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Can Ketoacidosis Cause Seizures

Association Between Seizures And Diabetes Mellitus: A Comprehensive Review Of Literature.

Association Between Seizures And Diabetes Mellitus: A Comprehensive Review Of Literature.

Abstract Epilepsy or seizures are often observed in patients with diabetes mellitus (DM), and an emerging association between the two diseases is more than coincidental based on recent research. Approximately 25% of patients with DM experience different types of seizures. Furthermore, diabetic patients who experienced episodes of DKA also have seizures more frequently. The precise pathogenesis of seizures in the diabetes patient remains undetermined. Currently, the leading hypotheses in the literature suggest that multiple physiological factors, such as immune abnormalities, microvascular lesions in the brain, local brain damage, metabolic factors and gene mutation, may contribute to this condition. To date, there are no international criteria for the diagnosis and treatment of this condition. Although it is commonly assumed that antiepileptic drugs are necessary, most of the partial epilepsy patients with non-ketotic diabetes are resistant to frequently used antiepileptic drugs. In contrast, partial status epilepticus can be treated by diazepam, and carbamazepine is reported to be effective to some DM patients with epilepsy. However, anti-diabetic drugs are considered to be the most important factors in the treatment of this condition. When the blood glucose levels gradually return to normal levels, patients can no longer generate seizures even when antiepileptic drugs are discontinued. Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention Definition Diabetes is a higher level of glucose in the blood than is normal. Glucose travels through the body in the blood. A hormone called insulin then helps glucose move from the blood to the cells. Once glucose is in the cells it can be used for energy. A problem making or using insulin means glucose cannot move into cells. Insulin also helps glucose to move into the liver for storage if there is too much to use. Without enough insulin, glucose will build up in the blood. In type 1 diabetes, the body does not make insulin. This will lead to the build up of glucose in the blood, also called hyperglycemia. At the same time, cells are not getting glucose they need to function well. Over a long period of time high blood glucose levels can also damage vital organs. The blood vessels, heart, kidneys, eyes, and nerves are most commonly affected organs. Type 1 diabetes is often found during childhood and young adulthood. Causes Our immune system keeps us well by fighting off and destroying viruses and bacteria. Unfortunately, sometimes the immune system attacks healthy tissue. Most type 1 diabetes develop because the immune system attacks and destroys the cells that make insulin. These cells are in the pancreas. It is not yet clear why the immune system attacks these cells. It is believed that some people have genes that make them prone to getting diabetes. For these people, certain triggers in the environment may make the immune system attack the pancreas. The triggers are not known but may be certain viruses, foods, or chemicals. Type 1 diabetes may also develop as a complication of other medical conditions. It may develop in: People with chronic type 2 diabetes who lose the ability to mak Continue reading >>

What Is The Longest A Diabetic Can Go Without An Injection?

What Is The Longest A Diabetic Can Go Without An Injection?

Type one diabetes at the most two to three days, by that time they would be severely ketotic, risking a sometimes fatal diabetes hyperglycemic ketoacidotic coma. For type 2 diabetes mostly that can be for months, even years, like we see in those war torn areas. My erstwhile partner, when I met him already a senior physician, told me that the experience during WW II in The Netherlands, those mostly type 2 diabetics who couldn’t get insulin didn’t die from not having insulin (which at the end was air-dropped by the British into German occupied territories), in fact did quite well with their blood sugars, unfortunately for a very sad reason: the Dutch famine of 1944–45 - Wikipedia costing about 18,000 people their lives. Of course not having their diabetes well controlled would cause them to develop a lot more complications so would shorten their lifespan appreciably. Continue reading >>

