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Can Ketoacidosis Cause A Heart Attack

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus.[1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness.[1] A person's breath may develop a specific smell.[1] Onset of symptoms is usually rapid.[1] In some cases people may not realize they previously had diabetes.[1] DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances.[1] Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids.[1] DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies.[3] DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine.[1] The primary treatment of DKA is with intravenous fluids and insulin.[1] Depending on the severity, insulin may be given intravenously or by injection under the skin.[3] Usually potassium is also needed to prevent the development of low blood potassium.[1] Throughout treatment blood sugar and potassium levels should be regularly checked.[1] Antibiotics may be required in those with an underlying infection.[6] In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended.[1][6] Rates of DKA vary around the world.[5] In the United Kingdom, about 4% of people with type 1 diabetes develop DKA each year, while in Malaysia the condition affects about 25% a year.[1][5] DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost univ Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

As fat is broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis. Diabetic ketoacidosis (DKA) is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to DKA in people with type 1 diabetes. People with type 2 diabetes can also develop DKA, but it is less common. It is usually triggered by uncontrolled blood sugar, missing doses of medicines, or a severe illness. Continue reading >>

What Are The Causes And Symptoms Of Diabetic Ketoacidosis?

What Are The Causes And Symptoms Of Diabetic Ketoacidosis?

An Overview Diabetic ketoacidosis (DKA) is considered to be one of the most severe metabolic imbalance associated with type 1 diabetes mellitus. Type 1 diabetes mellitus is also known as insulin dependent diabetes mellitus, wherein a patient depends upon external sources of insulin as its body is unable to make it as per the body’s requirement. DKA is seen very commonly in about 35% to 40% of young diabetic patients including small children and teenagers when diagnosed with type 1 diabetes. Patients who are not suffering with type 1 form of diabetes could also fall under the risk of acquiring DKA condition due to various other reasons. Every diabetic patient irrespective of the type of diabetes, can develop DKA, when facing any other form of illness. Diabetic ketoacidosis is often a serious condition that may require immediate hospitalization for the patient. Approximately, 160,000 hospital admissions per year in the United States occur in this regard. Unfortunately DKA is seen to show maximum complication in young adults including teenagers and of course the elderly patients. Complication arising out diabetic ketoacidosis also accounts for a number of deaths in the US for children and young patients suffering from diabetes. The biggest challenge in the management of this condition comes with the lack of awareness of the unmanaged diabetes in patients that is not taken very seriously event today. What is Diabetic Ketoacidosis? Diabetic ketoacidosis is a life threatening complication associated with diabetes. This condition arises when the body produces excess quantities of ketoacids. The risk of developing ketoacidosis is greater in people with Type 1 diabetes. The condition develops when the amount of insulin produced by the body is insufficient. As insulin levels dr Continue reading >>

The Silent Heart Attacks That Can Strike Diabetics Without Warning

The Silent Heart Attacks That Can Strike Diabetics Without Warning

Property consultant Michael Green was adamant that his type 2 diabetes was nothing to worry about. 'It's the non-serious type,' he'd say dismissively. Michael's laid-back attitude is in some ways understandable. The father-of-one had never suffered any obvious ill-effects from the condition he'd lived with for 28 years, and he'd been diagnosed not as a result of any troubling symptoms, but by chance following a routine blood test. Compared to a family friend who had type 1 diabetes, he was lucky, he insisted. At least he didn't have to monitor his blood sugar levels every few hours, and inject insulin. Then one night, two years ago, he went to sleep and never woke up. At just 53, he'd suffered a 'silent heart attack' - a little-known complication of diabetes. A silent attack is almost symptomless and occurs without any of the chest pain normally associated with a heart attack. Yet they can be just as dangerous - if not more so - as a normal heart attack. They're also surprisingly common. It is estimated that around a quarter of the 175,000 heart attacks in the UK each year are the silent type - and people with diabetes are at greatest risk. This is because the nerve damage linked to their condition can prevent warning signals being transmitted in the usual way. This, in turn, can lead to a delay in seeking treatment and result in damage to the blood vessels and heart muscle that make the heart attack more lethal. Heart attacks occur when there is a blockage in the artery supplying blood to the heart. Normally, this is as a result of a fatty plaque breaking off from the artery wall, triggering a blood clot. When the blood supply to the heart is reduced, the body produces chemicals that affect nerves and trigger pain. Often, people describe the pain of a heart attack as a Continue reading >>

