ribose is akin to eating a gram of sucrose,
    i.e. refined sugar.
    If d-Ribose is considered a refined sugar, then it would be regarded as
    off limits by many or most keto pundits.
    So what does d-Ribose do to blood sugar ?
    Is d-Ribose like refined sugar in terms of it's Glycemic Index ?
    Is it like a rice ? Is it like a carrot ?
    The answer is a surprise.
    d-Ribose *lowers* blood sugar. It's like un-sugar or anti-sugar.
    It is half as sweet as sugar, it gives you energy and focus, and it lowers blood sugar.
    For confirmation of this do a google search for
    "Effect of D-Ribose on Insulin and Blood Glucose: A Chronological Examination "
    I found this paper at:
    http://docplayer.net/9693016-Effect-of-d-ribose-on-insulin-and-blood-glucose-a-chronological-examination.html
    1. Prime Facie it's a better choice than stevia or xylitol etc.
    as a sweetener for keto cakes, pastries etc.
    2. Prime facie, d-Ribose might be a good choice as a
    supplement during the initial 3 or more weeks of keto
    adaptation .... since many report having problems with
    brain fog and energy levels. .
    But i wonder what the effect on ketosis would be if you
    had say, 100 grams of d-Ribose during the day ?
    Or say... 25 grams of d-Ribose with a given a meal ?
    Could d-Ribose kick you out of ketosis ?
    Does anyone know the answer to these questions ?

    Sebastian :)

  2. sebastian16

    Addendum... A question on d-ribose already exists:
    [QUOTE]
    Supplements and recommendations → D-ribose, does it effect insulin or leptin?
    -----------------------------------------------------------------------------------------------------------
    Hi Dr Rosedale, whats your opinion of D-ribose, does it effect insulin or leptin , if not why? and what is it made from

    It does not effect insulin or leptin directly. Taking D-ribose will not get into the cell. Benfotiamine, a fat soluble form of thiamine that converts glucose into ribose intracellularly, and then the ribose itself is a great substrate for RNA (and other important intracellular molecules, and is a much better option in my opinion. Benfotiamine helps to reduce intracellular glycation unlike D-ribose.
    [/QUOTE]
    ------------------------------------
    Presumably, ribose must get into the cell.
    Or how else would ribose provide the energy and focus for which it is famous ?
    Nice to know about benfotiamine.

  3. Ken

    Great to see the Knowledge Base being used...
    It is a go to place for me ..

    Ken/ Rosedale Support Team

  4. -> Continue reading
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