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How Are Ketones Produced In Dka?

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Hyperglycaemic Crises And Lactic Acidosis In Diabetes Mellitus

Hyperglycaemic crises are discussed together followed by a separate section on lactic acidosis. DIABETIC KETOACIDOSIS (DKA) AND HYPERGLYCAEMIC HYPEROSMOLAR STATE (HHS) Definitions DKA has no universally agreed definition. Alberti proposed the working definition of “severe uncontrolled diabetes requiring emergency treatment with insulin and intravenous fluids and with a blood ketone body concentration of >5 mmol/l”.1 Given the limited availability of blood ketone body assays, a more pragmatic definition comprising a metabolic acidosis (pH <7.3), plasma bicarbonate <15 mmol/l, plasma glucose >13.9 mmol/l, and urine ketostix reaction ++ or plasma ketostix ⩾ + may be more workable in clinical practice.2 Classifying the severity of diabetic ketoacidosis is desirable, since it may assist in determining the management and monitoring of the patient. Such a classification is based on the severity of acidosis (table 1). A caveat to this approach is that the presence of an intercurrent illness, that may not necessarily affect the level of acidosis, may markedly affect outcome: a recent study showed that the two most important factors predicting mortality in DKA were severe intercurrent Continue reading >>

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Popular Questions

  1. Santosh Anand

    Insulin plays a key role in helping sugar (glucose) enter your cells, thus providing them energy. When your cells don't get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are acidic and so when they build up in the blood, they make the blood more acidic, leading to the condition called diabetic ketoacidosis (DKA).
    Now, in type-1 diabetes, there is no insulin production whereas in type-2, there is impairment of insulin production. Thus why Type-2 diabetic people hardly get DKA.
    Note: Diabetic ketoacidosis is a serious condition that might lead to diabetic coma or even death.

  2. Lucas Verhelst

    In order for the cells in your body to access the glucose in your bloodstream so they can use it as energy they need insulin. Insulin acts like a key, opennin the cell door to allow the entry of glucose. Type 1 diabetics produce no insulin and need to inject it, thus the amount of insulin they have is strictly limited. Once they run out of insulin the glucose remains in the blood stream. If this occurs over a long period of time their blood glucose levels will rise due to the release of glucose from the liver. High blood sugar levels causes ketoacidosis which leads to coma and death.

  3. Keith Phillips

    Although type 2 diabetics suffer from insulin resistance, the condition rarely has an absolute negative effect on the bodies ability to convert glucose to usable energy. Type 1 diabetics have little or no ability to produce insulin. With the exception of neural cells, the rest of the body which without insulin is experiencing starvation, will consume its own tissues. (this is how people have endured periods of famine). This process however produces by products that eventually overwhelm the body's ability to process toxins.

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