Management Of Hyperglycemic Crises In Patients With Diabetes
Management of Hyperglycemic Crises in Patients With Diabetes Abbas E. Kitabchi, PHD, MD, Guillermo E. Umpierrez, MD, Mary Beth Murphy, RN, MS, CDE, MBA, Eugene J. Barrett, MD, PHD, Robert A. Kreisberg, MD, John I. Malone, MD, Barry M. Wall, MD, Division of Endocrinology (A.E.K., G.E.U., M.B.M.), University of Tennessee, and the Department of Nephrology (B.M.W.), Veterans Administration Hospital, Memphis, Tennessee; the Division of Endocrinology (E.J.B.), University of Virginia, Charlottesville, Virginia; the College of Medicine (R.A.K.), University of South Alabama, Mobile, Alabama; and the Department of Pediatrics (J.I.M.), University of South Florida, Tampa, Florida. The therapeutic goals for treatment of hyperglycemic crises in diabetes consist of 1) improving circulatory volume and tissue perfusion, 2) decreasing serum glucose and plasma osmolality toward normal levels, 3) clearing the serum and urine of ketones at a steady rate, 4) correcting electrolyte imbalances, and 5) identifying and treating precipitating events ( Table 2 and Table 3 ). As shown in Figs. 4 and 5, monitoring of serum glucose values must be done every 1-2 h during treatment. Serum electrolytes, phosphate, and venous pH must be assessed every 2-6 h, depending on the clinical response of the patient. Foremost, the precipitating factor must be identified and treated. See Table 7 for a review of the laboratory evaluation of metabolic causes of acidosis and coma. A flow sheet (Fig. 6) is invaluable for recording vital signs, volume and rate of fluid administration, insulin dosage, and urine output and for assessing the efficacy of medical therapy.[ 6 ] Figures 4 and 5 represent a successful protocol used by the authors for the treatment of DKA and HHS in adult patients. There are some differences i Continue reading >>
Summers And Diabetes - Points To Remember This Season
Summers and Diabetes - Points to remember this season Points to remembers this Summer for Diabetics What has the weather got to do with Diabetes control? seems an obvious question. Summer season has different implications in different parts of the world.. There are many factors which influence the management of Diabetes in this period of time. In the Colder countries summers bring plenty of fruits and vegetables which are highly recommended for Diabetics, Green leafy vegetables, fresh berries, available in plenty and good for diabetics. Vegetables , specially salads have almost zero calories, they can be had as much as desired, help increase HDL ( the Good Cholesterol) and keep sugar down as they are of Low Glycemic Index and would decrease the absorption of foods consumed with them. But some fruits should be avoided in summers - they are Bananas, Cheekoos- Sapota, Grapes, Litchi, Mango... In most of the Indian subcontinent (except the north which may have climate similar to the western countries) A lot of refreshing drinks are consumed during the summers. Care must be taken to avoid fresh fruit or vegetable juices specially Sugarcane juice, which is very popular in North India, as well as other sugar containing beverages and aerated drinks like the popular Colas, lemon, mango and fruit drinks. Chach or buttermilk is one of the best thirst quenching drinks for diabetics in the scorching hot weather, lemonade or Freshlime Soda should be taken either with salt and masala or with sugar substitutes . Generally appetite is decreased in the hot weather which goes in favour of Diabetes control. This season also causes a lot of diseases related to Gastrointestinal system like Diarrhea, vomiting leading to loss of water and salts from the body. Children are more prone to such d Continue reading >>
Can A Diabetic Take Who Ors Solution In Diarrhoea & Dehydration? - Nutrition - Medhelp
Forums > Nutrition >can a diabetic take WHO ORS SOLUTION in diarrhoea & dehydration? This expert forum is not accepting new questions. Please post your question in one of our medical support communities . can a diabetic take WHO ORS SOLUTION in diarrhoea & dehydration? if a person who is diabeticsuffers diarrhoea & dehydration. Is it advisable for him to take WHO ORS SOLUTION whICH is available in market if his blood sugar is controlled within normal. I'm 21yr s old n I'm a hypothyroid patient. my height is 5.3" n my weight is 80 kg s. can you please tell me if ors electral is the same as pedialyte? n whether it will help me lose weight? please reply soon. thanks. This expert forum is not accepting new questions. Please post your question in one of our medical support communities . Here are 12 simple and fun! ways to boost your brainpower. Copyright 1994-2018 MedHelp. All rights reserved. MedHelp is a division of Vitals Consumer Services, LLC. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in Continue reading >>
Faq - O.r.s Hydration Tablets
