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What Causes High Ketones In Diabetics?

Ketoacidosis: A Diabetes Complication

Ketoacidosis: A Diabetes Complication

Ketoacidosis can affect both type 1 diabetes and type 2 diabetes patients. It's a possible short-term complication of diabetes, one caused by hyperglycemia—and one that can be avoided. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two of the most serious complications of diabetes. These hyperglycemic emergencies continue to be important causes of mortality among persons with diabetes in spite of all of the advances in understanding diabetes. The annual incidence rate of DKA estimated from population-based studies ranges from 4.8 to 8 episodes per 1,000 patients with diabetes. Unfortunately, in the US, incidents of hospitalization due to DKA have increased. Currently, 4% to 9% of all hospital discharge summaries among patients with diabetes include DKA. The incidence of HHS is more difficult to determine because of lack of population studies but it is still high at around 15%. The prognosis of both conditions is substantially worsened at the extremes of age, and in the presence of coma and hypertension. Why and How Does Ketoacidosis Occur? The pathogenesis of DKA is more understood than HHS but both relate to the basic underlying reduction in the net effective action of circulating insulin coupled with a concomitant elevation of counter regulatory hormones such as glucagons, catecholamines, cortisol, and growth hormone. These hormonal alterations in both DKA and HHS lead to increased hepatic and renal glucose production and impaired use of glucose in peripheral tissues, which results in hyperglycemia and parallel changes in osmolality in extracellular space. This same combination also leads to release of free fatty acids into the circulation from adipose tissue and to unrestrained hepatic fatty acid oxidation to ketone bodies. Some drugs ca Continue reading >>

High And Low Blood Sugar Issues

High And Low Blood Sugar Issues

Blood sugar concentrations or blood glucose levels are the amount of sugar or glucose present in your blood stream. Your body naturally regulates blood sugar (glucose) levels as a part your body”s metabolic processes. Glucose or sugar is the primary energy mechanism for cells and blood lipids. Glucose or blood sugar is transported from your intestines or liver to the cells in your body via the bloodstream. The absorption of glucose is promoted by insulin or the hormone produced in the pancreas. If your sugar levels are not balanced you may have high or low blood sugar issues. Low sugar issues are hypoglycemia and high blood sugar indicates that you have hyperglycemia or hyperglycemia symptoms. High or low blood sugar levels cause different problems. Low blood sugar levels can cause dementia, comas or death. High blood sugar is a major cause of damage to your body”s internal organs. Low Blood Sugar Low blood sugar or hypoglycemia indicates the level of glucose in your blood has dramatically dropped below what your body need to function. When your blood sugar drops below 70 milligrams per deciliter symptom will develop. You may feel tired and anxious or weak and shaky. Your heart rate may be rapid and you feel as if you are having a heart attack. Eating something sugary will bring your sugar levels back to normal almost immediately and symptoms will subside. Sugar levels that are below 40 mg/dL cause you to have behavior changes. You may feel very irritable and become weak and confused. You may not realize you need to eat to raise your blood sugar levels. Blood sugar levels below 20 mg/dL will most certainly cause a loss of consciousness or perhaps you will experience seizures. You will need medical care immediately. Hypoglycemia symptoms happen very quickly. If you a Continue reading >>

Ketones

Ketones

Excess ketones are dangerous for someone with diabetes... Low insulin, combined with relatively normal glucagon and epinephrine levels, causes fat to be released from fat cells, which then turns into ketones. Excess formation of ketones is dangerous and is a medical emergency In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketones can develop. What are ketones and why do I need to know about them? Ketones and ketoacids are alternative fuels for the body that are made when glucose is in short supply. They are made in the liver from the breakdown of fats. Ketones are formed when there is not enough sugar or glucose to supply the body’s fuel needs. This occurs overnight, and during dieting or fasting. During these periods, insulin levels are low, but glucagon and epinephrine levels are relatively normal. This combination of low insulin, and relatively normal glucagon and epinephrine levels causes fat to be released from the fat cells. The fats travel through the blood circulation to reach the liver where they are processed into ketone units. The ketone units then circulate back into the blood stream and are picked up by the muscle and other tissues to fuel your body’s metabolism. In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketone Continue reading >>

