How To Prevent Ketoacidosis

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A Novel Approach To Preventing Diabetic Ketoacidosis In A Patient Treated With An Insulin Pump

A 56-year-old man with brittle type 1 diabetes and unaware of the effects of hypoglycemia was started on a continuous subcutaneous insulin infusion (CSII) in April 2000. After 12 months, he achieved excellent glycemic control, and his HbA1c values averaged 6.5%. During this time, however, the patient required admission to the hospital on four separate occasions for diabetic ketoacidosis despite frequent self-monitored blood glucose (SMBG) (six to eight times per day) and frequent catheter insertion site changes. The patient insisted that he administered subcutaneous injections, as directed, when there was any question of pump dysfunction. Medical teams noted that the patient developed diabetic ketoacidosis very rapidly on several occasions. During one admission, he reported an SMBG value of 99 mg/dl at 10:00 a.m. Within 95 min, the patient was brought to the emergency room with a glucose level of 510 mg/dl and an anion gap of 35 mmol/l. Because of the frequent episodes of diabetic ketoacidosis, the patient’s insulin therapy was switched from CSII to multiple daily insulin injections. However, the patient preferred CSII therapy for the quality-of-life benefits provided by the insu 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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