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Can Ketoacidosis Cause Death

How Dangerous Can High Sugar Levels Be?

How Dangerous Can High Sugar Levels Be?

Higher average sugar dietary allowance leads to higher average insulin levels which leads to suppressed expression of a series of DNA repair genes. All else kept equal this means a faster rate of aging, and shorter time before impairment of important regulatory genes, meaning a shorter time before the development of cancers. Higher average blood sugar also means a higher rate of glycation reactions within the body. Glycation is when a sugar molecule binds a protein. This impairs the protein’s normal function. Table sugar - “saccharose”- is a dimer (two molecules bound together) of two simple sugars: Glucose, which is the primary form of sugar used within the body, and Fructose, which comes from fruits. Fructose happens to be up to 11x more potent in inducing glycation than the sugar our body would naturally produce (Glucose). Glycation within blood vessels impairs the natural flexibility of these vessels. The ensuing increased rigidity (1) decreases their mechanical buffering of the cardiac impulse, which leads to increased Systolic Blood Pressure, and increased overall blood pressure, (2) makes them more fragile and more prone to breakage, which leads to a higher propensity for aneurysm, thrombosis, heart attack and stroke (and varicosities, for the aesthetical part). In the eye glycation accounts for the greater part of lens opacities which develop with age (cataract). Rendering the lense more rigid, glycation also slightly impairs its shape, and its ability to its shape to be modulated by eye muscles to be adapted to produce a focused image at different distances and of moving objects. High average insulin levels also signals the body not to use up fatty acids within the blood stream, and to store them instead within fat cells. This means that a higher portion 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 >>

Will Obese People Starve To Death Before Their Fat Runs Out?

Will Obese People Starve To Death Before Their Fat Runs Out?

Treating obesity by total starvation is not advised as it can be very dangerous. There are many reports of total starvation leading to death. Some people have died of heart failure during the fast. Some people have died during the re-feeding period after the fast from lactic acidosis. There was a case of a successful medically managed fast in Scotland in 1965. A 27-year-old man weighing 207 kilograms, described as "grossly obese" turned up at the Department of Medicine at the Royal Infirmary in Dundee. He said he was sick of being fat and wanted to lose weight by eating nothing and living off his body fat. Doctors advised against this but told them he was going to fast flat out, whatever they said, so they may as well monitor him along the way. The staff gave him yeast tablets, multi-vitamins and essential minerals. Potassium is essential for the proper working of the heart, and when his potassium levels got a little low around the 100-day mark, he was given potassium tablets for about 70 days. He defecated infrequently, roughly every 40 to 50 days. He ended up fasting for one year and 17 days. Apart from water and the vitamin and mineral supplements he lived entirely off his copious body fat. He lost about 125 kilograms of weight over 382 days. Link below to paper about the case from BMJ Publishing Group: Features of a successful therapeutic fast of 382 days' duration: Continue reading >>

Is Diabetes A Terminal Illness?

Is Diabetes A Terminal Illness?

No, but the complications can become terminal. There are a few main types of diabetes. Type 2 is generally a lifestyle disease where patients are generally older or obese. Sometimes T2 can be controlled by diet and exercise, sometimes medications such as metformin or insulin are needed. Gestational diabetes appears during pregnancy. I know about Type 1 so I'll answer in regards to that kind of diabetes, which accounts for around 10% ish of all diabetes patients. Type 1, formeraly known as juvenile diabetes, is an autoimmune disease that usually (but not always) presents at a younger age (I was just 13 at my diagnosis). Type 1 patients must have insulin injected into their body by syringe, pump, or pen in order to survive. There is no way around it. Lack of insulin means a T1 will get very sick very very quickly. Unless insulin and medical attention is administered quickly the patient will die. Now, it's easy for (uninformed) people to say “well, just take insulin problem solved!” - but they don't understand how acting like your own pancreas 24/7/365 is an impossible task! Things like illness, hormones, stress, exercise, and even the wind blowing a different direction cause fluctuations in blood sugar, the way food is metabolised, and the way injected insulin behaves. The same food in the exact same quantity with the same insulin dose can result in different glucose readings on different days. It's easy for people to say “just control your blood sugar and you'll be fine” but they have no concept how difficult this is to do all of the time. This can mean a fast descent into diabetic ketoacidosis (where the blood literally becomes acidic and is easily the worst illness I've ever experienced). A person can die quickly if help doesn't reach them in time. DKA clouds j 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 >>