Diabetes: Ketone Testing

Diabetes: Ketone Testing

www.CardioSmart.org Not having enough insulin can keep your body from using sugar for energy, even when your blood sugar level is very high. Instead, your body has to break down fats to get the fuel it needs. The fats are broken down into a type of acid which, if it builds up, can cause serious problems with vital organs. These acids are called ketones. When ketone levels get high, your kidneys release them into your urine. Having large amounts of ketones can be a sign of diabetic ketoacidosis. This is a dangerous condition caused by a lack of insulin. When to test for ketones Test for ketones whenever: • You feel sick to your stomach, are vomiting, or have belly pain. • You have an illness or infection. • You are dehydrated. • Your blood sugar is higher than the level your doctor set for you (for example, above 300). • You have missed a dose of your diabetes medicine. • You have symptoms of high blood sugar. • You are pregnant. Ask your doctor about testing for ketones during pregnancy. Symptoms of high blood sugar If you have mild high blood sugar, you may feel very thirsty and may urinate more, especially at night. Your skin may be warm and dry. If you have moderate high blood sugar, your breathingmay be fast and deep. Your breath may have a fruity odor. You may lose your appetite and have stomach pain and vomiting. You may become dizzy and weak when you sit or stand. Your urine may be dark, and you may urinate less. Your vision could become blurred. If you have severe high blood sugar, you may have rapid, deep breathing with a strong, fruity breath odor. You may feel very sleepy and weak, and you may faint. You may have a fast heart rate and a weak pulse. This is a very dangerous condition. How to test for ketones Blood test Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis, sometimes called DKA, is a condition caused when you have a high blood sugar level, and not enough insulin in your body to break it down to use for energy. As a result, the body starts burning its stores of fat for energy instead. This process produces by-products called ketones. As the level of ketones in the body increases, it can lead to dehydration and confusion. If not treated, people with ketoacidosis can become unconscious. DKA usually occurs in people with type 1 diabetes. It is rare in type 2 diabetes. The symptoms of diabetic ketoacidosis include high blood glucose, high levels of ketones in the urine, and: quick breathing flushed cheeks breath that smells like sweet acetone (similar nail polish remover) dehydration. DKA is a serious condition that requires immediate assessment. If someone you know has diabetes and becomes confused or unconscious, or has the symptoms listed above, call triple zero (000) for an ambulance. If you have diabetes and you find your blood sugar level is higher than it should be, it’s important that you follow the advice provided by your doctor or diabetes nurse or educator. You may also find it useful to read the advice provided in the article on hyperglycaemia (high blood sugar). Continue reading >>

The Signs, Diagnosis & Types Of Diabetes Mellitus In Cats

The Signs, Diagnosis & Types Of Diabetes Mellitus In Cats

There are certain signs or symptoms which are commonly seen in cats with diabetes mellitus. Unfortunately, these signs also occur in other diseases and conditions. Therefore, laboratory tests are necessary to diagnose diabetes mellitus in cats. The following article includes a discussion of how this diagnosis is made and the types of diabetes found in cats. What are the signs of diabetes mellitus in cats and why do they occur? Depending on how severely insulin production is impaired, there may be few signs of disease, or the signs may be severe. Dogs with diabetes often develop cataracts; cats do not. The most common signs of diabetes are: Increased thirst (polydipsia) and urination (polyuria) Change in appetite Weight loss Change in gait (walking) Decreased activity, weakness, depression Vomiting Increased Thirst and Urination: Because the glucose cannot enter the cells, the glucose levels in the blood become abnormally high (hyperglycemia). The glucose is filtered out by the kidneys and is found in the urine (glucosuria). When it is filtered out, it carries water with it. The animal, then, is losing more water through the urine than normal and has to make up for it by drinking more. Inappropriate Elimination: The increased urination may result in the cat not always urinating in the litter box. This inappropriate urination may be one of the first signs of diabetes in cats. In addition, cats with diabetes can often develop urinary tract infections, which may also result in inappropriate elimination. Change in Appetite: Some diabetic cats eat less, because frankly, they do not feel well. Other cats may have voracious appetites and eat a lot (polyphagia) because their hypothalamus keeps telling them they are hungry. Weight Loss: Because the cat cannot use the calories he Continue reading >>

Why Does Diabetes Cause Headaches?

Why Does Diabetes Cause Headaches?