Diabetic Seizures – What Are They? Symptoms, Causes, And Treatments

Diabetic Seizures – What Are They? Symptoms, Causes, And Treatments

A diabetic seizure is a serious medical condition and without emergency treatment, it has proven to be fatal. Extremely low levels of sugar in the diabetic’s blood cause these seizures. That is why it is so important for those who have diabetes to monitor and control their blood sugar. What Are the Causes? A number of different things can actually cause a diabetic seizure to occur. It could happen because too much insulin is injected, or because the diabetic did not eat right after taking insulin. Some of the other potential causes include not eating meals regularly or drinking too much alcohol. Even certain oral diabetes medications can make the body produce excess insulin. Those who are exercising too much without taking into account how this will affect their insulin levels will also be at a greater risk of suffering a diabetic stroke. No matter what causes the seizure, it is always a medical emergency and those who have one need immediate medical attention. What Are the Symptoms? When entering the first stages of a diabetic seizure, the person may exhibit a number of different symptoms. Some of the most common symptoms include: Sweating Clamminess Drowsiness Confusion Bodily shakes Hallucinations Rapid and unexpected emotional changes Weakness in the muscles Anxiety Vision changes Loss of ability to speak clearly After these initial symptoms, the next phase of symptoms begin and the danger level rises. Now, the person may stare into space and be non-communicative and uncontrollable body movements and contractions of the muscles may occur. In some cases, the diabetic will be unaware of the movements and may even fall into unconsciousness. What Is the Prevention and Treatment? The best way to deal with this problem is by ensuring it does not occur in the first place Continue reading >>

The Dangers In Bulimia Are Real - This Illness Can Kill!

The Dangers In Bulimia Are Real - This Illness Can Kill!

People often overlook the dangers in bulimia. They think that because bulimics are often within a healthy weight range, that it's a 'safe' eating disorder. The truth could not be more different... I was bulimic for over 10 years. The illness ravaged my body and I knew that it was close to killing me. But thankfully, I got help and I recovered... Too many people don't seek help for their bulimia and suffer from it for years on end, sometimes for many decades. Too often, bulimia kills. To help you realize the dangers in bulimia, I've listed the 10 most worrying ones below. TOP 10 Terrifying Dangers in Bulimia Please click on the links below to jump to that part of the 'dangers in bulimia' page, or just scroll down. Suicide Ketoacidosis Malnutrition and then see... Seizures or Fits If you suffer from bulimia you have an increased risk of having seizures or fits. The seizures may be caused by dehydration, hyperglycemia or ketoacidosis. Seizures are one of the serious dangers in bulimia because they can cause brain damage. Electrolyte Imbalance Electrolytes are important chemicals in your body. Having the right balance of electrolytes is essential for your nerves, muscles and organs to work properly. Electrolyte imbalances are caused by a mix of dehydration and the loss of potassium and sodium. This can be caused by excessive vomiting or laxative abuse. Bulimics often develop electrolyte abnormalities... Which can lead to sudden cardiac arrest and death. Because of the stress that electrolyte imbalances place on the organs - this is one of the most deadly dangers in bulimia. When I was bulimic, my electrolyte balance was so messed up that my heartbeat became very irregular. I am lucky that bulimia didn't kill me. Terri Schiavo had a heart attack, which was caused by a massiv Continue reading >>

Diabetic Seizures In Dogs

Diabetic Seizures In Dogs

Seeing your dog have a seizure can be pretty scary, especially the first time this happens. If the seizure is caused by diabetes complications, the good news is that future seizures can be prevented by controlling the dog's diabetes. Why Seizures Happen Any seizure—in a dog or a human—is caused by a kind of electrical storm in the brain. If a dog has diabetes, her body doesn't produce the right amount of insulin for control of blood sugar levels. Insulin is produced by the pancreas, and diabetes can be caused by too much or too little. Very low blood sugar levels can interrupt the normal functioning of the brain, leading to a diabetic seizure. Hypoglycemia and Hyperglycemia Problems relating to diabetes in dogs usually stem from a state of either hypoglycemia or hyperglycemia. A hypoglycemic dog has very low blood sugar and may experience a seizure as a result. In diabetic dogs, hypoglycemia commonly occurs when an insulin dose is given without sufficient food for the dog's body to utilize the insulin properly. The opposite diabetic state, hyperglycemia, occurs when the dog's blood sugar levels are extremely high. Although hyperglycemia does not typically cause seizures, this is a serious state in which the dog may become depressed, weak and anorexic. Hyperglycemia can cause a dog to become comatose. Seizure Prevention If your dog is diabetic, seizure prevention primarily involves preventing a state of hypoglycemia. Use insulin that is formulated specifically for dogs—Novolin, Vetsulin and Caninsulin are some of the most commonly used forms of canine insulin. Monitor your dog's blood glucose regularly to make sure the insulin dosage is correct and having the desired effect. Monitor your dog's feeding and exercise patterns, if possible with a regular daily schedule Continue reading >>

