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Alcoholic Ketoacidosis Uptodate

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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.....

Alcoholic Ketoacidosis

Alcoholic ketoacidosis is a metabolic complication of alcohol use and starvation characterized by hyperketonemia and anion gap metabolic acidosis without significant hyperglycemia. Alcoholic ketoacidosis causes nausea, vomiting, and abdominal pain. Diagnosis is by history and findings of ketoacidosis without hyperglycemia. Treatment is IV saline solution and dextrose infusion. Alcoholic ketoacidosis is attributed to the combined effects of alcohol and starvation on glucose metabolism. Alcohol diminishes hepatic gluconeogenesis and leads to decreased insulin secretion, increased lipolysis, impaired fatty acid oxidation, and subsequent ketogenesis, causing an elevated anion gap metabolic acidosis. Counter-regulatory hormones are increased and may further inhibit insulin secretion. Plasma glucose levels are usually low or normal, but mild hyperglycemia sometimes occurs. Diagnosis requires a high index of suspicion; similar symptoms in an alcoholic patient may result from acute pancreatitis, methanol or ethylene glycol poisoning, or diabetic ketoacidosis (DKA). In patients suspected of having alcoholic ketoacidosis, serum electrolytes (including magnesium), BUN and creatinine, glucose, Continue reading >>

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  1. 2blessed4stress

    metformin and lactic acidosis

    I am hoping that I can get some guidance from the members here. There are many of you that have a wealth of information on diabetes and things related so please bear with me. I went to the doctor yesterday and finally asked her for metformin er and was all set to try it out. Then I read the paper that came with it from the pharmacy. The warning about lactic acidosis stopped me in my tracks. Now I am afraid to take it. I searched the posts her a DD about lactic acidosis and I also found that some members said it caused them to be really fatigued. Another member posted that she had trouble with exercise because it caused leg cramps. I feel so overwhelmed now. I really wanted to try it out I believe it could help me but I don't want to put my life at risk to try it. I looked up lactic acidosis and I was reading about the bloods ph and acid in your blood. I have a problem with uric acid in my blood but I believe that is not related to lactic acidosis. I have had a problem with kidney infections and a lot of crystals in my urine and kidney stones the past year, but I believe my kidney function is ok. Does metformin cause lactic acidosis very often? Are the symptoms of lactic acidosis easy enough to pick up on so it can be caught early. I am sorry I am such a worry wart. Thank you in advance for any guidance/reassurance from you.

  2. furball64801

    All I can tell you is that millions upon millions take met with 0 issues. You are reading the absolute worst side affects. Have you see tv commericails on meds that is any meds. They say could cause heart attack, fatigue, even death no kidding. I been on met and so has my diabetic family and 0 issues other than a tad of diahrea. To me its extemely rare many here are on met me a very very long time on it. What am I saying to me its about the best D med out there other than exercise its free. It is just my opion for what its worth, I know others might have other ideas and of course its is there opinion also. Some take b-12 if they get fatigued on met, I do not get that way, all I can say is to me its as safe as can be.

  3. coravh

    Every drug has potential side effects. Some more common than others. I'm not sure of the exact specifics, but I believe that for a side effect to be listed, it needs to happen in 1% of the people that take it.
    My husband has been on met with no side effects other than a little bit of tummy trouble. I have a dozen local diabetic friends (through volunteer work) that are also on it, and have no side effects. I do have one friend who reacts to everything and has no issues with it. I think i've only seen people with this issue a couple of times after about 15 years online haunting a variety of message boards.
    Take for example my warfarin. It can cause bleeding. Even a baby aspirin can cause this. And it does happen to some people. But the vast majority of folks don't have issues.
    Do you have some history of lactic acidosis? Or is this simply general anxiety over something new?
    All meds are a cost benefit analysis. Do you want to try the drug to alleviate a serious issue ( like high blood sugar) or do you decide to refuse it on the basis of a rare side effect and maybe get into trouble due to glucose issues? Why not try it? Discuss with your phamacist what to look for if you are worried. But basically it is a safe, effective drug.
    Cora

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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.

Emergent Treatment Of Alcoholic Ketoacidosis

Exenatide extended-release causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared to controls. It is unknown whether BYDUREON BCise causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of exenatide extended-release-induced rodent thyroid C-cell tumors has not been determined BYDUREON BCise is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC with the use of BYDUREON BCise and inform them of symptoms of thyroid tumors (eg, mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for detection of MTC in patients treated with BYDUREON BCise Acute Pancreatitis including fatal and non-fatal hemorrhagic or necrotizing pancreatitis has been reported. After initiation, observe patients carefully for symptoms of pancreatitis. If suspected, discontinue promptly and do not restart if confirmed. Consider other antidiabetic therapies in patients with a hi Continue reading >>

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Popular Questions

  1. skysiris

    I know that every diabetic should know what ketones are since I see a lot of people talking about them in Facebook groups, but I have no idea what that means. Can someone please explain to me what ketones are and how they're caused? Thanks in advance.

  2. justinsemag

    In short, ketones are a by-product of the body breaking down fat to create energy

  3. nitya_sharma

    Ketones are the result of the body burning fat for energy or fuel. For a person with diabetes, ketones are often the result of prolonged high blood sugar and insulin deficiency.If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. These include:
    a dry mouth, blood sugar levels greater than 240 milligrams per deciliter (mg/dL), strong thirst, frequent urination,
    If you don’t get treatment, the symptoms can progress to:
    confusion, extreme fatigue, flushed skin, a fruity breath odor, nausea, vomiting, stomach pain, trouble breathing.
    Managing the carbohydrate intake and insulin dosage is vital for managing diabetes. If they have vomiting and/or have a high blood sugar that is not coming down despite medication, should contact the doctor immediately.

