diabetestalk.net

Can Ketoacidosis Cause Stroke

Complications Of Type 1 Diabetes

Complications Of Type 1 Diabetes

Hypoglycemia is low blood sugar, usually 50-60 milligrams per deciliter (mg/dL) or 2.8-3.3 millimoles per liter (mmol/L). It can be caused by any of the following: Taking too much insulin for the amount of food you ate Taking too much insulin to treat "fasting" blood sugar Skipping a meal or eating a smaller meal than usual without lowering your insulin dose Exercising harder or longer than normal without lowering your insulin dose Hypoglycemia can be managed fairly easily if you are able to recognize the symptoms and treat it right away. The symptoms of hypoglycemia include: Shakiness Sweating Rapid heart rate Lightheadedness Headache Hunger Pale skin color Sudden moodiness or behavior change, such as crying for no apparent reason Clumsy or jerky movements Confusion or difficulty paying attention Tingling sensations around the mouth Passing out leading to coma If you think you are hypoglycemic, test your blood with your blood glucose monitor. If your blood glucose level is below your normal range, treat the hypoglycemia. (If you do not know what your normal blood sugar range is, ask your doctor). Or, if you recognize the symptoms of low blood sugar, you may want to treat it immediately, without waiting to test. If you are just starting treatment, you may feel some of these symptoms when your blood sugar level is close to the normal range for you. This is called relative hypoglycemia. This happens because your body is adjusting from a high blood sugar level to a lower, more normal level. In this case, it is important that you test your level if you feel these symptoms. By testing your blood sugar, you can avoid treating a normal level. If you have had diabetes for a long time or have frequent hypoglycemia, you may lose the ability to sense hypoglycemia with these sympto Continue reading >>

Dka And Thrombosis

Dka And Thrombosis

Josephine Ho and associates1 report an unfortunate case of a 6-year-old girl with diabetic ketoacidosis (DKA) and thromboembolic stroke. Although the authors do a credible job of describing the diverse causes of pediatric stroke and the controversies surrounding treatment of children, there was little emphasis on the danger of extreme hyperosmolar states and risks of thrombosis. More information about the initial presentation of the patient, with specific reference to the concentration of serum sodium and serum osmolarity, would have been helpful in determining her risks of thrombosis. Diabetes is associated with a prothrombotic state through a number of mechanisms.2 The mostly adult entity of hyperosmolar nonketotic coma has had various degrees of association with thrombosis,2,3 as has extreme hypernatremia in breast-feeding neonates.4 Recent evidence has also demonstrated that among children with DKA, there is a higher incidence of deep venous thrombosis with femoral central venous lines.5,6 Serum glucose and sodium concentrations and hence effective plasma osmolarity were significantly higher in those patients with blood clots.5 Although there is no direct evidence for its efficacy, our practice has been to use prophylactic anticoagulation in patients with DKA who are in a significant hyperosmolar state, as well as to eliminate the use of femoral catheters in patients with these risk factors. There is significant controversy surrounding the dose of anticoagulant therapy, specifically whether the efficacy of dosages for prophylaxis of deep venous thrombosis outweighs the risks associated with full systemic anticoagulation.7 As with most clinical issues, particularly in pediatric critical illness, this controversy lends itself well to a clinical trial in patients with Continue reading >>

