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Diabetic Ketoacidosis Treatment

What Kind Of Diseases Result In Death Within 2 Weeks Of Diagnosis?

What Kind Of Diseases Result In Death Within 2 Weeks Of Diagnosis?

How to cure serious Diseases by a simple Meditation So now let's start the procedure. Before starting the meditation procedure, first check that you have very deep belief within yourself that you can go to any heights to cure your diseases and even if it will not be cured even then you have strongest belief that you will try every possible effort to cure it. Then, if you have that strong belief then start the procedure. Sit in a cross legged position with eyes closed. And try to do what I tell you here, if you cannot do it perfectly then at least keep your belief upon doing all this. Don't think anything, forget the world and everything in it, also forget that you have any illness and need to recover from it, forget that you are doing meditation for something. Then try to look into God's eyes, but forget any of the worldly Gods. Just look into the eyes of the God which comes to your mind naturally without any thinking. And then you will see slowly in 1-2 weeks your illness passes away. I hope this will do it and that too without any heavy and cumbersome medical procedure. Continue reading >>

Management Of Feline Diabetic Ketoacidosis

Management Of Feline Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a complication of diabetes mellitus with concurrent and often severe metabolic derangements associated with hyperglycaemia, glucosuria, metabolic acidosis, ketonaemia +/- ketonuria. Patients with ketonaemia/ketosis are usually still bright, eating and maintaining their hydration. Those with ketoacidosis are dehydrated, clinically unwell (e.g., anorexia, vomiting, lethargy) and typically require hospitalisation and intensive management. DKA is distinguished from uncomplicated diabetes mellitus (DM) by a relative insulin lack and increased counter-regulatory hormones. The latter are thought to occur secondary to intercurrent disease. Concurrent disease has been documented in approximately 90% of cats with DKA, with the most common being hepatic lipidosis, chronic kidney disease, acute pancreatitis, bacterial or viral infections and neoplasia (Bruskiewicz et al. 1997). Heinz bodies, neutrophilia with a left shift, increased ALT and azotaemia is common. Most cats presenting with DKA are newly diagnosed diabetics or recently diagnosed but poorly controlled diabetics. Diagnosis Hyperglycaemia, Glucosuria, Metabolic Acidosis Plus Ketones in Plasma and/or Urine Traditionally DKA has been diagnosed using urinary ketone dipsticks, which detect acetoacetate but not beta-hydroxybutyrate. However as the latter is the principle ketone body in DKA, measuring serum beta-hydroxybutyrate is a more sensitive indicator of DKA. In humans portable meters that measure beta-hydroxybutyrate in whole blood have largely superseded urine dipsticks. These ketone meters have recently proven useful in diagnosing DKA in cats, although they tend to underestimate beta-hydroxybutyrate at higher values (Zeugswetter, Rebuzzi 2012; Weingart et al. 2012). In the absence of a ke Continue reading >>

The Emedicinehealth Doctors Ask About Diabetic Ketoacidosis:

The Emedicinehealth Doctors Ask About Diabetic Ketoacidosis:

A A A Diabetic Ketoacidosis (cont.) A person developing diabetic ketoacidosis may have one or more of these symptoms: excessive thirst or drinking lots of fluid, frequent urination, general weakness, vomiting, loss of appetite, confusion, abdominal pain, shortness of breath, a generally ill appearance, increased heart rate, low blood pressure, increased rate of breathing, and a distinctive fruity odor on the breath. If you have any form of diabetes, contact your doctor when you have very high blood sugars (generally more than 350 mg) or moderate elevations that do not respond to home treatment. At initial diagnosis your doctor should have provided you with specific rules for dosing your medication(s) and for checking your urinary ketone level whenever you become ill. If not, ask your health care practitioner to provide such "sick day rules." If you have diabetes and start vomiting, seek immediate medical attention. If you have diabetes and develop a fever, contact your health care practitioner. If you feel sick, check your urinary ketone levels with home test strips. If your urinary ketones are moderate or higher, contact your health care practitioner. People with diabetes should be taken to a hospital's emergency department if they appear significantly ill, dehydrated, confused, or very weak. Other reasons to seek immediate medical treatment include shortness of breath, chest pain, severe abdominal pain with vomiting, or high fever (above 101 F or 38.3 C). Continue Reading A A A Diabetic Ketoacidosis (cont.) The diagnosis of diabetic ketoacidosis is typically made after the health care practitioner obtains a history, performs a physical examination, and reviews the laboratory tests. Blood tests will be ordered to document the levels of sugar, potassium, sodium, and oth Continue reading >>