5 Common Type 1 Diabetes Complications

5 Common Type 1 Diabetes Complications

3 0 Type 1 diabetes carries with it a much higher risk of developing some associated serious health problems. While in the past, getting diabetes-related health complications was almost a certainty, with modern blood glucose monitoring, control, and treatment, the risks have decreased significantly. Even a few decades ago, life expectancy for people with diabetes was regularly considered to be 10 years shorter than for people without the disorder. In 2012, however, a large-scale study found that life-expectancy was now only about 6 years less than average. For comparison, a lifetime of smoking will reduce life expectancy by 10 years. So what are the diabetes complications that you need to be looking out for? Largely, they fall into either cardiovascular or neuropathic categories. To make diabetes complications even more complicated, they tend to affect people of different sexes and different ethnicities differently. One more wild card is that recent studies have found that some people with Type 1 diabetes actually never develop most of the complications associated with diabetes. The good news is that with proper blood glucose control and a healthy lifestyle, the risks for developing Type 1 diabetes complications are drastically reduced. Some studies have actually found that careful monitoring and management can reduce the chances of developing any of these by as much as 50%. Still, everyone with Type 1 diabetes should keep a careful eye out for the five most common diabetes complications. Diabetic Ketoacidosis Diabetic Ketoacidosis (or DKA), is a condition caused by severe hyperglycemia (high blood sugar) which causes rapid fat breakdown in the body. As the fat breaks down, they release fatty acids which are then converted into chemicals called ketones, which are highly Continue reading >>

Diabetes With Ketone Bodies In Dogs

Diabetes With Ketone Bodies In Dogs

Studies show that female dogs (particularly non-spayed) are more prone to DKA, as are older canines. Diabetic ketoacidosis is best classified through the presence of ketones that exist in the liver, which are directly correlated to the lack of insulin being produced in the body. This is a very serious complication, requiring immediate veterinary intervention. Although a number of dogs can be affected mildly, the majority are very ill. Some dogs will not recover despite treatment, and concurrent disease has been documented in 70% of canines diagnosed with DKA. Diabetes with ketone bodies is also described in veterinary terms as diabetic ketoacidosis or DKA. It is a severe complication of diabetes mellitus. Excess ketone bodies result in acidosis and electrolyte abnormalities, which can lead to a crisis situation for your dog. If left in an untreated state, this condition can and will be fatal. Some dogs who are suffering from diabetic ketoacidosis may present as systemically well. Others will show severe illness. Symptoms may be seen as listed below: Change in appetite (either increase or decrease) Increased thirst Frequent urination Vomiting Abdominal pain Mental dullness Coughing Fatigue or weakness Weight loss Sometimes sweet smelling breath is evident Slow, deep respiration. There may also be other symptoms present that accompany diseases that can trigger DKA, such as hypothyroidism or Cushing’s disease. While some dogs may live fairly normal lives with this condition before it is diagnosed, most canines who become sick will do so within a week of the start of the illness. There are four influences that can bring on DKA: Fasting Insulin deficiency as a result of unknown and untreated diabetes, or insulin deficiency due to an underlying disease that in turn exacerba Continue reading >>

Diabetes Complications In Dogs And Cats: Diabetes Ketoacidosis (dka)

Diabetes Complications In Dogs And Cats: Diabetes Ketoacidosis (dka)