O.R.S Hydration Tablets use a precise combination of electrolytes, glucose, and minerals to replenish water and salts and help you to maintain a proper fluid balance. Anyone who may require hydration. O.R.S Hydration Tablets are used by professional athletes, people taking exercise and participating in sport, people travelling and those who may be suffering from dehydration due to illness. Can I use O.R.S Hydration Tablets when travelling? Yes, O.R.S Hydration Tablets are considered by many to be a travel essential. Flights, particularly long haul flights, hot climates or even a day of energetic skiing can all lead to dehydration. Can I use O.R.S Hydration Tablets when Im sick? Yes. O.R.S Hydration Tablets should be used to restore healthy fluid balance. Can children take O.R.S Hydration Tablets? Yes. Children can safely use O.R.S Hydration Tablets, please follow instructions as indicated on the back of the pack. Please speak to your GP or a Pharmacist before using in children under the age of 3. No, the O.R.S solution is not carbonated. It is a still hydration drink when each tablet is fully dissolved. No. O.R.S Hydration Tablets do contain salts and electrolytes, but use sucralose and natural flavourings to create a lemon, blackcurrant, or strawberry hydration solution. How long do O.R.S Hydration Tablets take to dissolve? Each tablet can take a few minutes to fully dissolve depending on the temperature of water. The reasons O.R.S takes a few minutes to dissolve relative to some other soluble tablets include the following: Helps with the preparation of a homogeneous solution and even distribution of ingredients in water and thus better absorption by the body. Helps ensure the active ingredients are intact in hot conditions/climate where many people will be using O.R. Continue reading >>
Trioral Oral Rehydration Salts - Official Website
Perfect to take after vomiting, sweating, or experiencing diarrhea from unexpected food poisoning. Effective hydration for patients recuperating from gastrointestinal/ bariatric surgery or other medical conditions.* Rehydrate and feel better quickly. On the road, in the air, on a train, or on foot all travel can result in the unexpected. Be prepared. Whether you are visiting family out of state or adventure traveling abroad, fluid losses resulting in dehydration from exposure to new climates, different foods and unwelcomed viruses can occur when you least expect it. Hiking in the mountains, camping with friends, training for sports such as cycling or marathon running are fun and exciting. But in hot, humid weather, with prolonged activity, even professional athletes can dehydrate quickly. Outdoor labor as a job or as a hobby especially in hot, humid weather places you at risk for sudden and serious dehydration. On the construction site, in the fields, or in your own backyard, be prepared. What exactly are TRIORAL Oral Rehydration Salts (ORS)? TRIORAL Oral Rehydration Salts are effective, inexpensive, safe and convenient packets of pre-formulated salts/ sugar when mixed with water will rehydrate your body fast, regardless of the cause. Each TRIORAL Oral Rehydration Salts packet is a sealed, pre-measured and pre-formulated powder that contains: Glucose anhydrous 13.5g, Trisodium Citrate Dehydrate 2.9g, Sodium Chloride 2.6g and Potassium Chloride 1.5g. How does TRIORAL Oral Rehydration Salts work and why are these electrolytes important? This combination of electrolytes with glucose optimizes efficient absorption via the intestinal tract. With TRIORAL Oral Rehydration Salts both the active transport of glucose and diffusion of salts/water through the intestinal lining are Continue reading >>
- Hidden Salts and Diabetes
- KINGS Herbal | REH KINGS Herbal Official website | Ka Rey Herrera KINGS Herbal - one of leading herbal food supplement in the Philippines | Herbal supplement best for diabetes, hypertension, cancer, kidney stone and various diseases and illnesses
- KINGS Herbal | REH KINGS Herbal Official website | Ka Rey Herrera KINGS Herbal - one of leading herbal food supplement in the Philippines | Herbal supplement best for diabetes, hypertension, cancer, kidney stone and various diseases and illnesses
Management Of Acute Diarrhoea In Diabetic Patients Using Oral Rehydration Solutions Containing Glucose, Rice, Or Glycine.
Management of acute diarrhoea in diabetic patients using oral rehydration solutions containing glucose, rice, or glycine. OBJECTIVE--To assess the risk of hyperglycaemia with two standard oral rehydration solutions that contain carbohydrate compared with a carbohydrate free solution during rehydration of diabetic patients with acute diarrhoea. DESIGN--Prospective randomised allocation to one of three oral rehydration solutions (World Health Organisation (glucose), rice, or glycine) groups after admission to hospital with acute diarrhoea. SETTING--Dhaka hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh. SUBJECTS--45 diabetic patients aged between 15 and 60 who had had diarrhoea for fewer than three days on admission. MAIN OUTCOME MEASURES--Fluctuation of blood glucose concentrations measured three times a day, daily stool output, and time taken for recovery from diarrhoea. RESULTS--There were no significant differences in blood glucose concentrations, stool output, and duration of recovery from diarrhoea among the three groups. CONCLUSIONS--Oral rehydration solutions containing glucose, rice powder, or glycine can be safely administered to diabetic patients with acute diarrhoea and some dehydration. Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (714K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References . Continue reading >>
Ors Day: Can Diabetics Have Oral Rehydration Solution?
