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Non Diabetic Ketoacidosis Definition

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Pediatric Non-diabetic Ketoacidosis: A Case-series Report

Abstract This study is to explore the clinical characteristics, laboratory diagnosis, and treatment outcomes in pediatric patients with non-diabetic ketoacidosis. Retrospective patient chart review was performed between March 2009 to March 2015. Cases were included if they met the selection criteria for non-diabetic ketoacidosis, which were: 1) Age ≤ 18 years; 2) urine ketone positive ++ or >8.0 mmol/L; 3) blood ketone >3.1 mmol/L; 4) acidosis (pH < 7.3) and/or HCO3 < 15 mmol/L; 5) random blood glucose level < 11.1 mmol/L. Patients who met the criteria 1, 4, 5, plus either 2 or 3, were defined as non-diabetic ketoacidosis and were included in the report. Five patients with 7 episodes of non-diabetic ketoacidosis were identified. They all presented with dehydration, poor appetite, and Kussmaul breathing. Patients treated with insulin plus glucose supplementation had a quicker recovery from acidosis, in comparison to those treated with bicarbonate infusion and continuous renal replacement therapy. Two patients treated with bicarbonate infusion developed transient coma and seizures during the treatment. Despite normal or low blood glucose levels, patients with non-diabetic ketoacido Continue reading >>

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  1. kris90

    Non Diabetic Ketoacidosis?

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  2. kris90

    I had been trying to correct what I believe to be small intestinal bacterial overgrowth (something I believe I have suffered from for years) with a ketogenic diet which has given me success in the past. My symptoms included: abdominal cramping/distention, bloating, gas (very foul), constipation, fatigue, and intense sugar cravings. I am otherwise very healthy (26 years old, 5'8 @ 160 lbs approx 8% bodyfat and active).
    This time around, I decided to follow a more strict ketogenic diet (one that is epi-paleo). I ate lots of salmon, mussels, grassfed beef, eggs, grass fed butter, coconut oil, occasional mixed nuts and almond butter. After a few days to a week in, I noticed more severe symptoms: nausea, racing heart, and spiking random fevers with chills after eating and worsening constipation & bloating let alone major headaches. I ended up checking in to the ER, and was given lactulose to help with constipation. It worked, and my bloating was gone, but still didn't feel right. I went back for some bloodwork, and everything came back normal (I can post results) blood glucose was 4.5 mmol/L. I noticed I would feel ok if I fasted, but as soon as I ate the high-fat keto meal, within an hour I'd spike a fever, and get major nausea and chills. I literally felt poisoned. I decided to check my urinary ketone levels using ketostix, and came back around 8 mmol/L. I was a little concerned given that on the pamphlet that a doctor should be contacted with a reading over 4 mmol/L. I thought perhaps my ketones were too high, so I decided to take in around 50g of carbs to see if that would bring me down. Bad idea. Nausea hit harder than ever and I was over the toilet thought I was dying (everything spinning, vision was fading out, body went numb and tingly, I was slowly drifting away). I had to get my wife to call 911, and luckily before they arrived, I snapped out of it, but had a mild fever and sweats and was shooken up.
    Paramedics said everything was fine, blood pressure a little high but normal with the stress. Also blood glucose was at 8 mmol/L. Decided to have them take me in. Had ketones checked at hospital and read 6 mmol/L, and blood glucose went up to 8.2 mmol/L. They monitored me for a few hours, and blood glucose dropped back to normal by early morning (4.0 mmol/L) and ketones slowly fell as well.
    The next day, I consumed a well balanced diet with carbs (avoiding refined/sugary carbs) and brought myself out of ketosis. All my symptoms went away and I felt better (other than feeling exhausted). Now today (a day later) I continued the well balanced diet, only now all my "pre-keto" symptoms reappeared (major foul gas, bloating, and constipation).
    Can anyone make any sense of this madness? Was this maybe a bad case of "die-off" symptoms? Or could my ketone level have caused me to feel "poisoned"? I wonder why my levels climbed so high since I am not a diabetic. I found a case of "non-diabetic ketoacidosis" which describes my case almost identically: http://www.empr.com/case-studies/a-...betic-patient-whats-the-cause/article/443559/
    Need suggestions on how to combat these GI issues/bacterial overgrowth now. Perhaps a non-keto/low carb diet (100g per day)?

  3. Jenelle

    I have had great success with a low-FODMAP approach. When I eliminate most of the foods that are high in FODMAPs, I experience almost zero digestive distress. If you haven't heard of this ~ definitely worth a Google.

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