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Beta Hydroxybutyrate Dka

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http://allenfamilymed.com/ Lab Test Lipid Panel Mesa AZ Allen Family Medicine (480) 699-2222 Patients ranging from newborns to geriatrics are welcome at Allen Family Medicine. Dr. Allen is dedicated to providing the highest level of compassionate, personal and trustworthy medical care to help boost overall health and wellness for the entire family. Allen Family Medicine 7233 East Baseline, Suite 123 Mesa, AZ 85209 (480) 699-2222 http://allenfamilymed.com/

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Measurement of beta-hydroxybutyrate in whole blood, serum, or plasma to evaluate ketone-producing metabolic energy deficits that usually occur when there is insufficient carbohydrate metabolism, thereby increasing the catabolism of fatty acids. Clinical Application Common tests for ketone bodies, such as Acetest, Chemstrip, and Ketostix, do not detect beta-hydroxybutyrate. A handheld meter sensor system is available to monitor beta-hydroxybutyrate and glucose levels. Elevated levels beta-hydroxybutyrate is diagnostic of ketoacidosis, whereas the absence of concomitant hyperglycemia supports the diagnosis of alcoholic ketoacidosis (AKA). Levels ³ 3 mmol/L are indicative of ketoacidosis. In very severe diabetic ketoacidosis (DKA), the beta-hydroxybutyrate serum concentration may exceed 25 mmol/L. Patients presenting with isopropanol intoxication can present with high acetone levels without any acidosis, anion gap or abnormal glucoses levels. Plasma (lithium-heparin or fluoride-oxalate), serum, or perchloric acid (PCA) extracts can be analyzed. EDTA-plasma samples will produce values that are 60% lower than specimens preserved with fluoride-oxalate or PCA. Continue reading >>

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  1. kaazoom

    I recently had my Hba1c tests and it was over 9 . The doctor increased my metformin from 1 tablet twice a day to 2 tablets twice a day. I was told to start by increasing the morning dose and after 2 weeks increase my evening dose. I have had a lot of stomach discomfort, and terrible indigestion since increasing the does. I work up the other morning in extreme pain like I was having a heart attack. The pain went after taking antacids. Indigestion is something I get every now and then, but it is usually due to eating something I should avoid. This day I don't think I had eaten anything that would cause it. But I had increased my evening dose of metformin, so I was and am on 4 tablets a day. I have had more general discomfort than usual, muscle pains and more breathlessness.The difficult is I have other health problems so knowing which one is caused by which is a nightmare.
    I also tend to let myself get dehydrated at night as I have bladder problems which I having investigations for at the moment. If I don't stop drinking about at about 7pm I end up waking numerous times to go to the loo. The only drink I have after 7pm is a few sips of water to help swallow my medications.
    Sorry for being so long winded. My main question is does lactic acidosis come on suddenly, or does it build up over days or weeks?
    Paul

  2. destiny0321

    Hi. If you find your metformin could be causing problems which it did with me runs,breathing problems and generally really poorly go back to your gp I did and I was put on me form in slow release which is much gentler on the stomach hope this helps you destiny
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  3. kaazoom

    Thanks.
    I've got to see my GP next week about something else so I will talk to him about it. I don't think I have lactic acidosis, I was curious about whether it was sudden or gradual onset. I saw something on the TV yesterday that said patients are risking their health because they don't read the information sheets that come with their medication. So I had a look at mine. It gave a number of symptoms to watch out for including severe indigestion,muscle spasms etc it said if you have any of these symptoms when taking Metformin to go immediately to the nearest hospital A&E because these symptoms can be signs of lactic acidosis. I don't think what I'm experiencing is severe enough for A&E.
    I had muscle spasms, pains and a number of the other symptoms list prior to my diabetes diagnose due to other illnesses, and they can vary in severity. They seem to have got somewhat worse since my metformin was increased, but it could just be coincidence. The indigestion and stomach problems are particularly bad. My feeling is my body is taking time to adapt to them. i will ask my doctor if I can change to a slow release version.
    Paul