Diabetic Ketoacidosis: Evaluation And Treatment

Diabetic Ketoacidosis: Evaluation And Treatment

Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis can occur in persons of all ages, with 14 percent of cases occurring in persons older than 70 years, 23 percent in persons 51 to 70 years of age, 27 percent in persons 30 to 50 years of age, and 36 percent in persons younger than 30 years. The case fatality rate is 1 to 5 percent. About one-third of all cases are in persons without a history of diabetes mellitus. Common symptoms include polyuria with polydipsia (98 percent), weight loss (81 percent), fatigue (62 percent), dyspnea (57 percent), vomiting (46 percent), preceding febrile illness (40 percent), abdominal pain (32 percent), and polyphagia (23 percent). Measurement of A1C, blood urea nitrogen, creatinine, serum glucose, electrolytes, pH, and serum ketones; complete blood count; urinalysis; electrocardiography; and calculation of anion gap and osmolar gap can differentiate diabetic ketoacidosis from hyperosmolar hyperglycemic state, gastroenteritis, starvation ketosis, and other metabolic syndromes, and can assist in diagnosing comorbid conditions. Appropriate treatment includes administering intravenous fluids and insulin, and monitoring glucose and electrolyte levels. Cerebral edema is a rare but severe complication that occurs predominantly in children. Physicians should recognize the signs of diabetic ketoacidosis for prompt diagnosis, and identify early symptoms to prevent it. Patient education should include information on how to adjust insulin during times of illness and how to monitor glucose and ketone levels, as well as i Continue reading >>

Management Of Diabetic Ketoacidosis In Children And Adolescents

Management Of Diabetic Ketoacidosis In Children And Adolescents

Objectives After completing this article, readers should be able to: Describe the typical presentation of diabetic ketoacidosis in children. Discuss the treatment of diabetic ketoacidosis. Explain the potential complications of diabetic ketoacidosis that can occur during treatment. Introduction Diabetic ketoacidosis (DKA) represents a profound insulin-deficient state characterized by hyperglycemia (>200 mg/dL [11.1 mmol/L]) and acidosis (serum pH <7.3, bicarbonate <15 mEq/L [15 mmol/L]), along with evidence of an accumulation of ketoacids in the blood (measurable serum or urine ketones, increased anion gap). Dehydration, electrolyte loss, and hyperosmolarity contribute to the presentation and potential complications. DKA is the most common cause of death in children who have type 1 diabetes. Therefore, the best treatment of DKA is prevention through early recognition and diagnosis of diabetes in a child who has polydipsia and polyuria and through careful attention to the treatment of children who have known diabetes, particularly during illnesses. Presentation Patients who have DKA generally present with nausea and vomiting. In individuals who have no previous diagnosis of diabetes mellitus, a preceding history of polyuria, polydipsia, and weight loss usually can be elicited. With significant ketosis, patients may have a fruity breath. As the DKA becomes more severe, patients develop lethargy due to the acidosis and hyperosmolarity; in severe DKA, they may present with coma. Acidosis and ketosis cause an ileus that can lead to abdominal pain severe enough to raise concern for an acutely inflamed abdomen, and the elevation of the stress hormones epinephrine and cortisol in DKA can lead to an elevation in the white blood cell count, suggesting infection. Thus, leukocytosi Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia:[1] Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA.[2] Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA.[2] However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>

What's An Unforgettable Statement That Your Boss Told You?

What's An Unforgettable Statement That Your Boss Told You?

I sucked at my work. I failed to complete most tasks on time. My peers would joke about how me to sticking to a deadline was akin to a politician living up to his word. I would put in 10 — 12 hours each day. But I never moved forward. One day, my boss emailed me asking for a list of tasks I perform during that day. I freaked out. Surely I was going to lose my job. I sent him my list after 3 days — after all, I had to live up to my reputation of missing deadlines. I didn’t sleep that night. The next day, my boss called me into his cabin. This is it, I thought. I’m gonna get fired for the first time in my life. I should start preparing for the handover process. But that didn’t happen. He made me sit down and offered a glass of water. Then he said, “Vishal, I noticed you cannot perform important tasks. You do a hundred things, but I can’t see any results.” “I try sir, but I keep getting burdened with additional work,” I said. Beads of sweat formed on my brow despite the cool temperature in his cabin. “Team members tell me their work is urgent. I know I get distracted. But I want to help everyone. When I try to say ‘no’, it doesn’t work. Yesterday Nishant scolded me for turning down his work.” The last sentence was a (harmless) lie. But hey, I was trying to defend myself. The ABCD of the Professional World I think my boss saw through the lie. Because he smiled and said, “Vishal, today I’ll share a piece of wisdom with you, which I got from the boss I learned the most from. It’s this: When you work in the corporate, prioritize your work as ABCD. A — Apna kaam (your own work) B — Boss ka kaam (your boss’ work) C — Company ka kaam (your organization’s work) D — Doosron ka kaam (others’ work).” How to Apply ABCD 1. Apna Kaam P Continue reading >>

