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Diabetic Ketoacidosis Symptoms And Signs

Diabetic Ketoacidosis Nclex Review

Diabetic Ketoacidosis Nclex Review

NCLEX review on Diabetic Ketoacidosis for nursing lecture exams and the NCLEX exam. DKA is a life-threatening condition of diabetes mellitus. It is important to know the differences between diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) because the two complications affect the diabetic patient. However, there are subtle difference between the two conditions. Don’t forget to take the DKA Quiz. In these notes you will learn about: Key Player of DKA Causes of DKA Signs and Symptoms of DKA Nursing Interventions of DKA Lecture on Diabetic Ketoacidosis Diabetic Ketoacidosis Define: a complication of diabetes mellitus that is life-threatening, if not treated. It is due to the breakdown of fats which turn into ketones because there is no insulin present in the body to take glucose into the cell. Therefore, you will see hyperglycemia and ketosis and acidosis. Key Players of DKA: Glucose: fuels the cells so it can function. However, with DKA there is no insulin present to take the glucose into the cell…so the glucose is not used and the patient will experience hyperglycemia >300 mg/dL. Insulin: helps take glucose into the cell so the body can use it for fuel. In DKA, the body isn’t receiving enough insulin…so the GLUCOSE can NOT enter into the cell. The glucose floats around in the blood and the body starts to think it is starving because it cannot get to the glucose. Therefore, it looks elsewhere for energy. Liver & Glucagon: the body tries an attempt to use the glucose stores in the liver (because it doesn’t know there is a bunch of glucose floating around in the blood and thinks the body is experiencing hypoglycemia). In turn, the liver releases glucagon to turn glycogen stores into more GLUCOSE….so the patient becomes even more hyp Continue reading >>

Diabetic Ketoacidosis In The Pediatric Population With Type 1 Diabetes

Diabetic Ketoacidosis In The Pediatric Population With Type 1 Diabetes

Diabetic Ketoacidosis in the Pediatric Population with Type 1 Diabetes Abstract: Diabetic ketoacidosis (DKA) is a leading cause of morbidity and mortality in patients with type 1 diabetes (T1DM). Individuals familiar with this complication of diabetes should be able to identify the earliest signs and symptoms and act promptly to prevent further deterioration. However, even in patients with established diabetes, the rates of DKA are considerable. This chapter discusses in detail the various aspects of DKA in the pediatric population with T1DM. The prevalence and regional effects on the prevalence of DKA as well as the specific risk factors, whether disease, patient, or physician related, are reviewed. Patients with DKA experience a condition of starvation despite the abundance of metabolic substrate (i.e., glucose); the pathophysiological mechanisms responsible for the development of DKA are outlined. Next, a detailed discussion of the clinical aspects of DKA is provided. This includes the clinical findings at presentation, the approach to treatment, and potential complications. Prevention is the best method for reducing rates of DKA. Somewhat different factors apply in patients with new-onset diabetes when compared with those with established diabetes and these are reviewed. Continue reading >>

What You Should Know About Diabetic Ketoacidosis

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too. It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system. People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction. DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration. Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes. Call your doctor or go to the emergency room right away if that doesn't work, if you have any of the symptoms below and your ketones aren't normal, or if you have more than one symptom. You've been throwing up for more than 2 hours. You feel queasy or your belly hurts. Your breath smells fruity. You're tired, confused, or woozy. You're having a hard time breathing. Continue reading >>

The Main Signs And Symptoms Of Type 1 Diabetes Include:

The Main Signs And Symptoms Of Type 1 Diabetes Include:

Signs and symptoms When your blood glucose levels become too high your body will do whatever it can to try and remove the glucose from the blood Going to the toilet more. Your body will try to get rid of excess glucose through urination Being extremely thirsty. If you’re going to the toilet more, you’ll be very thirsty Tiredness. Type 1 diabetes stops your body making the energy it needs, so you’ll be exhausted Weight loss. Your body has to get energy from somewhere, so will break down fat stores Fruity-smelling breath. If your body continues to operate like this, acid called ketones will build up. This will cause your breath to smell like pear drops, and can also lead to stomach pain. If ketones continue to build up in the blood they cause a potentially fatal condition called diabetic ketoacidosis (DKA), with can be fatal. You can read more about DKA below. You may also experience: Changes in vision An increased appetite. What should I do? The onset of type 1 diabetes symptoms is rapid, happening over a matter of days and weeks rather than months. If you, or someone you know, are experiencing these symptoms you must go to your doctor immediately. Diabetic ketoacidosis (DKA) If your blood glucose levels are too high for too long, it can lead to a condition called Diabetic Ketoacidosis (DKA). DKA is most common at diagnosis, and people with type 1 are often only diagnosed once they’ve gone into DKA. DKA can also occur when you’re ill, during a growth spurt or puberty, or if you haven’t taken your insulin. DKA occurs when a severe lack of insulin means the body cannot use glucose for energy and starts to break down fat instead. Organic compounds called ketones are the by-product of the breakdown of fat and, if left unchecked, can build up and cause the body to Continue reading >>