Diabetes is a condition where the body cannot make enough of the hormone insulin, or cannot use it properly, causing glucose to build up in the blood. According to the Centers for Disease Control and Prevention (CDC), over 29 million people in the United States have diabetes. Diabetes does not usually cause headaches. But, while headaches are not dangerous, they may be an indication of poor blood sugar control in a person with diabetes. Over time, periods of continuous high or low blood sugar can lead to serious and even life-threatening health complications, such as heart disease and kidney failure. This article looks at the connection between diabetes and headaches and suggests ways to relieve diabetes-induced headaches. Contents of this article: Types of headache According to the International Classification of Headache Disorders, published by the International Headache Society, there are over 150 types of headaches. Broadly speaking, headaches can be classified as either primary or secondary: Primary headaches are ones that are not linked to another medical condition. Examples of primary headaches include migraines and tension headaches. Secondary headaches are caused by underlying medical conditions or health issues and include the type of headache often experienced by people with diabetes. Other causes of secondary headaches include: hormone fluctuations infection nerve disorders overuse of medication trauma The pain associated with either primary or secondary headaches can vary in severity and duration. Some people may not experience headaches often, while others can get a headache several days each week. Depending on the type of headache, other symptoms may be present. For example, migraines can be linked with nausea and increased sensitivity to sound or light. Continue reading >>

Diabetes: Short Term Problems

Diabetes: Short Term Problems

Complications Diabetes can cause other health problems. Sometimes these problems are referred to as complications (COM-pli-KAY-shuns). Short-term problems can happen at any time when you have diabetes. Long-term problems may develop when you have diabetes for a long time. In case of emergency, you should always wear a form of medical identification (ID). Examples are ID bracelets and necklaces. To reduce your risk of getting other health problems from diabetes, you need good control of your blood glucose (sugar). Good control means keeping blood glucose at certain levels. To learn more about good control and healthy blood glucose numbers, see the UPMC patient education page Diabetes: Your Management Plan. This patient education sheet tells you about short-term problems, what to do for them, and how to prevent them: Low blood glucose High blood glucose with ketones High blood glucose without ketones Low Blood Glucose Low blood glucose is also called hypoglycemia (HI-po-glice-EE-me-uh). Blood glucose numbers under 70 mean you have low blood glucose. Several things can cause low blood glucose: Too much insulin Too much sulfonylurea (SULL-fon-ilyour-EE-uh) medicine Not enough food Too much exercise Symptoms of low blood glucose include: Hunger Feeling nervous Heavy sweating Weakness Shaking (tremors) Confusion Seizures Coma If you get low blood glucose If you get low blood glucose and you are awake and able to swallow, eat or drink something with sugar. Here is a list of some suggested foods: 4 ounces of fruit juice 4 to 6 ounces of sugary (non-diet) soft drink 3 to 4 glucose tablets (or 1 tube of glucose gel) 1 cup of skim milk 6 to 7 hard candies (not sugar-free), such as Lifesavers Wait for 10 to 15 minutes. Test your blood glucose again. If your blood glucose is above 7 Continue reading >>

Diabetes And Ketones

Diabetes And Ketones

Tweet The presence of high levels of ketones in the bloodstream is a common complication of diabetes, which if left untreated can lead to ketoacidosis. Ketones build up when there is insufficient insulin to help fuel the body’s cells. High levels of ketones are therefore more common in people with type 1 diabetes or people with advanced type 2 diabetes. If you are suffering from high levels of ketones and seeking medical advice, contact your GP or diabetes healthcare team as soon as possible. What are ketones? Ketones are an acid remaining when the body burns its own fat. When the body has insufficient insulin, it cannot get glucose from the blood into the body's cells to use as energy and will instead begin to burn fat. The liver converts fatty acids into ketones which are then released into the bloodstream for use as energy. It is normal to have a low level of ketones as ketones will be produced whenever body fat is burned. In people that are insulin dependent, such as people with type 1 diabetes, however, high levels of ketones in the blood can result from taking too little insulin and this can lead to a particularly dangerous condition known as ketoacidosis. How do I test for ketones? Ketone testing can be carried out at home. The most accurate way of testing for ketones is to use a blood glucose meter which can test for ketones as well as blood glucose levels. You can also test urine for ketone levels, however, the testing of urine means that the level you get is representative of your ketone levels up to a few hours ago. Read about testing for ketones and how to interpret the results Who needs to be aware of ketones? The following people with diabetes should be aware of ketones and the symptoms of ketoacidosis: Anyone dependent on insulin – such as all people Continue reading >>

What To Do If You Get Gastroenteritis:

What To Do If You Get Gastroenteritis:

Gastroenteritis causes diarrhea and vomiting, which can lead to dehydration and the loss of sodium and potassium (electrolytes). The disease puts a stress on your body and often causes an increase in blood glucose (sugar) levels. The two main culprits are stress hormones (cortisol, adrenaline) and lack of physical activity when you are ill. In rare cases, blood glucose (sugar) levels will fall. Measure your blood glucose (sugar) frequently; Continue to take your medication or insulin as usual (or as adjusted by your doctor while you are sick), even if your food intake is reduced because you’ve lost your appetite or are vomiting; Modify your diet: if you find it difficult to eat solid foods, try to eat the usual amount of carbohydrates in liquid form or, at the very least, satisfy your body’s minimum carbohydrate requirements of 150 g per day while you are ill. What are the signs of dehydration? Mild to Moderate Dehydration Severe Dehydration Dry, sticky mouth Extreme thirst Unusual sleepiness or tiredness Irritability and confusion Dry and cool skin Sunken eyes Headache Dry skin that doesn't bounce back when you pinch it Dizziness and lightheadedness Low blood pressure Rapid heartbeat and breathing Dark urine in smaller quantity Call a doctor or go to Emergency if: Signs of severe dehydration; Your blood glucose (sugar) levels are higher than 25 mmol / L accompanied by excessive drowsiness (type 2 diabetes), or 20 mmol / L with a moderate to high ketone level in your urine or blood (type 1 diabetes); You are vomiting continuously and unable to keep liquids down; Your fever stays above 38.5 ºC (101.3 ºF) for more than 48 hours; Diarrhea lasts more than 24 hours or occurs more than 5 times per day. How to avoid becoming dehydrated Here are some ways to avoid dehydra Continue reading >>

Ketoacidosis

Ketoacidosis

Ketones in the urine, as detected by urine testing stix or a blood ketone testing meter[1], may indicate the beginning of diabetic ketoacidosis (DKA), a dangerous and often quickly fatal condition caused by low insulin levels combined with certain other systemic stresses. DKA can be fixed if caught quickly. Diabetics of all species therefore need to be checked for ketones with urine testing stix, available at any pharmacy, whenever insulin level may be too low, and any of the following signs or triggers are present: Ketone Monitoring Needed: Little or no insulin in last 12 hours High blood sugar over 16 mmol/L or 300 mg/dL (though with low insulin, lower as well...) Dehydration (skin doesn't jump back after pulling a bit gums are tacky or dry)[2] Not eating for over 12 hours due to Inappetance or Fasting Vomiting Lethargy Infection or illness High stress levels Breath smells like acetone (nail-polish remover) or fruit. Note that the triggers and signs are somewhat interchangeable because ketoacidosis is, once begun, a set of vicious circles which will make itself worse. So dehydration, hyperglycemia, fasting, and presence of ketones are not only signs, they're also sometimes triggers. In a diabetic, any urinary ketones above trace, or any increase in urinary ketone level, or trace urinary ketones plus some of the symptoms above, are cause to call an emergency vet immediately, at any hour of the day. Possible False Urine Ketone Test Results Drugs and Supplements Valproic Acid (brand names) Depakene, Depakote, Divalproex Sodium[3] Positive. Common use: Treatment of epilepsy. Cefixime/Suprax[4] Positive with nitroprusside-based urine testing. Common use: Antibiotic. Levadopa Metabolites[5] Positive with high concentrations[6]. Tricyclic Ring Compounds[7][8] Positive. Commo Continue reading >>

