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Diabetic Ketoacidosis Treatment

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What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin. Depending on the severity, insulin may be given intravenously or by injection under the skin. Usually potassium is also needed to prevent the development of low blood potassium. Throughout treatment blood sugar and potassium levels should be regularly checked. Antibiotics may be required in those with an underlying infection. In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended. Rates of DKA vary around the world. About 4% of people with type 1 diabetes in United Kingdom develop DKA a year, while in Malaysia the condition affects about 25% a year. DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost universally fatal. The risk of death with adequate and timely treatment is currently around 1–4%. Up to 1% of children with DKA develop a complication known as cerebral edema. The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. Those who measure their glucose levels themselves may notice hyperglycemia (high blood sugar levels). In severe DKA, breathing becomes labored and of a deep, gasping character (a state referred to as "Kussmaul respiration"). The abdomen may be tender to the point that an acute abdomen may be suspected, such as acute pancreatitis, appendicitis or gastrointestinal perforation. Coffee ground vomiting (vomiting of altered blood) occurs in a minority of people; this tends to originate from erosion of the esophagus. In severe DKA, there may be confusion, lethargy, stupor or even coma (a marked decrease in the level of consciousness). On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, tachycardia (a fast heart rate) and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity", often compared to the smell of pear drops whose scent is a ketone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.....

Diabetic Ketoacidosis

OVERVIEW potentially life-threatening complication of diabetes melitus resulting from the consequences of insulin deficiency Diagnostic criteria pH < 7.3 ketosis (ketonemia or ketonuria) HCO3 <15 mmol/L due to high anion gap metabolic acidosis (HAGMA) hyperglycemia (may be mild; euglycemic DKA can occur) PATHOGENESIS increased glucagon, cortisol, catcholamines, GH decreased insulin -> hyperglycaemia -> hyperosmolality + glycosuria -> electrolyte loss -> ketone production from metabolism of TG -> acidosis HISTORY dry, abdominal pain, polyuria, weight loss, coma risk factors: non-compliance, illness, newly diagnosed ROS to rule find out possible precipitant (infection, MI, pneumonia, GI illness) normal insulin regime diabetic control previous DKA’s/admissions previous ICU admissions EXAMINATION volume assessment signs of cause e.g. (infection) GCS work of breathing INVESTIGATIONS ABG electrolytes osmolality urinalysis: ketones pregnancy test standard investigations to rule out cause: FBC, ECG, CXR MANAGEMENT Goals (1) establish precipitant and treat (2) assess severity of metabolic derangement (3) cautious fluid resuscitation with replacement of body H2O (4) provision of insulin (5 Continue reading >>

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    There are a number of complications that can develop in long term diabetics.
    One of the earliest complication that can be seen in an Undiagnosed Type I diabetic is Diabetic Ketoacidosis (DKA)[1].
    In diabetics on treatment, hypoglycaemia is also a common complication that can occur.
    Footnotes
    [1] Causes, Symptoms and Treatment of DKA

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952: Evaluation Of A Diabetic Ketoacidosis Treatment Protocol Using Subcutaneous Insulin Aspart

Teevan, Colleen Introduction: Insulin therapy is one aspect of managing diabetic ketoacidosis (DKA), and the American Diabetes Association recommends regular insulin by continuous IV infusion as the treatment of choice for all but mild cases of DKA. Several studies, each enrolling a small number of patients, have examined rapid-acting subcutaneous insulin analogs for DKA treatment. Patients in these studies who received subcutaneous insulin analogs were treated outside of the ICU. Hypothesis: A DKA treatment protocol that uses subcutaneous insulin aspart, with weight-based doses administered every two hours, is safe and effective. Methods: This study was a retrospective chart review. Adult patients who received insulin aspart for treatment of DKA at Rush University Medical Center between January 2008 and December 2011 were eligible for study inclusion. Efficacy outcomes included time to resolution of DKA-associated laboratory abnormalities, length of stay, time to initiation of basal insulin, and amount of insulin received. The primary safety outcome was hypoglycemic events. Subgroup analyses were conducted for type 1 vs. type 2 diabetes, DKA severity, and whether or not patients r Continue reading >>

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  1. Karan Sharma

    Diabetes

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    What are the first complications of diabetes?




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    There are a number of complications that can develop in long term diabetics.
    One of the earliest complication that can be seen in an Undiagnosed Type I diabetic is Diabetic Ketoacidosis (DKA)[1].
    In diabetics on treatment, hypoglycaemia is also a common complication that can occur.
    Footnotes
    [1] Causes, Symptoms and Treatment of DKA

    168 Views · 1 Upvote








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    What are the complications of Diabetes mellitus?


    How long does a diabetic develop complications?


    How does eating saturated fats complicate diabetes?


    What is diabetes and its complications?


    What are the sign and symptoms of diabetes?


    What are the complications of a diabetic ulcer?


    What eye disease is a complication of diabetes mellitus?