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ford brewer md mph PrevMedHeartRisk.com There are 2 basic differences between LDL and HDL: content and protein type. LDL has 25% or less protein. HDL has 50% or more protein. In addition, the proteins are slightly different. the HDL protein is called A1; the protein with LDL, VLDL and other large lipoprotein groups is apo B. Why the prefix "apo"? Apo as a prefix simply means "part of". And Lipoproteins are the proteins that our bodies use to safely transport fats, oils, and cholesterol. About Dr. Brewer - Ford Brewer is a physician that started as an Emergency Doctor. After seeing too many patients coming in dead from early heart attacks, he went to Johns Hopkins to learn Preventive Medicine. He went on the run the post-graduate training program (residency) in Preventive Medicine at Hopkins. From there, he made a career of practicing and managing preventive medicine and primary care clinics. His later role in this area was Chief Medical Officer for Premise, which has over 500 primary care/ prevention clinics. He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, stroke, and diabetes prevention clinic. At PrevMed, we focus on heart attack and stroke and Type 2 diabetes prevention by reducing or eliminating risk through attentive care and state-of-the-art genetic testing, imaging, labs and telemedicine options. We serve patients who have already experienced an event as well as those have not developed a diagnosis or event. Our team of senior clinicians includes internationally recognized leaders in the research and treatment of cardiovascular disease, preventive medicine and wellness. We also provide preventive medicine by telemedicine technology to over 30 states. Contact Dr. Brewer at [email protected] or visit http://prevmedheartrisk.com.

Apo-gliclazide Mr

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. 30 mg Tablets What is in this leaflet This leaflet answers some common questions about gliclazide. It does not contain all the available information. It does not take the place of talking to your doctor, pharmacist or diabetes educator. The information in this leaflet was last updated on the date listed on the last page. More recent information on this medicine may be available. You can also download the most up to date leaflet from www.apotex.com.au. All medicines have risks and benefits. Your doctor has weighed the risks of you using this medicine against the benefits they expect it will have for you. Pharmaceutical companies cannot give you medical advice or an individual diagnosis. Keep this leaflet with your medicine. You may want to read it again. What this medicine is used for The name of your medicine is APO-Gliclazide MR. It contains the active ingredient gliclazide. The medicine is used to control, blood glucose in patients with Type II diabetes mellitus. This type of diabetes is also known as non-insulin-dependent diabetes mellitus (NIDDM) or maturity onset diabetes. Gliclazide Continue reading >>

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  1. x19delta

    How much weight loss on average during Keto

    I have read so much on this website and I just started looking into Keto. Im 6ft, 225 lbs, about 24-28% BF (depending on the damn scale). I work out 6 days a week. I have been doing high reps/low weight to cut. Although Im now thinking about low reps/high weight after reading so many sucess stories. I do 15-20 mins of cardio (treadmill or eliptical) after lifting every day.
    How much can I expect to lose on average on keto?
    Also if anyone has experience with those scales that tell body fat...I put in standard body type and it says 28% BF and then athletic and it says 23% BF....so I dont know which one to go by. Is the calipers/measurement method better than the scales?
    Thanks guys.

  2. taf1968

    The weight loss is all over the map . . . would be impossible to say what an average is. But you should drop quite a bit of water weight in the first week or so (it's not unusual for people to drop 5 or 10 pounds in the first 7 - 10 days). But don't get discouraged if you don't . . . or too excited if you lose more. Some people lose more/faster and for others it's more steady--it was more slow for me. As long as you are losing and seeing progress in weight loss, measurements, and the mirror it's all good.
    As for the bf% scales . . . don't waste your time. It will drive you crazy . . . those things are notoriously inaccurate and you will probably find that the bf% readings swing wildly from day to day (and even hour to hour). I have a Tanita and I don't trust it for anything except weight.
    You are much better off taking progress pics, measurements, and going by the mirror and how your clothes fit, IMHO. Calipers are good, but can be tricky to get the hang of and to be consistent. I have a pair and have gotten better at using them. But I still have trouble getting consistent readings sometimes.

  3. cfh1973

    Originally Posted by taf1968
    The weight loss is all over the map . . . would be impossible to say what an average is. But you should drop quite a bit of water weight in the first week or so (it's not unusual for people to drop 5 or 10 pounds in the first 7 - 10 days). But don't get discouraged if you don't . . . or too excited if you lose more. Some people lose more/faster and for others it's more steady--it was more slow for me. As long as you are losing and seeing progress in weight loss, measurements, and the mirror it's all good.
    As for the bf% scales . . . don't waste your time. It will drive you crazy . . . those things are notoriously inaccurate and you will probably find that the bf% readings swing wildly from day to day (and even hour to hour). I have a Tanita and I don't trust it for anything except weight.
    You are much better off taking progress pics, measurements, and going by the mirror and how your clothes fit, IMHO. Calipers are good, but can be tricky to get the hang of and to be consistent. I have a pair and have gotten better at using them. But I still have trouble getting consistent readings sometimes.

    This is why with calipers I will take measurements 3-4 times and then average it out.

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