Diabetic Emergencies: Warning Signs And What To Do

Diabetic Emergencies: Warning Signs And What To Do

Diabetes symptoms can quickly turn into emergencies. The disease of diabetes was the seventh leading cause of death in the United States in 2010, claiming nearly 70,000 lives. Responding promptly to symptoms of a diabetic emergency can be lifesaving. Causes and types Both type 1 and type 2 diabetes inhibit the body's ability to manage blood sugar levels. Type 1 diabetes does so by destroying the cells that produce insulin. Type 2 diabetes reduces how responsive the body is to insulin, while not enough insulin is produced to counter the sugar in the body. Hence, most diabetic emergencies are related to disruptions in a person's blood sugar levels. Occasionally, even too much of a drug being used to treat diabetes can trigger a diabetic emergency. The most common diabetic emergencies include the following: Severe hypoglycemia Hypoglycemia is when blood sugar levels are abnormally low. When blood sugar dips very low, it becomes a medical emergency. Hypoglycemia normally only occurs in people with diabetes who take medication that lowers blood sugar. Blood sugar levels may drop dangerously low when a person is: consuming too much alcohol exercising, especially without adjusting food intake or insulin dosage missing or delaying meals overdosing on diabetic medication Diabetic ketoacidosis Diabetic ketoacidosis occurs when the body does not have enough insulin to break down glucose properly, and hormones that normally work opposite insulin are high. Over time, the body releases hormones that break down fat to provide fuel. This produces acids called ketones. As ketones build up in the body, ketoacidosis can occur. Common causes of ketoacidosis include: uncontrolled or untreated diabetes an illness or infection that changes hormone production an illness or infection that chang Continue reading >>

What Is Diabetic Ketoacidosis?

What Is Diabetic Ketoacidosis?

Diabetic ketoacidosis, or DKA, is a serious health problem that can happen to a person with diabetes. It happens when chemicals called ketones build up in the blood. Normally, the cells of your body take in and use glucose as a source of energy. Glucose moves through the body in the bloodstream. Insulin is a hormone that helps your cells take in the glucose from the blood. If you have diabetes, your cells can’t take in and use this glucose in a normal way. This may be because your body doesn’t make enough insulin. Or it may be because your cells don’t respond to it normally. As a result, glucose builds up in your bloodstream and doesn’t reach your cells. Without glucose to use, the cells in your body burn fat instead of glucose for energy. When cells burn fat, they make ketones. High levels of ketones can poison the body. High levels of glucose can also build up in your blood and cause other symptoms. Ketoacidosis also changes the amount of other substances in your blood. These include electrolytes, such as sodium, potassium, and bicarbonate. This can lead to other problems. Ketoacidosis happens most often in a person with type 1 diabetes. This is a condition where the body does not make enough insulin. In rare cases, ketoacidosis can happen in a person with type 2 diabetes. It can happen when they are under stress, like when they are sick, or when they have taken certain medicines that change how their bodies handle glucose. Diabetic ketoacidosis is pretty common. It is more common in younger people. Women have it more often than men do. What causes diabetic ketoacidosis? High levels of ketones and glucose in your blood can cause ketoacidosis. This might happen if you: Don’t know you have diabetes, and your body is breaking down too much fat Know you have dia Continue reading >>

Hyperkalemia (high Blood Potassium)

Hyperkalemia (high Blood Potassium)