Hyperosmolar Hyperglycemic State

Hyperosmolar Hyperglycemic State

Epidemiology The hyperglycemic hyperosmolar state (HHS) or hyperglycemic hyperosmolar nonketotic coma (HHNK) is a serious and potentially lethal acute complication of diabetes.98 Cases of diabetic coma without the clinical features of ketoacidosis were initially described in the late 1800s; however, the importance of hyperosmolality as an essential component of the syndrome was not recognized until the late 1950s.99,100 Mortality in patients with HHS has decreased in recent decades, but remains higher than in patients with DKA.4,7,101-110 A recent observational study reported a weighted average mortality of 17.4% in 1284 adult cases of HHS.4 More pediatric cases are being diagnosed, with a mortality as high as 37%.111,112 Hyperosmolar coma (nonketotic hyperosmolar syndrome) is a state of extreme hyperglycemia, marked dehydration, serum hyperosmolarity, altered mental status, and absence of ketoacidosis. Nonketotic hyperosmolar syndrome Hyperosmolar nonketotic state PHYSICAL FINDINGS & CLINICAL PRESENTATION • Evidence of severe dehydration (poor skin turgor, sunken eyeballs, dry mucous membranes) • Neurologic defects (reversible hemiplegia, focal seizures) • Orthostatic hypotension, tachycardia • Evidence of precipitating factors (pneumonia, infected skin ulcer) • Coma (25% of patients), delirium • Infections, 20% to 25% (e.g., pneumonia, UTI, sepsis) • New or previously unrecognized diabetes (30% to 50%) • Reduction or omission of diabetic medication • Stress (MI, CVA) • Drugs: diuretics (dehydration), phenytoin, diazoxide (impaired insulin secretion) Presentation and clinical features The hyperosmolar hyperglycaemic state (HHS) was formerly known as hyperosmolar non-ketotic hyperglycaemia. The clinical features are dehydration, severe hyperglycaemia Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in Continue reading >>

Hypophosphatemia In Emergency Medicine

Hypophosphatemia In Emergency Medicine

Phosphate is the most abundant intracellular anion and is essential for membrane structure, energy storage, and transport in all cells. In particular, phosphate is necessary to produce ATP, which provides energy for nearly all cell functions. Phosphate is an essential component of DNA and RNA. Phosphate is also necessary in red blood cells for production of 2,3-diphosphoglycerate (2,3-DPG), which facilitates release of oxygen from hemoglobin. Approximately 85% of the body's phosphorus is in bone as hydroxyapatite, while most of the remainder (15%) is present in soft tissue. Only 0.1% of phosphorus is present in extracellular fluid, and it is this fraction that is measured with a serum phosphorus level. Reducing available phosphate may compromise any organ system, alone or in combination. The critical role phosphate plays in every cell, tissue, and organ explains the systemic nature of injury caused by phosphate deficiency. Serum phosphate or phosphorus normally ranges from 2.5-4.5 mg/dL (0.81-1.45 mmol/L) in adults. Hypophosphatemia is defined as mild (2-2.5 mg/dL, or 0.65-0.81 mmol/L), moderate (1-2 mg/dL, or 0.32-0.65 mmol/L), or severe (< 1 mg/dL, or 0.32 mmol/L). Mild to moderately severe hypophosphatemia is usually asymptomatic. Major clinical sequelae usually occur only in severe hypophosphatemia. If severe hypophosphatemia is present for longer than 2-3 days, serious complications can be seen, including rhabdomyolysis, respiratory failure, acute hemolytic anemia, and fatal arrhythmias. [1] It has also been shown to increase mortality by four-fold. [2] Approximately 5% of hospitalized patients have hypophosphatemia, mostly those patients with diabetic ketoacidosis, chronic obstructive pulmonary disease, malignancy, states of malnutrition, and sepsis. As in the cas Continue reading >>