July 29 is celebrated as ORS Day to focus attention on the importance of oral rehydration solution (ORS), a live-saver for infants and young children in a developing country like ours. Diarrhoea and vomiting can cause the depletion of water and salts in the human body, which can be fatal. That’s why ORS or electrolyte powder is given to prevent this loss due to dehydration. The latest formula or ORS released by the WHO is a combination of a sodium chloride or salt, potassium chloride, trisodium citrate and anhydrous glucose which simulates water and electrolyte absorption in the gut. Dehydration and diabetes Although it was introduced to combat infant mortality due to diarrhoea, ORS is also administered to adults who lose fluids as a result of illness or excessive sweating. Among the diabetics, dehydration is a serious issue. Insulin production in diabetics is less, which makes it difficult for the body to remove carbohydrates from the body. This causes the body to increase urine production to flush out the carbs, causing dehydration. Drinking a lot of water could fix the issue, but that wouldn’t do on its own. The body also has to be replenished with the essential electrolytes which are flushed away. (Read: How to prevent dehydration) Since the large part of the ORS solution is glucose, some diabetic patients express concern over drinking it, lest it spikes up their sugar level. So, to put an end to this riddle, researchers from International Centre for Diarrhoeal Disease Research, Bangladesh conducted a study to ascertain whether it is safe for diabetic patients to have the ORS solution, in case they suffer from dehydration. (Read: Tips to maintain acid-alkali balance for diabetics) What the study says The researchers themselves were sure, even before they conduct Continue reading >>
What Is A Suitable Rehydration Therapy For A Diabetic After
what is a suitable rehydration therapy for a diabetic after diarrhoea? Experience: Physician with 8 years of experience. Is diarrhea caused by infectious cause ,if yes you can replace yourself of you are dehydrated a lot with Oral rehydration solution(ORT).it contains salts and sugar according to normal serum osmolarity,may increase sugar levels transiently only but if you are dehydrated you need some sugar too. Bur if the diarrhea is caused by diabetes itself then you might need to your doctor first. How to know which kind of diarrhea it is? diabetic diarrhea is chronic(from days to weeks) and mostly presents with severe dehydration,mostly happens when a person does not mainatin his blood sugar level for a long time. My advise is that if you have infectious diarrhea then you can take ORT as i mentioned earlier but do watch for -if you have sweating,palpitation,chest pain then stop drinking it and go to your physician.These symptoms happen rarely but still is a possibilty If you have diabetic diarrhea then go to your physician and discuss about changes in your anti diabetic drugs requirement. Always ask if you need clarification/more information.Please click ACCEPT button to get my credit.POSITIVE feedback& BONUS are warmly appreciated. Please note that answer is for information only. It can't be a substitute to visit the doctor. Experience: Physician with 8 years of experience. Dr. B. and 87 other Medical Specialists are ready to help you Experience: Physician with 8 years of experience. A new question is answered every 9 seconds Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm. Get a Professional AnswerVia email, text message, or notification as you wait on our site. Continue reading >>
Vomiting, Nausea, And Diarrhea – Adjusting Your Diabetes Medication
Vomiting, nausea, and diarrhea are most commonly caused by bacterial or viral infections sometimes associated with flu-like illness. An essential part of treatment is to stop eating. Since you can certainly survive a few days without eating, this should pose no problem. But if you’re not eating, it makes sense to ask what dose of insulin or ISA you should take. Adjusting Your Diabetes Medication If you’re on one of the medication regimens described in this book, the answer is simple: you take the amount and type of medication that you’d normally take to cover the basal, or fasting, state and skip any doses that are intended to cover meals. If, for example, you ordinarily take detemir or glargine as basal insulin upon arising and at bedtime, and regular or lispro (or aspart or glulisine) insulin before meals, you’d continue the basal insulin and skip the preprandial regular or lispro for those meals you won’t be eating. Similarly, if you take an ISA on arising