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Can Ketoacidosis Cause Joint Pain

Childhood Ketoacidosis

Childhood 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 one of our health articles more useful. Diabetic ketoacidosis (DKA) is the leading cause of mortality in childhood diabetes.[1]The primary cause of DKA is absolute or relative insulin deficiency: Absolute - eg, previously undiagnosed type 1 diabetes mellitus or a patient with known type 1 diabetes who does not take their insulin. Relative - stress causes a rise in counter-regulatory hormones with relative insulin deficiency. DKA can be fatal The usual causes of death are: Cerebral oedema - associated with 25% mortality (see 'Cerebral odedema', below). Hypokalaemia - which is preventable with good monitoring. Aspiration pneumonia - thus, use of a nasogastric tube in the semi-conscious or unconscious is advised. Deficiency of insulin. Rise in counter-regulatory hormones, including glucagon, cortisol, growth hormone, and catecholamines. Thus, inappropriate gluconeogenesis and liver glycogenolysis occur compounding the hyperglycaemia, which causes hyperosmolarity and ensuing polyuria, dehydration and loss of electrolytes. Accelerated catabolism from lipolysis of adipose tissue leads to increased free fatty acid circulation, which on hepatic oxidation produces the ketone bodies (acetoacetic acid and beta-hydroxybutyric acid) that cause the metabolic acidosis. A vicious circle is usually set up as vomiting usually occurs compounding the stress and dehydration; the cycle can only be broken by providing insulin and fluids; otherwise, severe acidosis occurs and can be fatal. Biochemical criteria The biochemical criteria required for a diagnosis of DKA to be made are Continue reading >>

Diabetes Basics

Diabetes Basics

Basics of diabetes Diabetes is a condition caused by lack of a chemical in the body (a hormone) called insulin. There are two major forms of diabetes. In type 1 diabetes eventually no insulin is produced and individuals require insulin injections for survival. It used to be thought this only presented in children, but it is now clear this can occur at any age. The other more common form of diabetes called type 2 diabetes occurs due to the body's resistance to the effects of insulin in addition to an insufficient quantity of insulin. However, in this type of diabetes there is usually some insulin produced. For both types of diabetes, blood glucose levels are elevated. Furthermore, people with diabetes are prone to certain complications not seen in those without diabetes. These complications involve the eye (retinopathy), kidney (nephropathy) and nerves (neuropathy). People with diabetes also get early hardening of the arteries (atherosclerosis), leading to early heart attacks and strokes. The good news for people with diabetes is that with proper care all of these problems can be avoided. Immediate medical attention Uncontrolled diabetes presents with frequent thirst and urination. Over time, patients will become dehydrated as the glucose is "spilling" over into the urine. If insulin deficiency is severe enough, fat stores are used for energy as glucose cannot get into cells. This problem is much more common with type 1 diabetes and is called "ketoacidosis". It can be diagnosed at home with a simple urine test. When significant ketones are found in the urine, it is important to be in touch with a physician immediately. There are other conditions that require immediate attention. Blurry vision in someone with known diabetic eye disease or someone with a long history of di Continue reading >>

Diabetes Complications

Diabetes Complications

High blood sugar (glucose) that circulates in the bloodstream instead of being absorbed into cells damages nerves and blood vessels throughout the body and, ultimately, the major organs such as the kidneys and heart. It has been said that there isn’t a system in the body that isn’t affected by diabetes. The good news is that diabetes can be managed and the risk of developing complications significantly reduced. A nationwide study conducted from 1983-1993 called the Diabetes Control and Complications Trial showed that when blood sugar levels are checked consistently throughout the day – and kept close to normal – complications of the disease can be reduced by as much as 70 percent. This method is also referred to as "tight control" of blood sugar and has become standard of care in diabetes management. Diabetic Neuropathy (Nerve Damage) Approximately 60-70 percent of people with diabetes have mild to severe forms of nerve damage. Often the first symptoms of diabetes are tingling, numbness or pain in some part of the body, which is an indication that nerves have been damaged. Neuropathy from diabetes can affect many different parts of the body, including the lower limbs (legs, feet), the bladder and the gastrointestinal tract. Several theories exist as to why diabetes has such a devastating effect on the nervous system. One theory holds that excess sugar in the bloodstream reacts negatively with an enzyme in the cells surrounding the nerves and damages them. Another theory suggests that decreased blood flow to nerves, from damaged blood vessels caused by diabetes, results in neuropathy. In general, there are three types of neuropathy: sensory, autonomic and motor. Sensory neuropathy is the most common, affecting how we perceive temperature, texture and pain. Autono 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