    Can diabetics eat diabetic chocolate?


    What is diabetes mellitus?


    Is diabetes curable?
    Ask New Question






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    Can diabetes be reversed and if so, how?


    Is The Diabetes Destroyer a scam just like Diabetes Free?


    What are symptoms of diabetes complications?


    What are the complications of each type of diabetes and what is the relation between these complications?


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    What are the complications of Diabetes mellitus?


    How long does a diabetic develop complications?


    How does eating saturated fats complicate diabetes?


    What is diabetes and its complications?


    What are the sign and symptoms of diabetes?
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What is KETOACIDOSIS? What does KETOACIDOSIS mean? KETOACIDOSIS meaning - KETOACIDOSIS definition - KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and ß-hydroxybutyrate. Ketoacidosis is a pathological metabolic state marked by extreme and uncontrolled ketosis. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased. In extreme cases ketoacidosis can be fatal. Ketoacidosis is most common in untreated type 1 diabetes mellitus, when the liver breaks down fat and proteins in response to a perceived need for respiratory substrate. Prolonged alcoholism may lead to alcoholic ketoacidosis. Ketoacidosis can be smelled on a person's breath. This is due to acetone, a direct by-product of the spontaneous decomposition of acetoacetic acid. It is often described as smelling like fruit or nail polish remover. Ketosis may also smell, but the odor is usually more subtle due to lower concentrations of acetone. Treatment consists most simply of correcting blood sugar and insulin levels, which will halt ketone production. If the severity of the case warrants more aggressive measures, intravenous sodium bicarbonate infusion can be given to raise blood pH back to an acceptable range. However, serious caution must be exercised with IV sodium bicarbonate to avoid the risk of equally life-threatening hypernatremia. Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively. In diabetic ketoacidosis, a high concentration of ketone bodies is usually accompanied by insulin deficiency, hyperglycemia, and dehydration. Particularly in type 1 diabetics the lack of insulin in the bloodstream prevents glucose absorption, thereby inhibiting the production of oxaloacetate (a crucial molecule for processing Acetyl-CoA, the product of beta-oxidation of fatty acids, in the Krebs cycle) through reduced levels of pyruvate (a byproduct of glycolysis), and can cause unchecked ketone body production (through fatty acid metabolism) potentially leading to dangerous glucose and ketone levels in the blood. Hyperglycemia results in glucose overloading the kidneys and spilling into the urine (transport maximum for glucose is exceeded). Dehydration results following the osmotic movement of water into urine (Osmotic diuresis), exacerbating the acidosis. In alcoholic ketoacidosis, alcohol causes dehydration and blocks the first step of gluconeogenesis by depleting oxaloacetate. The body is unable to synthesize enough glucose to meet its needs, thus creating an energy crisis resulting in fatty acid metabolism, and ketone body formation.

Management Of Diabetic Ketoacidosis In Adults

Diabetic ketoacidosis is a potentially life-threatening complication of diabetes, making it a medical emergency. Nurses need to know how to identify and manage it and how to maintain electrolyte balance Continue reading >>

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Popular Questions

  1. Karan Sharma

    Diabetes

    Medical Conditions and Diseases

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    What are the first complications of diabetes?




    1 Answer







    There are a number of complications that can develop in long term diabetics.
    One of the earliest complication that can be seen in an Undiagnosed Type I diabetic is Diabetic Ketoacidosis (DKA)[1].
    In diabetics on treatment, hypoglycaemia is also a common complication that can occur.
    Footnotes
    [1] Causes, Symptoms and Treatment of DKA

    168 Views · 1 Upvote








    Promoted by PlateJoy


    A weight loss program so good your insurance pays for it.

    Click to see if your insurance participates!




    Learn More at platejoy.com/health








    Related Questions




    Can diabetes be reversed and if so, how?


    Is The Diabetes Destroyer a scam just like Diabetes Free?


    What are symptoms of diabetes complications?


    What are the complications of each type of diabetes and what is the relation between these complications?


    Can complications from diabetes be reversed?


    What are the complications of Diabetes mellitus?


    How long does a diabetic develop complications?


    How does eating saturated fats complicate diabetes?


    What is diabetes and its complications?


    What are the sign and symptoms of diabetes?


    What are the complications of a diabetic ulcer?


    What eye disease is a complication of diabetes mellitus?


    Can diabetics eat diabetic chocolate?


    What is diabetes mellitus?


    Is diabetes curable?
    Ask New Question






    Related Questions



    Can diabetes be reversed and if so, how?


    Is The Diabetes Destroyer a scam just like Diabetes Free?


    What are symptoms of diabetes complications?


    What are the complications of each type of diabetes and what is the relation between these complications?


    Can complications from diabetes be reversed?


    What are the complications of Diabetes mellitus?


    How long does a diabetic develop complications?


    How does eating saturated fats complicate diabetes?


    What is diabetes and its complications?


    What are the sign and symptoms of diabetes?
    Ask New Question

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