How does hyperkalemia affect the body? Potassium is critical for the normal functioning of the muscles, heart, and nerves. It plays an important role in controlling activity of smooth muscle (such as the muscle found in the digestive tract) and skeletal muscle (muscles of the extremities and torso), as well as the muscles of the heart. It is also important for normal transmission of electrical signals throughout the nervous system within the body. Normal blood levels of potassium are critical for maintaining normal heart electrical rhythm. Both low blood potassium levels (hypokalemia) and high blood potassium levels (hyperkalemia) can lead to abnormal heart rhythms. The most important clinical effect of hyperkalemia is related to electrical rhythm of the heart. While mild hyperkalemia probably has a limited effect on the heart, moderate hyperkalemia can produce EKG changes (EKG is a reading of theelectrical activity of the heart muscles), and severe hyperkalemia can cause suppression of electrical activity of the heart and can cause the heart to stop beating. Another important effect of hyperkalemia is interference with functioning of the skeletal muscles. Hyperkalemic periodic paralysis is a rare inherited disorder in which patients can develop sudden onset of hyperkalemia which in turn causes muscle paralysis. The reason for the muscle paralysis is not clearly understood, but it is probably due to hyperkalemia suppressing the electrical activity of the muscle. Common electrolytes that are measured by doctors with blood testing include sodium, potassium, chloride, and bicarbonate. The functions and normal range values for these electrolytes are described below. Hypokalemia, or decreased potassium, can arise due to kidney diseases; excessive losses due to heavy sweating Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

What is Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) is the hallmark of type 1 (insulin-dependent) diabetes mellitus. DKA is an emergency condition caused by a disturbance in your body’s metabolism. Extremely high blood glucose levels, along with a severe lack of insulin, result in the breakdown of body fat for energy and an accumulation of ketones in the blood and urine. Statistics on Diabetic Ketoacidosis Diabetic ketoacidosis can occur in between 16%-80% of children presenting with newly diagnosed diabetes. It remains the most common cause of death for young type 1 diabetes sufferers. Before the discovery of insulin, mortality rates were up to 100%. Today, the mortality has fallen to around 2% due to early identification and treatment. Death is usually caused by cerebral oedema (swelling of the brain). DKA is most common in type 1 diabetes sufferers but may also occur in those with type 2 diabetes mellitus. However, the latter group usually has at least some functioning insulin so suffer from another disorder called hyperosmolar non-ketotic coma (HONK). DKA tends to occur in individuals younger than 19 years, the more brittle of type 1 diabetic patients. However, DKA can affect diabetic patients of any age or sex. Risk Factors for Diabetic Ketoacidosis People with diabetes lack sufficient insulin, a hormone the body uses to metabolise glucose (a simple sugar) for energy. Therefore in diabetic patients glucose is not available as a fuel, so the body turns to fat stores for energy. However when fats are broken down they produce byproducts called ketones which build up in the blood and can be damaging to the body. In particular, accumulated ketones can “spill” over into the urine and make the blood become more acidic than body tissues (ketoacidosis). Blood gl Continue reading >>

Is There Any Poison That Causes Heart Attack?

Is There Any Poison That Causes Heart Attack?

Not a myocardial infarction, a wound to the heart muscle, but the very powerful heart drug Digoxin - DrugBank (found in the foxglove) can in an overdose cause specific arrhythmias, if not recognised and treated (by infusing specific anti-digoxin antibodies), cause death. A Dutch pharmacist used it to try to murder his young lady ex-lover who wanted to leave him, fortunately the resident who saw her recognised that arrhythmia - PAT = paroxysmal atrial tachycardia with AV block - so she was saved, he was arrested, tried and sentenced to a lengthy jail sentence. For a historical case that ended fatally see How to Treat a Broken Heart, or Poison Your Lover, with Foxglove Continue reading >>