What You Should Know About Diabetic Ketoacidosis

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious condition that can occur in diabetes. DKA happens when acidic substances, called ketones, build up in your body. Ketones are formed when your body burns fat for fuel instead of sugar, or glucose. That can happen if you don’t have enough insulin in your body to help you process sugars. Learn more: Ketosis vs. ketoacidosis: What you should know » Left untreated, ketones can build up to dangerous levels. DKA can occur in people who have type 1 or type 2 diabetes, but it’s rare in people with type 2 diabetes. DKA can also develop if you are at risk for diabetes, but have not received a formal diagnosis. It can be the first sign of type 1 diabetes. DKA is a medical emergency. Call your local emergency services immediately if you think you are experiencing DKA. Symptoms of DKA can appear quickly and may include: frequent urination extreme thirst high blood sugar levels high levels of ketones in the urine nausea or vomiting abdominal pain confusion fruity-smelling breath a flushed face fatigue rapid breathing dry mouth and skin It is important to make sure you consult with your doctor if you experience any of these symptoms. If left untreated, DKA can lead to a coma or death. All people who use insulin should discuss the risk of DKA with their healthcare team, to make sure a plan is in place. If you think you are experiencing DKA, seek immediate medical help. Learn more: Blood glucose management: Checking for ketones » If you have type 1 diabetes, you should maintain a supply of home urine ketone tests. You can use these to test your ketone levels. A high ketone test result is a symptom of DKA. If you have type 1 diabetes and have a glucometer reading of over 250 milligrams per deciliter twice, you should test your urine for keton Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Introduction Diabetic ketoacidosis (DKA) is a dangerous complication of diabetes caused by a lack of insulin in the body. Diabetic ketoacidosis occurs when the body is unable to use blood sugar (glucose) because there isn't enough insulin. Instead, it breaks down fat as an alternative source of fuel. This causes a build-up of a by-product called ketones. Most cases of diabetic ketoacidosis occur in people with type 1 diabetes, although it can also be a complication of type 2 diabetes. Symptoms of diabetic ketoacidosis include: passing large amounts of urine feeling very thirsty vomiting abdominal pain Seek immediate medical assistance if you have any of these symptoms and your blood sugar levels are high. Read more about the symptoms of diabetic ketoacidosis. Who is affected by diabetic ketoacidosis? Diabetic ketoacidosis is a relatively common complication in people with diabetes, particularly children and younger adults who have type 1 diabetes. Younger children under four years of age are thought to be most at risk. In about 1 in 4 cases, diabetic ketoacidosis develops in people who were previously unaware they had type 1 diabetes. Diabetic ketoacidosis accounts for around half of all diabetes-related hospital admissions in people with type 1 diabetes. Diabetic ketoacidosis triggers These include: infections and other illnesses not keeping up with recommended insulin injections Read more about potential causes of diabetic ketoacidosis. Diagnosing diabetic ketoacidosis This is a relatively straightforward process. Blood tests can be used to check your glucose levels and any chemical imbalances, such as low levels of potassium. Urine tests can be used to estimate the number of ketones in your body. Blood and urine tests can also be used to check for an underlying infec Continue reading >>

Diabetic Coma

Diabetic Coma

Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency.[1] Three different types of diabetic coma are identified: Severe low blood sugar in a diabetic person Diabetic ketoacidosis (usually type 1) advanced enough to result in unconsciousness from a combination of a severely increased blood sugar level, dehydration and shock, and exhaustion Hyperosmolar nonketotic coma (usually type 2) in which an extremely high blood sugar level and dehydration alone are sufficient to cause unconsciousness. In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious patient about whom nothing is known except that they have diabetes. An example might be a physician working in an emergency department who receives an unconscious patient wearing a medical identification tag saying DIABETIC. Paramedics may be called to rescue an unconscious person by friends who identify them as diabetic. Brief descriptions of the three major conditions are followed by a discussion of the diagnostic process used to distinguish among them, as well as a few other conditions which must be considered. An estimated 2 to 15 percent of diabetics will suffer from at least one episode of diabetic coma in their lifetimes as a result of severe hypoglycemia. Types[edit] Severe hypoglycemia[edit] People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia. It is usually mild enough to reverse by eating or drinking carbohydrates, but blood glucose occasionally can fall fast enough and low enough to produce unconsciousness before hypoglycemia can be recognized and reversed. Hypoglycemia can be severe enough to cause un 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 >>

Invokana Ketoacidosis Lawsuit

Invokana Ketoacidosis Lawsuit

Anyone who took Invokana and suffered heart attack, stroke, kidney failure or ketoacidosis. Attorneys across the country are speaking with Invokana users and their loved ones to determine whether lawsuits can be filed against the drug's maker, Janssen Pharmaceuticals. The attorneys have reason to believe Invokana is causing serious health problems due to a defect in its design. They also suspect the maker of Invokana didn't properly warn patients about the drug's risks. If you or a loved one has taken Invokana and suffered a serious injury, get in touch with us today by filling out the form on this page. After sending us your information, an attorney may reach out to you to learn more about what happened and to help determine whether you can file a lawsuit. It costs nothing to contact ClassAction.org or to speak with an attorney. Also, there's no obligation to take legal action after speaking with a lawyer. A lawsuit can help provide compensation for medical bills, lost earnings and, in the event of death, funeral expenses. It can also help hold Janssen Pharmaceuticals accountable for selling an allegedly defective drug. Attorneys across the country are speaking with Invokana users and their loved ones to determine whether lawsuits can be filed against the drug’s maker, Janssen Pharmaceuticals. Reports have surfaced that the type 2 diabetes drug can lead to ketoacidosis, a serious condition that causes the body to produce too much acid in the blood. One study required by the FDA also found that Invokana users had a 690% greater risk of suffering cardiovascular damage. If you or a loved one suffered any of the following side effects after taking Invokana, you may be able to sue the manufacturer for medical bills and other expenses: To learn more about filing a lawsuit, Continue reading >>