Diabetic Ketoacidosis - Symptoms

Diabetic Ketoacidosis - Symptoms

A A A Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel. In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common. The most common Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Definition: Diabetic ketoacidosis is a life-threatening problem that affects people with diabetes . It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead. When fat breaks down, waste products called ketones build up in the body. Causes: As fat is broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis. Diabetic ketoacidosis is often the first sign of type 1 diabetes in people who do not yet have other symptoms. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to diabetic ketoacidosis in people with type 1 diabetes. People with type 2 diabetes can also develop ketoacidosis, but it is less common. It is usually triggered by uncontrolled blood sugar or a severe illness. Symptoms: Common symptoms can include: Decreased alertness Dry skin and mouth Flushed face Frequent urination or thirst that lasts for a day or more Fruity-smelling breath Headache Muscle stiffness or aches Nausea and vomiting Stomach pain Exams and Tests: Ketone testing may be used in type 1 diabetes to screen for early ketoacidosis. The ketones test is usually done using a urine sample or a blood sample. Ketone testing is usually done: When the blood sugar is higher than 240 mg/dL During an illness such as pneumonia, heart attack, or stroke When nausea or vomiting occur During pregnancy Other tests for ketoacidosis include: This disease may also affect the results of the following tests: Treatment: The goal of treatment is to correct the high blood sugar level with insulin. Another goal is to replace flu Continue reading >>

5 Common Signs Of Diabetic Ketoacidosis Or Dka

5 Common Signs Of Diabetic Ketoacidosis Or Dka

One of the quickest ways for a person with diabetes to get themselves placed in the emergency room is through a DKA incident. DKA or diabetic ketoacidosis is a condition when your body over produces ketones which can adjust your bloods pH leading to toxicity in the blood or even death. Sometimes, DKA can literally sneak up on you, but most of the time there are underlying symptoms that can be called out before your body sinks too far into DKA. Let’s take a look at some of these signs to help you catch yourself in DKA in order to prevent one of those emergency room visits. If your blood sugar goes over 300 this can happen to pump users if their tubing is somehow kinked without them noticing. so make sure to keep an eye on your sugars because it may not be a miscalculation of bolus but DKA Combination of illness as well as sudden high blood sugar together sometimes when you’re sick your body requires more insulin that is not usually provided due to your physical condition, this can lead to DKA so make sure to check for ketones when you’re sick. Having difficult time breathing when your blood becomes more acidic one way your body tries to bring your pH back to normal is by getting rid of carbon dioxide through the respiratory system. When you hyperventilate you breathe out more CO2 which after a while can make your blood more basic. Very dry mouth and thirstier than usual your body goes into DKA due to the lack of insulin in the system. This means that there is a high amount of sugar in the system and one way for your body to return the balance of molecules in the body is through urine. The problem with this is you also lose a lot of fluid in the process, hence dry mouth and thirst. Fruity smelling breathe this is always a sure sign of DKA, if someone tells you that Continue reading >>

Severe Diabetic Ketoacidosis Complicated By Hypocapnic Seizure

Severe Diabetic Ketoacidosis Complicated By Hypocapnic Seizure

Summary In clinical practice, seizures independent of hypoglycemia are observed in patients with type 1 diabetes mellitus (T1DM) more frequently than expected by chance, suggesting a link. However, seizures during management of diabetic ketoacidosis (DKA) have generally been considered a bad prognostic factor, and usually associated with well-known biochemical or neurological complications. We present the case of a 17-year-old girl with known T1DM managed for severe DKA complicated by hypocapnic seizure. We review the literature on this rare occurrence as well as outline other possible differentials to consider when faced with the alarming combination of DKA and seizure. Learning points: Seizures during DKA treatment require immediate management as well as evaluation to determine their underlying cause. Their etiology is varied, but a lowered seizure threshold, electrolyte disturbances and serious neurological complications of DKA such as cerebral edema must all be considered. Sudden severe hypocapnia may represent a rare contributor to seizure during the treatment of DKA. Background Diabetic ketoacidosis (DKA) is an endocrine emergency occurring in patients with both new-onset and established type 1 diabetes (T1DM). In brief, the diagnosis is based on clinical suspicion followed by fulfillment of biochemical criteria: Hyperglycemia (blood glucose level (BGL) >11 mmol/L); ketonuria and/or ketonemia and metabolic acidosis (pH <7.3, bicarbonate <15 mmol/L). It is a leading acute cause of diabetes-related morbidity and mortality, particularly in children (1), often due to well-described complications of treatment. The most common of these include cerebral edema, and electrolyte disturbances such as hypoglycemia and hypokalemia. Seizure activity occurring during treatment o Continue reading >>