Diabetic Ketoacidosis

Practice Essentials Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria. Signs and symptoms The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia History of failure to comply with insulin therapy or missed insulin injections due to vomiting or psychological reasons or history of mechanical failure of insulin infusion pump Altered consciousness (eg, mild disorientation, confusion); frank coma is uncommon but may occur when the condition is neglected or with severe dehydration/acidosis Signs and symptoms of DKA associated with possible intercurrent infection are as follows: See Clinical Presentation for more detail. Diagnosis On examination, general findings of DKA may include the following: Characteristic acetone (ketotic) breath odor In addition, evaluate patients for signs of possible intercurrent illnesses such as MI, UTI, pneumonia, and perinephric abscess. Search for signs of infection is mandatory in all cases. Testing Initial and repeat laboratory studies for patients with DKA include the following: Serum electrolyte levels (eg, potassium, sodium, chloride, magnesium, calcium, phosphorus) Note that high serum glucose levels may lead to dilutional hyponatremia; high triglyceride levels may lead to factitious low glucose levels; and high levels of ketone bodies may lead to factitious elevation of creatinine levels. Continue reading >>

Can High Blood Sugar Cause Joint And Muscle Pain?

Can High Blood Sugar Cause Joint And Muscle Pain?

Diabetes can cause changes in your musculoskeletal system, which is the term for your muscles, bones, joints, ligaments, and tendons. These changes can cause numerous conditions that may affect your fingers, hands, wrists, shoulders, neck, spine, or feet. Symptoms of diabetes-related musculoskeletal problems include muscle pain, joint pain or stiffness, lessened ability to move your joints, joint swelling, deformities, and a “pins and needles” sensation in the arms or legs. Some musculoskeletal problems are unique to diabetes. Others also affect people without diabetes. For instance, diabetes can cause skin changes such as thickening, tightness, or nodules under the skin, particularly in the hands. Carpal tunnel syndrome is frequently seen in people with diabetes, as is trigger finger (a catching or locking of the fingers), although these conditions are commonly seen in people without diabetes, as well. The shoulder joint may also be affected in diabetes. And, of course, the feet are susceptible to problems caused by diabetes. Most of these conditions can be successfully treated with anti-inflammatory medications, steroid injections, or other therapies. It is important to mention any troubling symptoms to your doctor. Ask yourself the following questions, which address some of the more frequent symptoms people have when diabetes affects their muscles, ligaments, tendons, or joints. If you answer “yes” to any, consult your doctor. • Do you have stiffness in your hands that affects your ability to move or use them? • Do your fingers get “locked” in certain positions? • Do you have numbness or tingling in your hands, arms, or legs? • Do you have stiffness or decreased motion in your shoulders? • Do you have muscle pain or swelling? Continue reading >>

14 Ways To Reduce Joint Pain With Diabetes

14 Ways To Reduce Joint Pain With Diabetes

Diabetes can damage joints, making life and movement much harder. How does this happen, and what can we do about it? A lot. “Without properly functioning joints, our bodies would be unable to bend, flex, or even move,” says Sheri Colberg, PhD, author of The Diabetic Athlete, The 7 Step Diabetes Fitness Plan, and other books. Joint pain is often called “arthritis.” “A joint is wherever two bones come together,” Colberg writes. The bones are held in place by ligaments, which attach bones to each other, and by tendons, which attach bones to the muscles that move them. The ends of the bones are padded with cartilage, a whitish gel made from collagen, proteins, fiber, and water. Cartilage allows bones to move on each other without being damaged. Joint cartilage can be damaged by injuries or by wear and tear with hard use. “Aging alone can lead to some loss of [the] cartilage layer in knee, hip, and other joints,” says Colberg “but having diabetes potentially speeds up damage to joint surfaces.” Sometimes extra glucose sticks to the surfaces of joints, gumming up their movement. This stickiness interferes with movement and leads to wear-and-tear injury. High glucose levels also thicken and degrade the collagen itself. This is bad because tendons and ligaments are also largely made from collagen. Reduced flexibility of joints leads to stiffness, greater risk of physical injury, and falls. People with joint damage may reduce their physical activity due to discomfort and fear of falling. Reduced activity promotes heart disease and insulin resistance. Here are 14 things we can do to prevent and treat joint problems and to keep moving. • Stretching keeps muscles and tendons relaxed and aligned so they’ll move as needed. You might want to ask a physical ther Continue reading >>