Diabetic Ketoacidosis-associated Stroke In Children And Youth

Diabetic Ketoacidosis-associated Stroke In Children And Youth

Copyright © 2011 Jennifer Ruth Foster et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Diabetic ketoacidosis (DKA) is a state of severe insulin deficiency, either absolute or relative, resulting in hyperglycemia and ketonemia. Although possibly underappreciated, up to 10% of cases of intracerebral complications associated with an episode of DKA, and/or its treatment, in children and youth are due to hemorrhage or ischemic brain infarction. Systemic inflammation is present in DKA, with resultant vascular endothelial perturbation that may result in coagulopathy and increased hemorrhagic risk. Thrombotic risk during DKA is elevated by abnormalities in coagulation factors, platelet activation, blood volume and flow, and vascular reactivity. DKA-associated cerebral edema may also predispose to ischemic injury and hemorrhage, though cases of stroke without concomitant cerebral edema have been identified. We review the current literature regarding the pathogenesis of stroke during an episode of DKA in children and youth. 1. Introduction Type 1 diabetes mellitus (T1DM) is a common autoimmune condition that often presents in childhood and may be complicated by episodes of diabetic ketoacidosis (DKA). DKA is a state of severe insulin deficiency, either absolute or relative, resulting in hyperglycemia, ketonemia, acidemia, and systemic inflammation. Compared with adults, episodes of DKA in children carry a higher risk of morbidity and mortality. This is predominantly attributable to intracerebral complications [1–5], which occur in 3–10 pediatric patients per 1000 cases of DKA [6]. The most common Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Print Overview Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care. Symptoms Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: Excessive thirst Frequent urination Nausea and vomiting Abdominal pain Weakness or fatigue Shortness of breath Fruity-scented breath Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: High blood sugar level (hyperglycemia) High ketone levels in your urine When to see a doctor If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit. Contact your doctor immediately if: You're vomiting and unable to tolerate food or liquid Your blood sugar level is higher than your target range and doesn't respond to home treatment Your urine ketone level is moderate or high Seek emergency care if: Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 mill 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 >>

Hyperglycemia And Hypoglycemia In Stroke

Hyperglycemia And Hypoglycemia In Stroke

Practice Essentials Preexisting hyperglycemia worsens the clinical outcome of acute stroke. Nondiabetic ischemic stroke patients with hyperglycemia have a 3-fold higher 30-day mortality rate than do patients without hyperglycemia. In diabetic patients with ischemic stroke, the 30-day mortality rate is 2-fold higher. [1] With regard to hypoglycemia, the condition can mimic acute stroke or symptoms of transient ischemic attack (TIA). [2, 3, 4, 5] Signs and symptoms Hyperglycemia in stroke Patients may come to the attention of clinicians because of preexisting diabetes mellitus Diabetes may also be seen with other risk factors for stroke, such as hypertension and hypercholesterolemia High glycemic levels may also be seen in the setting of an acute stroke without a history of diabetes, presumably due to a sympathetic response to the infarct Retinopathy, neuropathy, and peripheral vascular disease may be found in patients with long-standing diabetes Hypoglycemia in strokelike occurrences In the literature, signs of an acute stroke, such as hemiplegia, aphasia, and cortical blindness, have been reported with hypoglycemia. In individuals presenting with low glycemic levels and strokelike symptoms, diabetes mellitus may have been previously diagnosed, and recent changes in the doses of hypoglycemic agents and insulin may have been instituted. In particular, aggressively tight glucose control, either patient driven or clinician directed, may give rise to chronic or recurrent episodes of hypoglycemia. However, if factitious hypoglycemia is suspected, such behavior may have manifested earlier as similar episodes or other factitious behaviors. Symptoms caused by hypoglycemia can occur suddenly and fluctuate, suggesting a vascular etiology. Diagnosis Laboratory studies In the settin Continue reading >>