Unfortunately, we veterinarians are seeing an increased prevalence of diabetes mellitus in dogs and cats. This is likely due to the growing prevalence of obesity (secondary to inactive lifestyle, a high carbohydrate diet, lack of exercise, etc.). So, if you just had a dog or cat diagnosed with diabetes mellitus, what do you do? First, we encourage you to take a look at these articles for an explanation of the disease: Diabetes Mellitus (Sugar Diabetes) in Dogs Once you have a basic understanding of diabetes mellitus (or if you already had one), this article will teach you about life-threatening complications that can occur as a result of the disease; specifically, I discuss a life-threatening condition called diabetes ketoacidosis (DKA) so that you know how to help prevent it! What is DKA? When diabetes goes undiagnosed, or when it is difficult to control or regulate, the complication of DKA can occur. DKA develops because the body is so lacking in insulin that the sugar can’t get into the cells -- resulting in cell starvation. Cell starvation causes the body to start breaking down fat in an attempt to provide energy (or a fuel source) to the body. Unfortunately, these fat breakdown products, called “ketones,” are also poisonous to the body. Symptoms of DKA Clinical signs of DKA include the following: Weakness Not moving (in cats, hanging out by the water bowl) Not eating to complete anorexia Large urinary clumps in the litter box (my guideline? If it’s bigger than a tennis ball, it’s abnormal) Weight loss (most commonly over the back), despite an overweight body condition Excessively dry or oily skin coat Abnormal breath (typically a sweet “ketotic” odor) In severe cases DKA can also result in more significant signs: Abnormal breathing pattern Jaundice Ab Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Initial Evaluation Initial evaluation of patients with DKA includes diagnosis and treatment of precipitating factors (Table 14–18). The most common precipitating factor is infection, followed by noncompliance with insulin therapy.3 While insulin pump therapy has been implicated as a risk factor for DKA in the past, most recent studies show that with proper education and practice using the pump, the frequency of DKA is the same for patients on pump and injection therapy.19 Common causes by frequency Other causes Selected drugs that may contribute to diabetic ketoacidosis Infection, particularly pneumonia, urinary tract infection, and sepsis4 Inadequate insulin treatment or noncompliance4 New-onset diabetes4 Cardiovascular disease, particularly myocardial infarction5 Acanthosis nigricans6 Acromegaly7 Arterial thrombosis, including mesenteric and iliac5 Cerebrovascular accident5 Hemochromatosis8 Hyperthyroidism9 Pancreatitis10 Pregnancy11 Atypical antipsychotic agents12 Corticosteroids13 FK50614 Glucagon15 Interferon16 Sympathomimetic agents including albuterol (Ventolin), dopamine (Intropin), dobutamine (Dobutrex), terbutaline (Bricanyl),17 and ritodrine (Yutopar)18 DIFFERENTIAL DIAGNOSIS Three key features of diabetic acidosis are hyperglycemia, ketosis, and acidosis. The conditions that cause these metabolic abnormalities overlap. The primary differential diagnosis for hyperglycemia is hyperosmolar hyperglycemic state (Table 23,20), which is discussed in the Stoner article21 on page 1723 of this issue. Common problems that produce ketosis include alcoholism and starvation. Metabolic states in which acidosis is predominant include lactic acidosis and ingestion of drugs such as salicylates and methanol. Abdominal pain may be a symptom of ketoacidosis or part of the inci Continue reading >>