Diabetes And Heart Disease

Diabetes And Heart Disease

Tweet Heart disease is a complication that may affect people with diabetes if their condition is not managed well for a prolonged period of time.. Coronary heart disease is recognized to be the cause of death for 80% of people with diabetes, however, the NHS states that heart attacks are largely preventable. [48] How are heart disease and diabetes linked? People suffering from type 1 and type 2 diabetes are more likely to be at risk from heart attacks, strokes and high blood pressure. Vascular problems, such as poor circulation to the legs and feet, are also more likely to affect diabetes patients. Like diabetes itself, the symptoms of cardiovascular disease may go undetected for years. A Diabetes UK report from 2007 estimates that the risk of cardiovascular disease in people with diabetes is: [1] 5 times higher in middle aged men 8 times higher in women with diabetes. More than half of type 2 diabetes patients will exhibit signs of cardiovascular disease complications at diagnosis. Who does heart disease affect? Many people think that heart disease only affects the middle-aged and elderly. However, serious cardiovascular disease may develop in diabetics before the age of 30. Both type 1 and type 2 diabetics are at greater risk of developing heart disease. What is the cause of heart disease amongst diabetics? Hyperglycemia, which characterises diabetes, in combination with free fatty acids in the blood can change the makeup of blood vessels, and this can lead to cardiovascular disease. The lining of the blood vessels may become thicker, and this in turn can impair blood flow. Heart problems and the possibility of stroke can occur. What symptoms can identify heart disease? The following are common symptoms of heart disease, although this may vary from individual to indiv Continue reading >>

Stroke And Diabetic Ketoacidosis – Some Diagnostic And Therapeutic Considerations

Stroke And Diabetic Ketoacidosis – Some Diagnostic And Therapeutic Considerations

Go to: Cerebrovascular insult (CVI) is a known and important risk factor for the development of diabetic ketoacidosis (DKA); still, it seems that the prevalence of DKA among the patients suffering CVI and its influence on stroke outcome might be underestimated. Diabetic ketoacidosis itself has been reported to be a risk factor for the occurrence of stroke in children and youth. A cerebral hypoperfusion in untreated DKA may lead to cerebral injury, arterial ischemic stroke, cerebral venous thrombosis, and hemorrhagic stroke. All these were noted following DKA episodes in children. At least some of these mechanisms may be operative in adults and complicate the course and outcome of CVI. There is a considerable overlap of symptoms, signs, and laboratory findings in the two conditions, making their interpretation difficult, particularly in the elderly and less communicative patients. Serum pH and bicarbonate, blood gases, and anion gap levels should be routinely measured in all type 1 and type 2 diabetics, regardless of symptomatology, for the early detection of existing or pending ketoacidosis. The capacity for rehydration in patients with stroke is limited, and the treatment of the cerebrovascular disease requires intensive use of osmotic and loop diuretics. Fluid repletion may be difficult, and the precise management algorithms are required. Intravenous insulin is the backbone of treatment, although its effect may be diminished due to delayed fluid replenishment. Therefore, the clinical course of diabetic ketoacidosis in patients with CVI may be prolonged and complicated. Keywords: CVI, type 2 diabetes complications, acid-base disturbances, fluid management Go to: Introduction Cerebrovascular incidents (CVI) are significant and well-known risk factors for the development Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia:[1] Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA.[2] Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA.[2] However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

What Is It? Diabetic ketoacidosis is a potentially fatal complication of diabetes that occurs when you have much less insulin than your body needs. This problem causes the blood to become acidic and the body to become dangerously dehydrated. Diabetic ketoacidosis can occur when diabetes is not treated adequately, or it can occur during times of serious sickness. To understand this illness, you need to understand the way your body powers itself with sugar and other fuels. Foods we eat are broken down by the body, and much of what we eat becomes glucose (a type of sugar), which enters the bloodstream. Insulin helps glucose to pass from the bloodstream into body cells, where it is used for energy. Insulin normally is made by the pancreas, but people with type 1 diabetes (insulin-dependent diabetes) don't produce enough insulin and must inject it daily. Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School. Continue reading >>

Diabetic Ketoacidosis - Symptoms

Diabetic Ketoacidosis - Symptoms

A A A Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel. In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common. The most common Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

The Facts Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, most often in those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a fatal coma. DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. It can also occur in people already diagnosed with type 1 diabetes that have missed an insulin dose, have an infection, or have suffered a traumatic event or injury. Although much less common, DKA can occasionally occur in people with type 2 diabetes under extreme physiologic stress. Causes With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take in glucose from the blood. In the case of type 2 diabetes, the pancreas is unable to make sufficient amounts of insulin in order to take in glucose from the blood. Glucose, a simple sugar we get from the foods we eat, is necessary for making the energy our cells need to function. People with diabetes can't get glucose into their cells, so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL) while insulin levels are very low. Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood, causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able Continue reading >>

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