What Is The Science Behind The Ketogenic Diet?

What Is The Science Behind The Ketogenic Diet?

There is a lot of science behind it. This article details 23 peer reviewed studies of it. I’ll break down some of the science behind the diet: Insulin is the primary hormone driving fat burning and fat storage. When the body has high levels of insulin, the tendency is to store things as fat. So, in order to lose weight you want to lower levels of insulin in the body. Low calorie diets also lower insulin, but the ketogenic diet does it simply by the macronutrient content of the diet. The biggest driver of insulin are carbohydrates. By dramatically reducing carbohydrates the body needs to produce less insulin to move the glucose they produce into cells in the body. Fats have almost no insulin impact. By increasing fats in the diet and substituting them for carbohydrates and proteins, you eat without causing great insulin spikes. Ketones Ketones are not some dangerous substance in the body. They are a natural part of human metabolism and everybody has circulating levels of ketones. The key here is again the hormone insulin. Higher levels of insulin mean fewer ketones in the body. The reason non-diabetic people on a ketogenic diet do not get ketoacidosis is that they still have adequate levels of insulin. Type 1 diabetics can get ketoacidosis if they do not have any insulin. Ketones are an alternate fuel for the body. Certain tissues cannot fuel with fat in the body. The brain is a classic example. When you stop consuming glucose producing foods, the body ups the production of ketones. The brain can burn these ketones as a fuel. The science here is centered around the benefits of ketones in the brain. The ketogenic diet has been used for years as a treatment for epilepsy. For some reason a brain fueling with ketones is less likely to trigger seizures. However, there appea 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 >>

Diabetes In Dogs

Diabetes In Dogs

Diabetes-Related Emergencies Diabetes in dogs is treated with insulin, much the same way as it is in humans. But if too much or too little insulin is administered, it can be very dangerous for the animal. What To Watch For Diabetes causes high blood sugar levels and is signaled primarily by excessive urination, excessive drinking, increased appetite and weight loss. In cases where the diabetes is not treated promptly and allowed to progress to the point of a crisis, symptoms may include a loss of appetite, weakness, seizures, twitching, and intestinal problems (diarrhea or constipation). Primary Cause Diabetic emergencies can be caused by either injecting too much or too little insulin, or not treating the diabetes in the first place. Both cases are equally dangerous for the dog and can cause coma or death. In cases where the diabetes is not treated, it can progress to diabetic ketoacidosis, a very serious condition that can cause death of your pet. Diabetic ketoacidosis can also be seen in dogs where the diabetes had been regulated and yet in which another condition has developed affecting the body's ability to regulate the diabetes. Immediate Care If signs of an insulin dosage problem are noticed, it should be treated as an extreme emergency. The following steps may provide aid to your dog until you are able to bring her to a veterinarian (which should be as quickly as possible): Syringe liquid glucose into the dog’s mouth. This can be in the form of corn syrup, maple syrup, honey, etc. If the dog is having a seizure, lift its lips and rub glucose syrup on the gums. Be careful not to get bit. Veterinary Care Depending on the cause of the crisis, dogs suffering from diabetic emergencies may need to be given glucose or insulin intravenously. In cases of diabetic ketoa Continue reading >>

