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Diabetic Ketoacidosis Treatment Guidelines Ada

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Hyperglycemic Crises: Diabetic Ketoacidosis (dka), And Hyperglycemic Hyperosmolar State (hhs)

Go to: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are acute metabolic complications of diabetes mellitus that can occur in patients with both type 1 and 2 diabetes mellitus. Timely diagnosis, comprehensive clinical and biochemical evaluation, and effective management is key to the successful resolution of DKA and HHS. Critical components of the hyperglycemic crises management include coordinating fluid resuscitation, insulin therapy, and electrolyte replacement along with the continuous patient monitoring using available laboratory tools to predict the resolution of the hyperglycemic crisis. Understanding and prompt awareness of potential of special situations such as DKA or HHS presentation in comatose state, possibility of mixed acid-base disorders obscuring the diagnosis of DKA, and risk of brain edema during the therapy are important to reduce the risks of complications without affecting recovery from hyperglycemic crisis. Identification of factors that precipitated DKA or HHS during the index hospitalization should help prevent subsequent episode of hyperglycemic crisis. For extensive review of all related areas of Endocrinology, visit WWW.ENDOTEXT. Continue reading >>

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Popular Questions

  1. kristin

    Hello! MY name is Kristin and I have R.A and Type 1 Diabetes. I was diagnosed with JRA when I was 18mo old. Per my Mom, I stopped walking and started crawling again due to the pain in my hips and legs. I would cry constantly and sometimes they couldnt even put a diaper on me.
    This was way back in 1970, so they didnt have too many options for treatment. I was put on a heavy regiment of St. Josephs Baby Aspirin every four hours for years!!! Its amazing I still have a stomach! I had to take it with milk to help the stomach issues. Today at 49yrs years old, I cannot stand the tast of fake orange or plain white milk! I literally get nauseous 🙁
    I went into remission and started riding horses to strenghen my muscles. It worked. I only had slight discomfort that to me was NOTHING! Mostly after riding or during the changes in weather in Ohio.
    At 38 with the pregnancy of my Son, They found out I had diabetes which they thought was gestational, but after the pregancy, I just declined. Lost TONS of weight and got really weak/sick. They ran tests and YES, my second auto-immune disease had taken over!
    About 5 years later while working with my daughter who was 9yrs old at an Ohio 4-H Horse event in 90+ heat… I knew something else was VERY wrong! Every thing started swelling! I was in so much pain, I could barely do anything to help her. I thought maybe it was just the heat, but it just kept going and Id get better for a week or two and than bad again. I went to Doctor after Doctor only to get SO FRUSTRATED that I just stopped going! I just dealt with the pain. I didnt even think it would be my R.A. I had heard so many different people tell me that JRA goes away! Its gone! But….later to find out from a P.A. not a Doctor that Auto immune issues are always there, they are just dormant.
    So we ran tests and I found an amazing Rheumatoligist who actually took the time to listen to me! AMAZING these days – right?
    Sure enough, she said even though my blood work did not specifically jump out and say I had R.A., Given my medical records I still had from when I was a child and my new symptoms that she could clearly see… she was assured it was indeed R.A.
    I am writing all this because…. I am 49 with a husband, 2 kids 15yrs and 10yrs, it seems like a whole little farm worth of animals and a LOT of chores and housework that seems to NEVER get done!
    If its not the R.A. killing me one day, its My high or low sugars. Or God forbid somedays its BOTH! HORRIBLE!
    Trying to balance it all and still have energy at the end of the day is a HUGE challenge! Not to mention to even be in a good mood somedays. BUT I try!
    Its so VERY discouraging though having 2 invisible diseases and I basically feel like everyone thinks Im a big baby or a nut case out side our house anyways.
    SO Im looking for support. Help talking life out and everyday obstacles. How do you all do it? Any tricks?
    Would love to hear from someone that has 2 autoimmune like type 1 and R.A or Lupus or Similar.

  2. Richard Faust

    Thanks for sharing your story Kristen. Please know that you are always welcome here for support and information. Dealing with the emotional aspects of RA can certainly be difficult. This article from our editorial team looks at managing the emotional aspects: https://rheumatoidarthritis.net/living-with-ra/managing-emotional-problems-and-stress/.
    Sorry to hear about the duel diagnosis, which unfortunately, is not uncommon with autoimmune conditions. I’m sure this only adds to the fatigue issues. This article offers some thoughts on managing fatigue: https://rheumatoidarthritis.net/symptoms/fatigue-and-weakness/.
    Know that it is o.k. to not always be able to do everything. Learning to pace oneself can certainly be difficult. In this article one of our contributors offers up her guide to pacing: https://rheumatoidarthritis.net/living/shifting-gears-a-guide-to-pacing/.
    Hope this information is helpful. Please keep us posted on how you are doing. Best, Richard (RheumatoidArthritis.net Team)

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