What Is Diabetic Ketoacidosis?: Signs, Symptoms, Causes And Treatment

What Is Diabetic Ketoacidosis?: Signs, Symptoms, Causes And Treatment

What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) refers to a serious diabetes complication which happens when your body produces high amount of blood acids known as ketones. It is a very serious medical condition that could lead to diabetic coma or death. This life threatening medical condition happens when the body cells are unable to get the glucose they need for energy, because of a deficiency in insulin. Insulin is a hormone that helps glucose, a main source of energy for muscles and tissue, enter the body cells. When glucose cannot get into the body cells, it remains in the blood. The kidney will then filter some of the glucose from the blood, then excrete it from the body through the urine. When your body cells do not receive energy from glucose, they start to break body fat down into energy. When that happens, fatty acids or ketones are produced which then enter the bloodstream. This will lead to a chemical imbalance that causes DKA. Diabetic ketoacidosis mostly affect people with type 1 diabetes, but can also occur in people with type 2 diabetes. The reason for this is because people with type 1 diabetes cannot produce enough insulin on their own. Lack of insulin allows your blood to become acidic. Because your body cells cannot make it under acidic conditions, the liver will secrete glucose to help the starving cells. Research shows that there are over 200,000 cases of patients suffering from DKA every year in the US alone. Diabetic ketoacidosis signs and symptoms There are signs and symptoms you can look out for to know if you have diabetic ketoacidosis. These signs and symptoms usually develop quickly and could indicate you have diabetes. If you are experiencing symptoms of DKA, you need to call your doctor immediately. If not treated, DKA can be fa Continue reading >>

Diabetes Danger: Warning Over Life-threatening Complications Ketoacidosis And Diabulimia

Diabetes Danger: Warning Over Life-threatening Complications Ketoacidosis And Diabulimia

The condition occurs when the body is unable to use blood sugar (glucose) because there isn't enough insulin. Instead, it breaks down fat as an alternative source of fuel. This causes a build-up of a potentially harmful by-product called ketones. It's fairly common in people with type 1 diabetes and can very occasionally affect those with type 2 diabetes. “It sometimes develops in people who were previously unaware they had diabetes. NRS Healthcare has set out to raise awareness for people suffering with the condition and also highlight other issues including diabulimia, a recently reported condition where young people with diabetes choose not to take their insulin in order to lose weight. Alexandra Lomas, who is living with type 1 diabetes, has spoken out about how her delayed diagnosis led to her going through ketoacidosis and warned how young girls living with diabulimia risk experiencing the same horrific symptoms. “Before I had diabetes I had this long luscious thick hair, it was kind of like my crowning glory. “Six months leading up to my diagnosis I would be brushing my hair and pulling out these great big clumps of hair. “I lost six stone is as many months. I eventually lost so much weight that the sugar in my blood had started to eat away at my muscles. “Leading up to going into hospital was really really difficult. “When I got to the hospital they measured my heart rate and it was at 268 beats a minute - the normal rate is around 60 per minute. I felt like I was having a heart attack. “I recently read a story on diabulimia, where young girls across the UK aren’t taking their insulin as a type 1 diabetic in order to make their blood sugars rise and eat away at their fat and muscle and therefore they keep their weight down. “I wanted to make th Continue reading >>

Hyperglycemia And Diabetic Ketoacidosis

Hyperglycemia And Diabetic Ketoacidosis

When blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy. Hyperglycemia is the hallmark of diabetes — it happens when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose accumulates in the blood, resulting in hyperglycemia. Hyperglycemia can cause serious health problems if left untreated. Too much sugar in the bloodstream for long periods of time can cause damage to the vessels that supply blood to vital organs and can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, they can occur in adulthood in some people, particularly if they haven't managed or controlled their diabetes properly. Blood sugar levels are considered high when they're above someone's target range. The diabetes health care team will let you know what your child's target blood sugar levels are, which will vary based on factors like your child's age. A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible. It's a three-way balancing act of: diabetes medications (such as insulin) food activity level Continue reading >>