Diabetic Ketoacidosis Explained

Diabetic Ketoacidosis Explained

Twitter Summary: DKA - a major complication of #diabetes – we describe what it is, symptoms, who’s at risk, prevention + treatment! One of the most notorious complications of diabetes is diabetic ketoacidosis, or DKA. First described in the late 19th century, DKA represented something close to the ultimate diabetes emergency: In just 24 hours, people can experience an onset of severe symptoms, all leading to coma or death. But DKA also represents one of the great triumphs of the revolution in diabetes care over the last century. Before the discovery of insulin in 1920, DKA was almost invariably fatal, but the mortality rate for DKA dropped to below 30 percent within 10 years, and now fewer than 1 percent of those who develop DKA die from it, provided they get adequate care in time. Don’t skip over that last phrase, because it’s crucial: DKA is very treatable, but only as long as it’s diagnosed promptly and patients understand the risk. Table of Contents: What are the symptoms of DKA? Does DKA occur in both type 1 and type 2 diabetes? What Can Patients do to Prevent DKA? What is DKA? Insulin plays a critical role in the body’s functioning: it tells cells to absorb the glucose in the blood so that the body can use it for energy. When there’s no insulin to take that glucose out of the blood, high blood sugar (hyperglycemia) results. The body will also start burning fatty acids for energy, since it can’t get that energy from glucose. To make fatty acids usable for energy, the liver has to convert them into compounds known as ketones, and these ketones make the blood more acidic. DKA results when acid levels get too high in the blood. There are other issues too, as DKA also often leads to the overproduction and release of hormones like glucagon and adrenaline Continue reading >>

What Are The Effects Of Low-carbohydrate And Ketogenic Diets On Type 1 Diabetics?

What Are The Effects Of Low-carbohydrate And Ketogenic Diets On Type 1 Diabetics?

I am a T2D on low carb diet and have been exploring this topic for just over a year. It is actually the success of T1D low carbs advocate that encouraged me to explore ketogenic diet for glucose/insulin normalization. Check out the following Dr Troy Stapleton- Type 1 And the inspirational Dr RD Dikeman- Typeonegrit kids and parents who achieve normal blood glucose following Dr Bernstein’s guidance. Do reach out to them if you are keen on achieving near normal glucose level. All the best. Continue reading >>