Management Of Adult Diabetic Ketoacidosis

Management Of Adult Diabetic Ketoacidosis

Go to: Abstract Diabetic ketoacidosis (DKA) is a rare yet potentially fatal hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. Due to its increasing incidence and economic impact related to the treatment and associated morbidity, effective management and prevention is key. Elements of management include making the appropriate diagnosis using current laboratory tools and clinical criteria and coordinating fluid resuscitation, insulin therapy, and electrolyte replacement through feedback obtained from timely patient monitoring and knowledge of resolution criteria. In addition, awareness of special populations such as patients with renal disease presenting with DKA is important. During the DKA therapy, complications may arise and appropriate strategies to prevent these complications are required. DKA prevention strategies including patient and provider education are important. This review aims to provide a brief overview of DKA from its pathophysiology to clinical presentation with in depth focus on up-to-date therapeutic management. Keywords: DKA treatment, insulin, prevention, ESKD Go to: Introduction In 2009, there were 140,000 hospitalizations for diabetic ketoacidosis (DKA) with an average length of stay of 3.4 days.1 The direct and indirect annual cost of DKA hospitalizations is 2.4 billion US dollars. Omission of insulin is the most common precipitant of DKA.2,3 Infections, acute medical illnesses involving the cardiovascular system (myocardial infarction, stroke) and gastrointestinal tract (bleeding, pancreatitis), diseases of the endocrine axis (acromegaly, Cushing’s syndrome), and stress of recent surgical procedures can contribute to the development of DKA by causing dehydration, increase in insulin counter-regulatory hor Continue reading >>

Diabetic Ketoacidosis Treatment

Diabetic Ketoacidosis Treatment

Diabetic ketoacidosis is a life-threatening medical condition that is a complication of diabetes mellitus that is not in control. It is more common among type 1 diabetics that have no insulin but it can also be seen in severe cases of type 2 diabetes. In diabetic ketoacidosis, there are ketones in the bloodstream and urine because the fat in the body is broken down with ketones as a byproduct. Diabetic ketoacidosis occurs when the body isn’t making enough insulin by the pancreatic islet cells. In a normal person, insulin is secreted by the pancreas in response to elevated blood sugar levels. The insulin helps glucose (sugar) to enter the cells to be used as cellular fuel. If insulin is absent, the body breaks down fatty acids to be used for fuel. Ketones build up in the urine and blood, leading to the condition known as diabetic ketoacidosis. The main cause is being a type 1 diabetic who has not taken enough insulin. Symptoms of Diabetic Ketoacidosis The signs and symptoms of diabetic ketoacidosis can come on suddenly, within a day or so of having no insulin. When signs and symptoms do show up, the patient may have any or all of the following symptoms: Confusion Breath that smells fruity Shortness of breath Tiredness or weakness Pain in the abdomen Nausea and vomiting Increased frequency of urination Being excessively thirsty Clinical signs that the individual has diabetic ketoacidosis includes have extremely high blood sugar levels as well as elevated levels of ketones in the urine. Causes of Diabetic Ketoacidosis The main source of cellular fuel is glucose. All of the cells of the body rely on glucose to make energy to allow the cells to function in whatever capacity they happen to be in. When insulin is lacking, the body is unable to use glucose as fuel. These caus Continue reading >>

Developments In The Management Of Diabetic Ketoacidosis In Adults: Implications For Anaesthetists

Developments In The Management Of Diabetic Ketoacidosis In Adults: Implications For Anaesthetists

Diabetic ketoacidosis (DKA) is a medical emergency and bedside capillary ketone testing allows timely diagnosis and identification of successful treatment. 0.9% saline with premixed potassium chloride should be the main resuscitation fluid on the general wards and in theatre; this is because it complies with National Patient Safety Agency recommendations on the administration of potassium chloride. Weight-based fixed rate i.v. insulin infusion (FRIII) is now recommended rather than a variable rate i.v. insulin infusion (VRIII). The blood glucose must be kept above 14 mmol litre−1 with the FRIII. Precipitating factor(s) needs to be identified and treated. Surgery and also critical care may be indicated to manage the patient presenting with DKA. Diabetic ketoacidosis (DKA) is a medical emergency. The diagnostic triad is: DKA can occur in both type 1 and type 2 diabetes mellitus and, although preventable, it remains a frequent and life-threatening complication. Errors in the management of DKA are not uncommon and are associated with significant morbidity and mortality. The majority of mortality and morbidity in DKA are attributable to delays in presentation and initiation of treatment. Rapid recognition and treatment of DKA is critical. Ketonaemia ≥3.0 mmol litre−1 or significant ketonuria (more than 2+ on urine sticks) Blood glucose >11.0 mmol litre−1 or known diabetes mellitus Bicarbonate <15.0 mmol litre−1, venous pH <7.3, or both. To overcome these concerns and to highlight current management strategies, the Joint British Diabetes Societies (JBDS) published guidelines in 2010. This was updated in consultation with the Intensive Care Society in September 2013.1 This article will review the pathophysiology of DKA and highlight the modern management of DKA that 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 >>

