Ketoacidosis Word Breakdown

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Sodium Glucose Transporter 2 Inhibitors And Diabetic Ketoacidosis In Three Patients With Diabetes: Underlying Causation

Byline: Jordan. Kelley, Matthew. Strum, Daniel. Riche, Andrew. Chandler Sodium glucose transporter 2 inhibitors (SGLT2i) inhibit the reabsorption of glucose in the renal tubules reducing glycemia and increasing glucosuria. The increased glucosuria causes a shift in normal flora and colonization of pathogenic microorganisms leading to an increase in mycotic genital infections. Recent Food and Drug Administration reported cases of diabetic ketoacidosis (DKA) after initiation of SGLT2i probes the question of safety with such agents. The mechanisms of ketoacidosis and the breakdown of lipids are often misunderstood, and blame is placed on lack of insulin or on medications used to treat diabetes. However, many patients living with diabetes do not experience DKA if the proper treatment and management of concomitant comorbidities are addressed. After a retrospective chart review of 250 patients, three patients were identified with DKA while on SGLT2i, but for three distinct contrasting reasons. Assessment of the pharmacodynamics of SGLT2i and the pathophysiology of DKA infers that emphasis for prevention of SGLT2i-associated DKA should be placed on appropriate diagnosis, infection, and el Continue reading >>

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Popular Questions

  1. Diamattic

    This may be a weird questions but i was comparing some blood work i had done in January 2011 (back before i had T1D) and the blood work that was conducted a couple days after i was admitted to the hospital. I have nothing in between those dates.
    I was admitted to the Emergency room with Diabetic Ketoacidocis, and they drew blood everyday but only on the first day did they do a full work up which included my cholesterol levels.. when i compare these numbers to what i had come back from the lab in 2011 i find quite a difference. The May 2014 numbers are much lower across the board then the Jan 2011 numbers.
    My question is - Is this change because i likely spent so much time undiagnosed and in which case they will likely go back up? or does DKA not really affect these numbers and thats just an accurate look at my levels these days?

  2. Diamattic

    Well, i kept searching and found this research paper - http://pubs.niaaa.nih.gov/publications/arh22-3/211.pdf
    It talks mostly about Alcohol use in diabetics, BUT it mentions DKA can occur tom alcohol abuse and then goes on to explain how that DKA can alter lipid metabolism, which isn't exactly what i was looking for BUT it does say that it can lower your LDL, and raise your HDL for a short period in which it will return to normal afterwards.. So maybe my levels were abnormally low but returned to where they were afterwards...
    SIDENOTE - This paper also mentions that in non-habitual drinkers having 2.5-5 standard alcoholic drinks occasionally can be beneficial to BS levels haha However, habitual drinking (i.e. - daily drinks) is a no-no..
    Does anyone know anything conclusive though, I am still wondering how much i can trust these numbers?

  3. pavlosn

    Ketosis based diets are known too rely on burning triglycerides for fuel instead of glucose of fuel, as well as to reduce LDL and increase HDL.
    DKA is effectively ketosis but on a more problematic scale. This time it is brought about not by a restriction in carbs and lowering of glucose but by a lack of insulin to transfer the glucose to the blood, I would expect both to have a similar effect on lipids.
    Where triglycerides significantly reduced after DKA?
    Not that DKA would ever qualify as a treatment for high cholesterol!

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