Symptoms Of Diabetes In Dogs

Symptoms Of Diabetes In Dogs

Diabetes in dogs is a condition where the pancreas does not produce sufficient amounts of insulin to effectively process the foods a dog eats. Because the food isn’t processed appropriately, it is unable to pass into the cells where it can be utilized, causing an excess of sugars to be passed into the bloodstream. Common symptoms of diabetes in dogs are extreme thirst, excessive urination, ravenous hunger and weight loss. As the disease progresses, almost every system in the dog’s body can be impacted. If you suspect your dog may have diabetes, it is important to see a veterinarian for testing, diagnosis and the beginning of treatment. Even though your dog may be drinking large amounts of water, its body is using more water than normal in order to flush its systems in an attempt to bring the blood sugar to a normal level. Weight loss is caused by the body’s inability to take in adequate nutrients. The body begins to consume itself producing ketoacidosis, a condition that can become deadly if not treated. Your dog may also exhibit symptoms of lethargy which is caused by its elevated blood sugar. The body and muscles are not able to operate efficiently under these conditions so it is easier for the dog to just lie around your house. Because the symptoms of diabetes in dogs could also be an indication of other diseases, your veterinarian will conduct a thorough examination to determine if any of your dog’s systems such as heart, eyes or kidneys have been damaged. Additional tests may be run on the blood and urine samples once the diagnosis of diabetes has been confirmed. The urine may be tested for protein presence. This indicates whether the diabetes has begun to break down muscle tissue in order to provide nutrients for your dog’s body. Your veterinarian may al Continue reading >>

Can Diabetes Cause Fatigue, Body Ache?

Can Diabetes Cause Fatigue, Body Ache?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society. Asked by Mike from Tennessee Can diabetes be a (possible) cause of fatigue, leg and lower back aches? I have had bursts of energy for 10 to 15 minutes, but then need to sit for about 10 minutes, and I'm ready to go full steam again. PLEASE, Thank You, Mike Expert answer Dear Mike: Thanks for an important question, as a lot of people with diabetes complain of these symptoms. The answer is that diabetes itself probably is not the cause of your fatigue, lower back and leg aches. The things that cause type 2 diabetes (also called adult onset diabetes), such as a weight problem and lack of exercise, are commonly the cause these symptoms. Fatigue incorporates three components: 1. The inability to initiate activity. 2. Reduced ability to maintain activity. 3. Difficulty with concentration and memory. Fatigue should be distinguished from sleepiness, shortness of breath on exertion and muscle weakness, although these can also be associated with fatigue. Fatigue lasting six months or more is referred to as chronic fatigue. Chronic fatigue is not necessarily the entity known as chronic fatigue syndrome, which is a diagnosis after exclusion of all other causes. Fatigue in anyone should be evaluated by a health care provider to exclude all possible causes and to get counseling on how to treat it. Other medical causes of fatigue are the side effect of drugs, thyroid dysfunction, high calcium levels, rheumatologic illnesses, adrenal, kidney or liver problems. Some infections such as tuberculosis or hepatitis can cause fatigue, and indeed, fatigue can be their only symptom. Depression is also a major cause of fatigue. While unus Continue reading >>

What You Should Know About Diabetic Ketoacidosis

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too. It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system. People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction. DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration. Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes. Call your doctor or go to the emergency room right away if that doesn't work, if you have any of the symptoms below and your ketones aren't normal, or if you have more than one symptom. You've been throwing up for more than 2 hours. You feel queasy or your belly hurts. Your breath smells fruity. You're tired, confused, or woozy. You're having a hard time breathing. Continue reading >>