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 >>

Am I The Real Me When I Take Sertraline (zoloft) Or When I Don't Take It?

Am I The Real Me When I Take Sertraline (zoloft) Or When I Don't Take It?

There is no real you. Brain-altering drugs make it so you are not who you were before you took them. Continually using them means you are continually not who you were before you took them. Sometimes even just short term use can mean the effects last indefinitely, whether or not you continue using those drugs. But, the point here is that altered states are fundamentally different from unaltered ones. The whole purpose of taking psychotropic drugs is to change who or how you feel to be. That does not mean the unaltered you is "the real you" and the altered you is "the unreal you", though. They are different, in whatever ways, but all concepts of "you" are dynamic—not fixed. The physical "you" changes on a daily basis, even minute to minute. Antidepressants cause alterations and dysfunction which results in different physical changes than you would normally experience, but in either case there is a dynamic organic situation occurring and I would not even say the "you" is simply reduced to that physical system. I don't mean that spiritually, either...I mean our decisions and range of experiences are not solely contingent upon how our brain or body are at a given moment. Our perspectives and self-estimations and experiences of life can all be changed by drugs that alter our physical functioning, but the system drugs are acting upon is the very "you" that is being discussed. So, the "you" is a contributing factor in the outcomes of physical as well as experiential happenings. The conscious assessment of and participation in those end products is, perhaps, another kind of "you". That "you" is also quite dynamic, but even more contextual. Antidepressants cause physical and functional changes in your brain which can affect personality, brain morphology, cognition, communicatio Continue reading >>

If A Patient With Diabetic Ketoacidosis Eats 2 Spoonful Sugar, Will He Die?

If A Patient With Diabetic Ketoacidosis Eats 2 Spoonful Sugar, Will He Die?

Diabetic ketoacidosis (DKA) is a medical emergency, and people in DKA are in a very dangerous situations. They are in no condition to eat two spoonfuls of anything. The blood glucose is very high, and the initial treatment uses small amounts of insulin, and enough saline to really dilute the the blood glucose. In the typical furor of DKA care, it is hard to imagine an five additional grams of glucose doing anything. It would require just a little bit more saline to take care of that amount. Glucose would never be given in the early stages of DKA care. Near the end of the treatment, when the glucose has already come down to about only double the normal level, glucose actually is given to patients in DKA. Continue reading >>

How To Treat Diabetic Ketoacidosis

How To Treat Diabetic Ketoacidosis

1 Call emergency services. Diabetic ketoacidosis can be a life-threatening condition. If you are experiencing symptoms like your blood sugar not lowering, you should immediately call emergency services or visit the emergency room.[2] Symptoms that require you to call emergency services include severe nausea, being nauseous for four or more hours, vomiting, being unable to keep fluids down, inability to get your blood sugar levels down, or high levels of ketones in your urine.[3] Leaving DKA untreated can lead to irreparable damage and even death. It is important to seek medical care as soon as you suspect you are having a problem. 2 Stay in the hospital. Ketoacidosis is usually treated in the hospital. You may be admitted to a regular room or treated in ICU depending on the severity of your symptoms. During the first hours you are there, the doctors will work on getting your fluids and electrolytes balanced, then they will focus on other symptoms. Most of the time, patients remain in the hospital until they are ready to return to their normal insulin regimen.[4] The doctor will monitor you for any other conditions that may cause complications, like infection, heart attack, brain problems, sepsis, or blood clots in deep veins. 3 Increase your fluid intake. One of the first things that will be done to treat your diabetic ketoacidosis is to replace fluids. This can be in the hospital, a doctor’s office, or home. If you are receiving medical care, they will give you an IV. At home, you can drink fluids by mouth.[6] Fluids are lost through frequent urination and must be replaced. Replacing fluids helps balance out the sugar levels in your blood. 4 Replace your electrolytes. Electrolytes, such as sodium, potassium, and chloride, are important to keep your body functioning p Continue reading >>

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