The Scary Experience Of Diabetic Ketoacidosis

The Scary Experience Of Diabetic Ketoacidosis

Today, we’re excited to share with you another guest blog from Katie Janowiak, who works for the Medtronic Foundation, our company’s philanthropic arm. When she first told me her story about food poisoning and Diabetic Ketoacidosis (DKA), I knew others could benefit from hearing it as well. Thanks Katie for your openness and allowing us to share your scary story so that the LOOP community can learn from it. Throughout this past year, I’ve had the honor of sharing with you, the amazing LOOP community, my personal journey and the often humorous sequence of events that is my life with T1. Humor is, after all, the best (and cheapest) therapy. Allow me to pause today to share with you the down and dirty of what it feels like to have something that is not the slightest bit humorous: diabetic ketoacidosis.You are hot. You are freezing. You are confused. You are blacked out but coherent. You go to talk but words fail you. Time flies and goes in slow motion simultaneously. You will likely smell and look like death. In my instance, this was brought on by the combination of excessive vomiting and dehydration caused by food poisoning and the diabetic ketoacidosis that followed after my body had gone through so much. In hindsight, I was lucky, my husband knew that I had food poisoning because I began vomiting after our meal. But I had never prepped him on diabetic ketoacidosis and the symptoms (because DKA was for those other diabetics.) Upon finding me in our living room with a bowl of blood and bile by my side (no, I am not exaggerating), he got me into the car and took me to emergency care. It was 5:30 p.m. – and I thought it was 11:00 a.m. The series of events that led up to my stay in the ICU began innocently enough. It was a warm summer night and my husband and I walke Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. DKA occurs mostly in type 1 diabetes mellitus (DM). It causes nausea, vomiting, and abdominal pain and can progress to cerebral edema, coma, and death. DKA is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia. Treatment involves volume expansion, insulin replacement, and prevention of hypokalemia. Diabetic ketoacidosis (DKA) is most common among patients with type 1 diabetes mellitus and develops when insulin levels are insufficient to meet the body’s basic metabolic requirements. DKA is the first manifestation of type 1 DM in a minority of patients. Insulin deficiency can be absolute (eg, during lapses in the administration of exogenous insulin) or relative (eg, when usual insulin doses do not meet metabolic needs during physiologic stress). Common physiologic stresses that can trigger DKA include Some drugs implicated in causing DKA include DKA is less common in type 2 diabetes mellitus, but it may occur in situations of unusual physiologic stress. Ketosis-prone type 2 diabetes is a variant of type 2 diabetes, which is sometimes seen in obese individuals, often of African (including African-American or Afro-Caribbean) origin. People with ketosis-prone diabetes (also referred to as Flatbush diabetes) can have significant impairment of beta cell function with hyperglycemia, and are therefore more likely to develop DKA in the setting of significant hyperglycemia. SGLT-2 inhibitors have been implicated in causing DKA in both type 1 and type 2 DM. Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Tweet Diabetic ketoacidosis (DKA) is a dangerous complication faced by people with diabetes which happens when the body starts running out of insulin. DKA is most commonly associated with type 1 diabetes, however, people with type 2 diabetes that produce very little of their own insulin may also be affected. Ketoacidosis is a serious short term complication which can result in coma or even death if it is not treated quickly. Read about Diabetes and Ketones What is diabetic ketoacidosis? DKA occurs when the body has insufficient insulin to allow enough glucose to enter cells, and so the body switches to burning fatty acids and producing acidic ketone bodies. A high level of ketone bodies in the blood can cause particularly severe illness. Symptoms of DKA Diabetic ketoacidosis may itself be the symptom of undiagnosed type 1 diabetes. Typical symptoms of diabetic ketoacidosis include: Vomiting Dehydration An unusual smell on the breath –sometimes compared to the smell of pear drops Deep laboured breathing (called kussmaul breathing) or hyperventilation Rapid heartbeat Confusion and disorientation Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period if blood glucose levels become and remain too high (hyperglycemia). Causes and risk factors for diabetic ketoacidosis As noted above, DKA is caused by the body having too little insulin to allow cells to take in glucose for energy. This may happen for a number of reasons including: Having blood glucose levels consistently over 15 mmol/l Missing insulin injections If a fault has developed in your insulin pen or insulin pump As a result of illness or infections High or prolonged levels of stress Excessive alcohol consumption DKA may also occur prior to a diagnosis of type 1 diabetes. Ketoacidosis can occasional Continue reading >>

Alcoholic Ketoacidosis As A Cause Of Death, Who Came First?

Alcoholic Ketoacidosis As A Cause Of Death, Who Came First?

I read with interest the article ‘The Postmortem Diagnosis of Alcoholic Ketoacidosis’ by Palmiere and Augsburger (2014). However for the sake of truth I must protest against the statement on page 272: ‘The first report in the forensic field suggesting that ketoacidosis could be partially responsible for unexplained deaths in alcoholics dates back to 1993 and concerns a study performed by L.N. Denmark on 49 autopsy cases that included chronic alcohol-abuse related deaths’. Together with my co-authors I submitted an article that was acknowledged by Forensic Science International on 19 January 1993 and published in vol. 60 (Thomsen et al., 1993). In that article we described our results as ‘strongly indicative of ketoacidosis as the sole or contributing cause of death…’. We were convinced that we solved the riddle of ‘Fatty liver deaths’. L.N. Denmarks excellent work on beta-hydroxybutyrate was received at Forensic Science International, 4 April 1993 and published in vol. 62. It had been known for many years that alcoholics, who stop drinking after a binge, may be found dead shortly after. The only abnormality to be found is a fatty liver. There are no drugs to be detected and only insignificant levels of alcohol or none at all. There have been numerous speculations as to the cause and mechanism of death. Severe metabolic disturbances including high levels of free fatty acids do probably play a major role due to the effect on the Krebs Cycle. It has since our publications been confirmed that alcoholic ketoacidosis is the cause of death in a substantial number of alcohol abusers. A quantitative measurement of ketone bodies is now a routine analysis at the institutes of forensic medicine in Denmark. Denmark (1993) measured the levels of beta-hydroxybutyrate Continue reading >>

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