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https://metabolicfuel.pruvitnow.com The clinical utility of beta hydroxybutyrate is an analyte in the laboratory so the first case i want to cover is actually a pediatric 13 year old Caucasian female. She's overweight has no past medical history family history of type 1 diabetes and she's going to her primary care practitioner with the two-week history of polydipsia polyuria a 20-pound weight loss. She seems not too big to complain to the primary care practitioner was she can get enough to drink she was waking up several times at night to urinate and at the physician's office she had a capillary glucose of about 440 4 milligrams per deciliter and your analysis done at the physician's office was a 4 plus ketones, so she was transferred to our emergency department and her ph was low she was acid addict had a high serum glucose. Her bicarb was very low so sure anion gap was up she had a high beta hydroxybutyrate it was 8.46 and the normal range for those of you who aren't familiar with it is 0-2 0.27 millimoles per liter. So this was orders of magnitude above the normal range and her sodium was 137 141. When you correct it for hyperglycemia now the second case we want to talk about is an african-american female 58 year-old. No previous history of diabetes she shows up in the emergency room with one week history of fatigue polyuria polydipsia. Blurry vision again her capillary glucose glucose meter was 380 mclogan a1c with 16.1 percent and again this was a little bit of a higher ni gap not as high as the last one was 33 better ketones on glucose 4+4 by dipstick and the beta hydroxy butyrate was in the 6.86 range, again very elevated. Then we have case 3 here is a 57-year old caucasian male is poorly controlled type 2 diabetes he's been diagnosed with his past history of reflux esophagitis alcohol abuse cirrhosis. He comes to the emergency room with vomiting blood abdominal pain is a recent history of increased alcohol consumption has not been eating or taking his insulin and i Just forgot is he was drinking so its pH was borderline at the low again in the idiotic range reporter line in the norm low. Normal glucose was elevated but not as elevated as the previous ones by carp was very low and I gap super-high lactate was up beta hydroxybutyrate. You can see was elevated about 10 times the normal limit blood-alcohol of 209 which is quite impressive and ketones was 2 plus so it just kind of brings home as you look at these pictures and the similarities between three different cases three different people showing up in the emergency room with similar and dissimilar analysis. They all kind of surround the ketone bodies and in all of these cases these patients had elevated ketone bodies. So what is a ketone bodies well it's actually a wood there are three of them they are water soluble compounds produced by products when fatty acids are actually metabolizer broken down by the liver beta hydroxybutyrate acetoacetate and acetone. Acetone is volatile beta hydroxybutyrate and acetoacetate are not so there are stable in serum after process. You don't have to really remember to keep the cap on there. In other words, normally when the body breaks down ketones they break them down into co2 and h2o. Well, but the build-up of ketones causes an acid in balance and that's where you get the ketone bodies. Both bodies actually if you look at this absolutely go back here so don't have a pointer if you look at the beta hydroxybutyrate it's butyric acid. So that gives you that the acid that is the unbound or unrecognized and the anion gap so it is one of the elements thats causing the increase tell any gaps along with the keto acetic acid if it's not diagnosed and treated ketoacidosis can be fatal. I do want to point out that in normal patients acetoacetate to beta hydroxybutyrate ratio is normally about 121 but when you go into ketoacidosis acetoacetate to beta-hydroxybutyrate is about a 126 ratio meaning beta-hydroxybutyrate outnumbers acetoacetate an acetone by about a 6 to 1 ratio beta-hydroxybutyrate. In other words, is favored in the ketosis states, so I want to point out here, that actually these are byproducts of metabolism and whether you are actually in the absence or presence of insulin. Introduction 0:10 BHB is a Molecule: 0:50 Ketosis 2:00 Beta Hydroxybutyrate 4:00 Ketone Supplement 5:00 Wrap Up 5:45 Beta Hydroxybutyrate Beta-Hydroxybutyrate Ketones Ketosis Burn Fat Ketogenic Diet beta hydroxybutyrate weight loss beta hydroxybutyrate buy beta hydroxybutyrate supplements beta hydroxybutyrate powder beta hydroxybutyrate effects beta hydroxybutyrate for sale visit https://metabolicfuel.pruvitnow.com/ for more information Visit https://www.youtube.com/playlist?list...

Children's Mercy Kansas City - Is Point Of Care (poc) Beta-hydroxybutyrate (bohb) [ketones] Greater Than Or Equal To 3.3 Mmol/l?