The Highs And Lows Of Dka

The Highs And Lows Of Dka

Kumar, Coleen P. RN, MS Q: What's diabetic ketoacidosis (DKA)? A: A disorder associated with a reduction in circulating insulin that results in hyperglycemia, DKA is one of the most serious acute complications of diabetes. In addition to the reduction of circulating insulin, an elevation in counterregulatory hormones, such as glucagon, catecholamines, cortisol, and growth hormone, leads to an increase in glucose production in the liver and kidneys, impaired use of glucose in the peripheral tissues, and the release of free fatty acids from adipose tissue into the circulation (lipolysis). The liver oxidizes fatty acids to ketone bodies, which results in excess ketones in the blood (ketonemia) and metabolic acidosis. The most common cause associated with DKA is infection. Other factors include stroke, alcohol abuse, pancreatitis, myocardial infarction, trauma, the use of drugs that affect carbohydrate breakdown (such as corticosteroids, thiazides, and sympathomimetic agents), and incorrect insulin administration or missed doses. DKA occurs more often in adults than children. At times a patient with diabetes may not take his insulin as prescribed for a variety of reasons, such as rebellion against authority or resistance to the diagnosis, fear of weight gain, or fear of hypoglycemia. Dealing with the stress of the day-to-day management of a chronic illness may also lead to the development of DKA. The classic signs and symptoms include polyuria, polydipsia, polyphagia, weight loss, vomiting, abdominal pain, dehydration, weakness, and dulled senses. Physical findings may include poor skin turgor, Kussmaul respirations (deep, rapid respirations), tachycardia, hypotension, changes in mental status, shock, and coma. Emesis is often coffee-ground-like in appearance and tests guai Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in Continue reading >>

Understanding The Presentation Of Diabetic Ketoacidosis

Understanding The Presentation Of Diabetic Ketoacidosis

Hypoglycemia, diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) must be considered while forming a differential diagnosis when assessing and managing a patient with an altered mental status. This is especially true if the patient has a history of diabetes mellitus (DM). However, be aware that the onset of DKA or HHNS may be the first sign of DM in a patient with no known history. Thus, it is imperative to obtain a blood glucose reading on any patient with an altered mental status, especially if the patient appears to be dehydrated, regardless of a positive or negative history of DM. In addition to the blood glucose reading, the history — particularly onset — and physical assessment findings will contribute to the formulation of a differential diagnosis and the appropriate emergency management of the patient. Pathophysiology of DKA The patient experiencing DKA presents significantly different from one who is hypoglycemic. This is due to the variation in the pathology of the condition. Like hypoglycemia, by understanding the basic pathophysiology of DKA, there is no need to memorize signs and symptoms in order to recognize and differentiate between hypoglycemia and DKA. Unlike hypoglycemia, where the insulin level is in excess and the blood glucose level is extremely low, DKA is associated with a relative or absolute insulin deficiency and a severely elevated blood glucose level, typically greater than 300 mg/dL. Due to the lack of insulin, tissue such as muscle, fat and the liver are unable to take up glucose. Even though the blood has an extremely elevated amount of circulating glucose, the cells are basically starving. Because the blood brain barrier does not require insulin for glucose to diffuse across, the brain cells are rece Continue reading >>

What Are Signs Of Diabetic Ketoacidosis In An Unconscious Person?

What Are Signs Of Diabetic Ketoacidosis In An Unconscious Person?

Prehospital situation, the only ways I would know is by a high blood glucose reading on our glucometer, and/or if I could smell an acetone/fruity smell on their breath. If family/friend is present, a history of diabetes and a description of how the patient has been over the past few days would also be helpful. If they were having frequent urination, fatigue, or extreme thirst over the last few days, I would suspect ketoacidosis even more. Also knowing if they are insulin dependent or on medications for diabetes is important. Prehospital treatment at my level of certification isn’t much. Obtain vascular access and replace fluids with normal saline if there is signs of dehydration. Treat any other problems that may arise, like hyperventilation, hypotension, hypoxia, and protect the airway because they’re unconscious. An EKG for the hospital wouldn’t be a bad choice either. Trying to arouse the patient is something I would also do. The most important treatment I can do for a patient like this is transport them quickly and safely to the ER. Continue reading >>

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