and/or at bedtime for the fasting state, and again to cover meals, you skip the doses for those meals that you do not plan to eat. In both of the above cases, it’s essential that the medications used for the fasting state continue at their full doses. This is in direct contradiction to traditional “sick day” treatment, but it’s a major reason why patients who carefully follow our regimens should not develop DKA or hyperosmolar coma when they are ill. Of course, if you’re vomiting, you won’t be able to keep down oral medication and this poses yet another problem. Remember, because infection and dehydration may each cause blood sugar to increase, you may need additional coverage for any blood sugar elevation. Such additional coverage should usually take the form of lispro insulin. This is one of Continue reading >>
Best Electrolyte Drinks For Diabetes
If you have diabetes and you are looking to stay hydrated with an electrolyte drink, you know it can be difficult to find one that isn’t too high in sugar and carbohydrates. If you have started an exercise regime, it can also be challenging to keep your blood sugar from getting too low. Exercise removes glucose from the blood without using insulin, and is crucial in getting diabetes under control, but it is a delicate balance for your blood sugar being too high when you are inactive, and too low when you are active. It is important that the electrolyte drink matches your activity level, and you are not drinking an electrolyte drink with 25 carbohydrates while you are sitting inside, or one with zero carbohydrates while you are combining Zumba, Jazzercize and CrossFit. In regards to these parameters, perhaps you were advised to choose an electrolyte drink that uses artificial sweeteners. While writing The New Menu for Diabetes, I did some research on artificial sweeteners and was shocked that these were recommended for diabetics. The studies clearly showed that these in fact should be avoided, and I wanted to go more in depth in this article regarding why you should avoid Splenda and Acesulfame K. Why You Should Avoid the Following Electrolyte Drinks The following is based on my research and opinion. 1. Powerade Zero After doing some research, I noticed that Powerade Zero was the drink of choice for many diabetics due to it having zero calories. What’s in Powerade Zero? UK Label: Water, citric acid, mineral salts (sodium chloride, magnesium chloride, calcium chloride, potassium phosphate), natural berry flavouring with other natural flavourings, acidity regulator (E332), sweeteners (sucralose, acesulfame K), colour (E133). US Label: Water, Citric Acid, Natural Flavor Continue reading >>
Dehydration And Diabetes
Tweet People with diabetes have an increased risk of dehydration as high blood glucose levels lead to decreased hydration in the body. Diabetes insipidus, a form of diabetes that is not linked with high blood sugar levels, also carries a higher risk of dehydration. Symptoms of dehydration The symptoms of dehydration include: Thirst Headache Dry mouth and dry eyes Dizziness Tiredness Dark yellow coloured urine Symptoms of severe dehydration Low blood pressure Sunken eyes A weak pulse and/or rapid heartbeat Feeling confused Lethargy Causes and contributory factors of dehydration The following factors can contribute to dehydration. Having more of these factors present at one time can raise the risk of dehydration: Dehydration and blood glucose levels If our blood glucose levels are higher than they should be for prolonged periods of time, our kidneys will attempt to remove some of the excess glucose from the blood and excrete this as urine. Whilst the kidneys filter the blood in this way, water will also be removed from the blood and will need replenishing. This is why we tend to have increased thirst when our blood glucose levels run too high. If we drink water, we can help to rehydrate the blood. The other method the body uses is to draw on other available sources of water from within the body, such as saliva, tears and taking stored water from cells of the body. This is why we may experience a dry mouth and dry eyes when our blood glucose levels are high. If we do not have access to drink water, the body will find it difficult to pass glucose out of the blood via urine and can result in further dehydration as the body seeks to find water from our body's cells. Treating dehydration Dehydration can be treated by taking on board fluids. Water is ideal because it has no add Continue reading >>
Management Of Acute Diarrhoea In Diabetic Patients Using Oral Rehydration Solutions Containing Glucose, Rice Or Glycine.