Diabeticketoacidosis (DKA) is a life-threatening complication of insulin dependentdiabetes. Historically, the diagnosis isbased on serum bicarbonate (CO2) level < 16 mmol/L or pH of < 7.30, thepresence of ketonuria (acetoacetate) or ketonemia (beta-hydroxybutyrate), andserum glucose level >200 mg/dL. AtChildrens Mercy Hospital, a CO2 16 mmol/L suggests that DKA is unlikely,whereas a CO2 < 16 mmol/L suggests DKA and the patient is then treated usingthe DKA Clinical Practice Guideline (CPG). As the name implies, the primary driver of theanion gap metabolic acidosis is the ketone, beta-hydroxybutyrate (OHB). Only recently has the ability to measure thisspecific ketone at the bedside been available. The Nova Max Plus -KetoneMonitoring System (Nova Biomedical) is used to monitor whole blood-hydroxybutyrate (OHB) at the bed-side in patients in the acute care andinpatient setting during DKA Comparativevalues for point-of-care (POC) OHB and serum bicarbonate (CO2) were evaluatedat Childrens Mercy Hospital and the POCOHB value corresponding to the CO2value < 16 was established. Receiver Operating Characteristic (ROC)analysis indicated that a POC OHB value of 3.3 mmol/L predicts DKA with 92 Continue reading >>

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  1. K.O.R.E.aga

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    I've heard a variety of different things. But basically I need to lose fat FAST (by August 1) and I'm starting ketosis. Now is this weight loss sustainable or is it like traditional starving methods which cause a yo-yo effect? If so, is there any way to avoid this inevitable weight gain? During now until then I'm going to be working out hard, 6 days a week, with combinations of weight lifting and HIITs.
    Btw, I'm completely aware of the all the negative side effects this will have on my body and muscles. My gf is a pre-med student and gives me enough to hear about it for one man.

  2. Squelchmeister

    Right, the short answer is there is no short answer.
    Ketogenic dieting is a VERY effective method for burning fat. However, if you stay ketogenic for longer than two weeks your blood starts to turn acidic and will do damage to your internal organs, so you'd be very smart to have a very heavy carb refeed day every couple of weeks or so.
    As for whether you'll gain it back... depends if you permanently change your eating habits or not. Most people don't and so they put back on any weight they've lost. I think ketogenic dieting is great for rapid weight loss and a 'kick start' to the process (particularly if you only have a moderate amount to lose such as 30lbs), but if you have a tremendous amount to lose then a more moderate diet would be smart, and if you're already trim but want to just get into really good nick then again, a more moderate approach would be smart.
    Basically I wouldn't do ketogenic dieting for more than a month or two at most, and that's with carb refeeds included.

  3. K.O.R.E.aga

    I plan on doing it for two weeks, and then resuming a healthy diet. I just want to make sure I don't mess up my metabolism or cycle by starving myself of carbs. Would this avoid heavy fat gain?

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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.....

Diabetic Ketoacidosis

Related conditions: Type 1 diabetes, type 2 diabetes, Insulin-dependent diabetes, childhood diabetes , hyperglycemic coma, hyperosmolar coma, septicemia Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication of diabetes mellitus, usually type 1 insulin-dependent diabetes. It can occasionally be seen in patients with type 2 diabetes in the presence of stress, trauma or infection. It is characterized by hyperglycemia, elevated blood ketones with metabolic acidosis and dehydration with body water and electrolyte depletion. DKA may occur from infancy to late adulthood. Important differences exist in management due to the almost exclusive complication of cerebral edema in children and adolescents. Polydipsia, polyuria and weight loss are the predominant presenting symptoms. Weight loss is not only due to loss of body water via diuresis or vomiting but may be accelerated by poor appetite and starvation. Nocturia is a common feature in childhood DKA. Other nonspecific symptoms include fever, fatigue, nausea, vomiting and abdominal pain. These may not always be related to a primary precipitating event (e.g. urinary tract infection, pancreatitis). In adults Continue reading >>

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  1. Courtney Schumacher

    Ketoacidosis

    Comas

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    Medical Conditions and Diseases


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    Why does Ketoacidosis cause coma? How is it treated?




    1 Answer







    I’m assuming that you do know that ketoacidosis does not have to mean that you have high blood sugar. It means that you have a high level of ketones in your blood, which are usually by-products of your body trying to break down fatty acids for fuel it’s not getting from your food intake.
    It is usually treated with fluids, electrolytes, and insulin. It is much more common in those with type 1 diabetes then type 2, but it can still occur.

    You can look up more specific information on diabetes at the Mayo Clinic site.

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