Epilepsy

Epilepsy

Tweet Epilepsy is a neurological condition which only has one visible symptom - repeated seizures, the severity of which can vary from person to person. While epilepsy is most commonly diagnosed during childhood, it can develop at any age, even in people who are over 65 years old. It is possible for people to have type 1 diabetes or type 2 diabetes alongside epilepsy, but the relationship between diabetes and epilepsy is unclear - there is currently a lack of research investigating a link between the two conditions. How do seizures happen? Seizures happen when there is too much electrical activity in groups of neurons in the brain. There are two main types of seizures: generalised and focal. Generalised seizures occur when large areas on both sides of the brain are affected by disruptions to its normal activity. Consciousness can often be lost during generalised seizures. In focal seizures a specific region of the brain is affected, and while consciousness may be altered, it is not always lost. Focal seizures can often present as if a person is daydreaming. Most times people recover quickly from seizures, which normally end within a few minutes. But frequent seizures can severely limit a person’s quality of life – for example, people can be prevented from driving and some might require regular supervision. Diabetes and seizures Seizures that happen as a direct result of diabetes, notably if very low sugar levels occur, are known as non-epileptic seizures. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being Continue reading >>

Understanding And Treating Diabetic Ketoacidosis

Understanding And Treating Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious metabolic disorder that can occur in animals with diabetes mellitus (DM).1,2 Veterinary technicians play an integral role in managing and treating patients with this life-threatening condition. In addition to recognizing the clinical signs of this disorder and evaluating the patient's response to therapy, technicians should understand how this disorder occurs. DM is caused by a relative or absolute lack of insulin production by the pancreatic b-cells or by inactivity or loss of insulin receptors, which are usually found on membranes of skeletal muscle, fat, and liver cells.1,3 In dogs and cats, DM is classified as either insulin-dependent (the body is unable to produce sufficient insulin) or non-insulin-dependent (the body produces insulin, but the tissues in the body are resistant to the insulin).4 Most dogs and cats that develop DKA have an insulin deficiency. Insulin has many functions, including the enhancement of glucose uptake by the cells for energy.1 Without insulin, the cells cannot access glucose, thereby causing them to undergo starvation.2 The unused glucose remains in the circulation, resulting in hyperglycemia. To provide cells with an alternative energy source, the body breaks down adipocytes, releasing free fatty acids (FFAs) into the bloodstream. The liver subsequently converts FFAs to triglycerides and ketone bodies. These ketone bodies (i.e., acetone, acetoacetic acid, b-hydroxybutyric acid) can be used as energy by the tissues when there is a lack of glucose or nutritional intake.1,2 The breakdown of fat, combined with the body's inability to use glucose, causes many pets with diabetes to present with weight loss, despite having a ravenous appetite. If diabetes is undiagnosed or uncontrolled, a series of metab Continue reading >>

Emt Test 3 (ch. 18-21)

Emt Test 3 (ch. 18-21)

Sort TIA Intermittent stroke-like episodes. -develop most of the same signs and symptoms as those who are experiencing a stroke. -key differences between TIA and stroke is that S&S of stroke will disappear and reappear for TIA patients without any permanent neurological deficits. -TIA will typically resolve with-in 1-2 hours after onset; however may last up to 24 hours. -Reversing ischemia will cause signs and symptoms of stroke to disappear. Ketoacidosis A serious diabetes complication where the body produces excess blood acids (ketones) due to the lack of insulin in the blood. -Excessive thirst -Frequent urination -Nausea and vomiting -Abdominal pain -Weakness or fatigue -Shortness of breath -Fruity-scented breath -Confusion Diabetic Ketone Acidosis -Caused by high blood sugar level, usually greater than 350 mg/dL. (DKA) It happens predominantly in those with type 1 diabetes, but it can occur in those with type 2 diabetes under certain circumstances. DKA results from a shortage of insulin; in response the body switches to BURNING FATTY ACIDS (FAT) and producing acidic ketone bodies that cause most of the symptoms and complications. -vomiting, -dehydration, -deep gasping breathing, -confusion and occasionally coma Continue reading >>

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