The Musculoskeletal Effects Of Diabetes Mellitus

The Musculoskeletal Effects Of Diabetes Mellitus

Go to: Abstract Diabetes mellitus (DM) is a multi-system disease characterized by persistent hyperglycemia that has both acute and chronic biochemical and anatomical sequelae, with Type-2 DM representing the most common form of the disease. Neuromusculoskeletal sequelae of DM are common and the practicing chiropractor should be alert to these conditions, as some are manageable in a chiropractic office, while others are life and/or limb threatening. This paper reviews the effects of DM on the musculoskeletal system so as assist the chiropractor in making appropriate clinical decisions regarding therapy, understanding contraindications to therapy, referring patients to medical physicians when appropriate and understanding the impact that DM may have on the prognosis for their patients suffering from the myriad musculoskeletal conditions associated with this disease. Keywords: diabetes, musculoskeletal, chiropractic Go to: Introduction Diabetes mellitus (DM) is a multi-system disease characterized by persistent hyperglycemia that has both acute and chronic biochemical and anatomical sequelae. It is thought to affect almost 17 million Americans, only 11 million of whom have been diagnosed according to the American Diabetes Association. In type 1 diabetes, a lack of insulin results in poor carbohydrate, fat, and protein metabolism. Insulin is functionally absent, typically due to immune-mediated destruction of the beta cells of the pancreas, though other etiologies of beta cell destruction have also been implicated, including drugs, chemicals, viruses, mitochondrial gene defects, pancreatectomy and ionizing radiation.1 Type 1 DM (DM1) occurs most commonly in juveniles. It can occur in adults, especially in those in their late 30s and early 40s. Unlike people with Type 2 DM ( Continue reading >>

Ketoacidosis: A Complication Of Diabetes

Ketoacidosis: A Complication Of Diabetes

Diabetic ketoacidosis is a serious condition that can occur as a complication of diabetes. People with diabetic ketoacidosis (DKA) have high blood sugar levels and a build-up of chemicals called ketones in the body that makes the blood more acidic than usual. Diabetic ketoacidosis can develop when there isn’t enough insulin in the body for it to use sugars for energy, so it starts to use fat as a fuel instead. When fat is broken down to make energy, ketones are made in the body as a by-product. Ketones are harmful to the body, and diabetic ketoacidosis can be life-threatening. Fortunately, treatment is available and is usually successful. Symptoms Ketoacidosis usually develops gradually over hours or days. Symptoms of diabetic ketoacidosis may include: excessive thirst; increased urination; tiredness or weakness; a flushed appearance, with hot dry skin; nausea and vomiting; dehydration; restlessness, discomfort and agitation; fruity or acetone smelling breath (like nail polish remover); abdominal pain; deep or rapid breathing; low blood pressure (hypotension) due to dehydration; and confusion and coma. See your doctor as soon as possible or seek emergency treatment if you develop symptoms of ketoacidosis. Who is at risk of diabetic ketoacidosis? Diabetic ketoacidosis usually occurs in people with type 1 diabetes. It rarely affects people with type 2 diabetes. DKA may be the first indication that a person has type 1 diabetes. It can also affect people with known diabetes who are not getting enough insulin to meet their needs, either due to insufficient insulin or increased needs. Ketoacidosis most often happens when people with diabetes: do not get enough insulin due to missed or incorrect doses of insulin or problems with their insulin pump; have an infection or illne Continue reading >>