Haider R; Khan AK; Roy SK; Dewan N; Alam AN; Mahalanabis D BMJ. British Medical Journal. 1994 Mar 5; 308(6929):624-6. At the hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh, physicians randomly allocated 45 diabetic patients, 15-60 years old, with acute diarrhea (duration, = or < 72 hours) to 1 of 3 treatment groups: the World Health Organization (WHO) oral rehydration solution (ORS) with glucose, rice ORS, or glycine ORS. Just 12 (26.6%) diabetic patients took ORS at home before admission to the hospital, compared to 77-81% of nondiabetic patients with acute diarrhea. Those who did not take ORS at home feared that hyperglycemia would occur if they took ORS with carbohydrate. Over the 4-day observation period, little difference in the volume of ORS intake and stool output existed among the groups. Serum electrolyte levels were similar in all 3 groups at admission, 24 hours after rehydration, and before discharge from the hospital. Even though the mean recovery time from diarrhea was shortest with rice ORS (50.5 hours) and glycine ORS (57.63%), it was not significantly different from that of the WHO ORS (71.33 hours). These findings suggest that diabetic patients with acute diarrhea and some dehydration can safely take glucose, rice, or glycine ORS. Continue reading >>
Rehydration Solutions For Medical Professionals - Hydralyte
Are you interested in stocking Hydralyte to provide to patients on site? Contact us about purchasing Hydralyte at wholesale rates, either directly or via a distributor. At Hydralyte, we are passionate about delivering real, clinically effective hydration, and are committed to supporting the work of the medical community globally by providing product and resources to those in need. Hydralyte is pleased to be partnering with Timmy Global Health: Timmy Global Health is an Indianapolis-based nonprofit that expands access to healthcare and empowers students and volunteers to tackle todays most pressing global health challenges. Timmys primary care medical trips help provide yearround health access to their adopted communities. TGH teams return to partner sites every 23 months, maintain detailed records, and ensure patients have access to the quality care they need and deserve. These shortterm efforts are vital to the longterm continuity. Even after the medical teams have gone home, patients have access to important medicines, have contact with a community health worker, receive subsidized surgeries and hospital care, and feel secure in the fact that they can reach a doctor in the event of an emergency. We are proud to support the following organizations with product donations: Our support of the medical community is ongoing. For inquiries on partnerships or donations, please contact us . Oral Rehydration Education Material and Programs Hydralyte has created a library of educational materials and tools for both healthcare professionals and their patients. Continue reading >>
Diabetes And Dehydration: Is Drip Drop A Safe Treatment?
According to the American Diabetes Association (ADA), more than 26 million American children and adults suffer from diabetes. And nearly 80 million are pre-diabetic and at a greater risk for developing the disease. For diabetics, dehydration is a serious health concern, because the disease decreases the body’s production of insulin, a hormone that regulates the body’s use of carbohydrates. Therefore, when a diabetic eats carbohydrates – sugar, breads and pastas – the body is unable to eliminate them fast enough. In turn, the body increases urine production to flush them out, which depletes fluids and causes dehydration. How Can Diabetics Prevent Dehydration? Drinking enough water is one of the best prevention strategies. But in certain cases when the body loses excessive electrolytes and sugars, water just isn’t enough. In these cases, Drip Drop can be used as an effective solution to manage dehydration. It contains a dose of electrolytes and sugars that are designed to replenish sodium and potassium in the body and speed up absorption of water into the bloodstream. Those additional sugars might alarm diabetics, and of course, when your blood sugar levels are high, Drip Drop should be avoided. But it can be incorporated into a carbohydrate-sensitive diet. According to the ADA, an adult male should consume between 135 and 270 grams of carbohydrates each day, depending on several factors. With 16 grams of carbohydrate per half-liter serving, Drip Drop has fewer sugars than unsweetened apple juice, coconut water and sports drinks, while providing a substantial dose of sodium and potassium. Of course, every patient’s nutritional needs are different, so always check with your physician or nutritionist to determine if Drip Drop fits your diet. When Drip Drop Shoul Continue reading >>
What's The Connection Between Diabetes And Diarrhea?
No one wants to talk about diarrhea. More so, no one wants to experience it. Unfortunately, diarrhea is often the body's natural way of expelling waste in liquid form when a bacterial or viral infection, or parasite is present. However, there are other things that can cause diarrhea for everyone, and some things that can cause diarrhea specifically in those with diabetes. Diabetes and diarrhea There are various things that can cause diarrhea. These include: Large amounts of sugar alcohols, such as sorbitol, that are often used in sugar-free products Some medications, such as metformin, a common medication used to treat diabetes In some cases, such as with illness or the use of sugar alcohols, diarrhea does not last for long. It tends to stop once the illness is over or the person stops using sugar alcohols. With metformin, the symptoms can go away with time. Some people in whom the diarrhea does not resolve may need to stop taking the medication, however. Bowel diseases may cause lasting problems for people with these conditions. Diarrhea and other symptoms can be managed or controlled with lifestyle changes such as stress reduction, and medications as needed. People with type 1 diabetes are at higher risk of celiac disease, and should check for this if long-term diarrhea is a problem for them. A long-term complication associated with diabetes that can lead to long-term diarrhea (and constipation) is called autonomic neuropathy. Autonomic neuropathy occurs when there is damage to the nerves that control how the body works. Autonomic neuropathy can affect the nerves that control all automatic bodily functions such as heart rate, sweating, and bowel function. Since diabetes is the most common cause of autonomic neuropathy, people with long-term diabetes complications stru Continue reading >>