Ketones In Blood And Urine

Ketones In Blood And Urine

Ketones are a chemical compound produced by the body to provide energy from the breaking down of fats and protein. The production of ketones is usually a natural process but people that require insulin doses, such as those with type 1 diabetes, need to be aware that high levels of ketones can quickly lead to a very dangerous condition called ketoacidosis. Who should test for ketones? People who should test for ketones are people that make very little of their own insulin. This commonly includes individuals with: Type 1 diabetes LADA diabetes who are on insulin Type 2 diabetes who have decreased beta cell function, or people who have had a pancreatectomy (surgical removal of the pancreas) Why are ketone levels important? Ketone levels rise when cells in the body need energy but there is not enough insulin in the body to let glucose from the blood into those cells. As a result the body turns to metabolizing fats and proteins to form ketones to use as energy. If the body needs to convert energy in this way for an extended period of time, it can cause higher levels of acidic ketones to develop in the blood and have a toxic effect on the body, resulting in a dangerous condition called diabetic ketoacidosis (DKA). People that don’t make enough of their own insulin need to be aware of any instances in which ketones levels are rising too high. When to test? It is advisable to test for ketones in the following situations: If your blood glucose levels are 240 mg/dL or more If you develop higher sugar levels when ill If you are vomiting or experiencing diarrhea During pregnancy How to test Ketone tests can be carried either using urine ketone testing strips or using a specialist blood glucose meter that takes blood ketone strips as well as blood glucose test strips. Most urine k Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Print Overview Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care. Symptoms Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: Excessive thirst Frequent urination Nausea and vomiting Abdominal pain Weakness or fatigue Shortness of breath Fruity-scented breath Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: High blood sugar level (hyperglycemia) High ketone levels in your urine When to see a doctor If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit. Contact your doctor immediately if: You're vomiting and unable to tolerate food or liquid Your blood sugar level is higher than your target range and doesn't respond to home treatment Your urine ketone level is moderate or high Seek emergency care if: Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 mill Continue reading >>

Hypo & Hyper Management

Hypo & Hyper Management

Home blood glucose monitoring The aim of treatment is to try to maintain your glucose level to as near a “non -diabetic” range as possible. In general terms this means to aim towards 4 -7 mmol/l before meals, and around 8 mmol/l if testing 2 hours after meals. This can be difficult at times as you are trying to mimic what the body had previously done of its own accord, and your readings may vary depending your carbohydrate intake, exercise and many other daily factors. This management takes time and practice and requires that you work closely with your doctor, diabetes nurse specialist and other members of your diabetes care team. They’ll guide you to maintain the best possible blood glucose control. HbA1c This is known as the “long term test” and is performed by a medical professional. This is a measure of your blood glucose control over a period of the previous approx 6 -8 weeks. It is a very good indicator of your overall control of your condition despite the odd high or low readings you may have had during that time. Hyperglycaemia or Hypoglycaemia This can be caused by high or low glucose levels. High blood glucose levels, also know as Hyperglycaemia or Hyper. You will notice that your blood glucose level may be higher if you: Are not taking enough insulin Miss or forget to take your insulin ( or take a lower amount in error) Eat more carbohydrate foods than usual Are less active than usual Are under stress Have an illness eg cold flu, infection (see further info re illness below) Sometimes it may be difficult to find a reason Low blood glucose levels, also known as Hypoglycaemia or Hypo. You may notice that your blood glucose may go to low (ie. Under 4 mmol/l) if you: Take too much insulin Eat less carbohydrate than usual Leave too long between meals Do Continue reading >>

Symptoms And Detection Of Ketoacidosis

Symptoms And Detection Of Ketoacidosis

Symptoms These symptoms are due to the ketone poisoning and should never be ignored. As soon as a person begins to vomit or has difficulty breathing, immediate treatment in an emergency room is required to prevent coma and possible death. Early Signs, Symptoms: Late Signs, Symptoms: very tired and sleepy weakness great thirst frequent urination dry skin and tongue leg cramps fruity odor to the breath* upset stomach* nausea* vomiting* shortness of breath sunken eyeballs very high blood sugars rapid pulse rapid breathing low blood pressure unresponsiveness, coma * these are more specific for ketoacidosis than hyperosmolar syndrome Everyone with diabetes needs to know how to recognize and treat ketoacidosis. Ketones travel from the blood into the urine and can be detected in the urine with ketone test strips available at any pharmacy. Ketone strips should always be kept on hand, but stored in a dry area and replaced as soon as they become outdated. Measurement of Ketones in the urine is very important for diabetics with infections or on insulin pump therapy due to the fact it gives more information than glucose tests alone. Check the urine for ketones whenever a blood sugar reading is 300 mg/dl or higher, if a fruity odor is detected in the breath, if abdominal pain is present, if nausea or vomiting is occurring, or if you are breathing rapidly and short of breath. If a moderate or large amount of ketones are detected on the test strip, ketoacidosis is present and immediate treatment is required. Symptoms for hyperglycemic hyperosmolar syndrome are linked to dehydration rather than acidosis, so a fruity odor to the breath and stomach upset are less likely. How To Detect Ketones During any illness, especially when it is severe and any time the stomach becomes upset, ketone Continue reading >>

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