Low Back Pain At Presentation In A Newly Diagnosed Diabetic

Low Back Pain At Presentation In A Newly Diagnosed Diabetic

Patients with insulin dependent diabetes mellitus (IDDM) are generally more susceptible to infections, which can cause hyperglycaemia and trigger diabetic ketoacidosis.1 In many cases, the focus of infection, such as the urinary or respiratory tract, may be apparent at presentation. Occasionally, however, patients can present with unusual foci of infection and vague clinical symptoms and signs. Both epidural2–5 and psoas6,7 abscesses have been reported in diabetics, but mainly in adults with longstanding disease. Presentation with an epidural abscess and psoas abscess in the same patient is extremely rare in adults, particularly at first presentation of IDDM,2 and, to our knowledge, has not been reported in children. CASE REPORT A 12 year old boy of mixed race (White/Afro-Caribbean) presented to casualty with a three day history of central abdominal pain, vomiting, lethargy, and low back pain, followed by a five hour history of difficulty in breathing. There was no previous history of respiratory problems, polyuria, polydipsia, or weight loss. His past medical history was unremarkable with normal development and no previous acute hospital admissions. On examination, he was 10% dehydrated with cold peripheries, dry mucous membranes, sunken eyes, and reduced skin turgor. He had Kussmaul breathing, with a respiratory rate of 60 breaths per minute, but good bilateral air entry on auscultation and no wheeze or crackles. There was no lymphadenopathy but he was noted to be anaemic. Axillary temperature was 36.0°C on admission. His heart rate was regular at 120 per minute with a blood pressure of 130/70 mm Hg. He had mild central abdominal pain with no hepatosplenomegaly. Examination of the spine revealed mild tenderness on palpation over the upper lumbar spine, but peripher Continue reading >>

Diabetic Ketoacidosis (dka) - Topic Overview

Diabetic Ketoacidosis (dka) - Topic Overview

Diabetic ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are unable to get the sugar (glucose) they need for energy because there is not enough insulin. When the sugar cannot get into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood and remove it from the body through urine. Because the cells cannot receive sugar for energy, the body begins to break down fat and muscle for energy. When this happens, ketones, or fatty acids, are produced and enter the bloodstream, causing the chemical imbalance (metabolic acidosis) called diabetic ketoacidosis. Ketoacidosis can be caused by not getting enough insulin, having a severe infection or other illness, becoming severely dehydrated, or some combination of these things. It can occur in people who have little or no insulin in their bodies (mostly people with type 1 diabetes but it can happen with type 2 diabetes, especially children) when their blood sugar levels are high. Your blood sugar may be quite high before you notice symptoms, which include: Flushed, hot, dry skin. Feeling thirsty and urinating a lot. Drowsiness or difficulty waking up. Young children may lack interest in their normal activities. Rapid, deep breathing. A strong, fruity breath odor. Loss of appetite, belly pain, and vomiting. Confusion. Laboratory tests, including blood and urine tests, are used to confirm a diagnosis of diabetic ketoacidosis. Tests for ketones are available for home use. Keep some test strips nearby in case your blood sugar level becomes high. When ketoacidosis is severe, it must be treated in the hospital, often in an intensive care unit. Treatment involves giving insulin and fluids through your vein and closely watching certain chemicals in your blood (electrolyt Continue reading >>

Headed In The Right Direction?

Headed In The Right Direction?

What is the most important information I should know about TRADJENTA? Serious side effects can happen to people taking TRADJENTA, including inflammation of the pancreas (pancreatitis), which may be severe and lead to death. Before you start taking TRADJENTA, tell your doctor if you have ever had pancreatitis, gallstones, a history of alcoholism, or high triglyceride levels. Stop taking TRADJENTA and call your doctor right away if you have pain in your stomach area (abdomen) that is severe and will not go away. The pain may be felt going from your abdomen through to your back. The pain may happen with or without vomiting. These may be symptoms of pancreatitis. Heart failure. Heart failure means your heart does not pump blood well enough. Before you start taking TRADJENTA, tell your doctor if you have ever had heart failure or have problems with your kidneys. Contact your doctor right away if you have any of the following symptoms: increasing shortness of breath or trouble breathing, especially when you lie down; swelling or fluid retention, especially in the feet, ankles, or legs; an unusually fast increase in weight or unusual tiredness. These may be symptoms of heart failure. Do not take TRADJENTA if you are allergic to linagliptin or any of the ingredients in TRADJENTA. Symptoms of a serious allergic reaction to TRADJENTA may include rash, itching, flaking or peeling; raised red patches on your skin (hives); swelling of your face, lips, tongue, and throat that may cause difficulty breathing or swallowing. If you have any of these symptoms, stop taking TRADJENTA and call your doctor or go to the emergency room right away. What should I tell my doctor before using TRADJENTA? Tell your doctor about all your medical conditions, including if you have or have had inflammati Continue reading >>

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