Diabetes, Heart Attack Risk And Diabetic Ketoacidosis

Diabetes, Heart Attack Risk And Diabetic Ketoacidosis

People with diabetes have heart attacks or strokes more than twice as often as people without diabetes. 1 In addition, two out of three people with diabetes eventually die from these conditions, according to the American Diabetes Association. 2 Heart Disease Risk Factors According to the Centers for Disease Control and Prevention (CDC), if you have diabetes your risk of death by heart disease may be two to four times greater than for someone who doesn’t have diabetes. 3 The American Heart Association cites the same statistic, adding that at least 68 percent of people with diabetes who are older than 65 years of age die of heart disease. 4 Other risks for heart disease include high LDL cholesterol levels, high blood pressure (hypertension), and high triglyceride levels, according to the CDC. 5 Many people with diabetes also have a combination of other risk factors: low HDL cholesterol, obesity and a sedentary lifestyle. 6 High Blood Sugar and Heart Disease Over time, high blood sugar may lead to increased fatty deposits on blood vessel walls, affecting blood flow and increasing the chance of blood vessel hardening. This is according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH). 7 Heart Attack Warning Signs The risk of having a heart attack is higher for diabetics and diabetics who have already suffered one heart attack have an even greater risk of having a second. NIDDK mentions some important warning signs that may indicate you might be experiencing a heart attack, such as chest, arm, jaw, neck, back or stomach pain. 8 Other possible symptoms of a heart attack include shortness of breath, nausea, sweating and lightheadedness. 9 Reducing Your Risks as a Diabetic If you have diabetes, th Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic acidosis is a life-threatening condition that can occur in people with type 1 diabetes. Less commonly, it can also occur with type 2 diabetes. Term watch Ketones: breakdown products from the use of fat stores for energy. Ketoacidosis: another name for diabetic acidosis. It happens when a lack of insulin leads to: Diabetic acidosis requires immediate hospitalisation for urgent treatment with fluids and intravenous insulin. It can usually be avoided through proper treatment of Type 1 diabetes. However, ketoacidosis can also occur with well-controlled diabetes if you get a severe infection or other serious illness, such as a heart attack or stroke, which can cause vomiting and resistance to the normal dose of injected insulin. What causes diabetic acidosis? The condition is caused by a lack of insulin, most commonly when doses are missed. While insulin's main function is to lower the blood sugar level, it also reduces the burning of body fat. If the insulin level drops significantly, the body will start burning fat uncontrollably while blood sugar levels rise. Glucose will then begin to show up in your urine, along with ketone bodies from fat breakdown that turn the body acidic. The body attempts to reduce the level of acid by increasing the rate and depth of breathing. This blows off carbon dioxide in the breath, which tends to correct the acidosis temporarily (known as acidotic breathing). At the same time, the high secretion of glucose into the urine causes large quantities of water and salts to be lost, putting the body at serious risk of dehydration. Eventually, over-breathing becomes inadequate to control the acidosis. What are the symptoms? Since diabetic acidosis is most often linked with high blood sugar levels, symptoms are the same as those for diabetes Continue reading >>

Diabetes And Stroke

Diabetes And Stroke

Tweet Stroke is a condition in which blood supply to be the brain is affected. A stroke can sometimes lead to permanent damage including communication problems, paralysis and visual problems. The risk factors of stroke are similar to the risk factors for heart problems. Statistically, people with diabetes have a higher risk of dying from heart disease and stroke than the general population. By maintaining stable blood glucose, blood pressure and cholesterol, people with diabetes can increase their chances of preventing a stroke. What is a stroke? Stroke occurs when blood supply to the brain is interrupted and brain tissue is damaged. The two main types of stroke are: Ischaemic - where a blood clot forms in the brain. This accounts for about 8 out of 10 instances of stroke. Haemorrhagic - whereby a blood vessel in the brain bursts and causes a brain haemorrhage. Stroke can be especially damaging physically, but may also cause mental problems with thought or speech. What are stroke symptoms? The warning signs of a stroke are given the acronym FAST: Face - stroke will often affect muscles on one side of the face causing the mouth or eyes to droop down in contrast with the unaffected side Arms - a person having had a stroke may be unable to hold up one of their arms Speech - slurred speech may be a sign of a stroke Time - refers to the need for urgent action, call 999 immediately if one or more of the symptoms are present Other symptoms of a stroke may include: Sudden numbness or weakness on one side of the body Confusion Trouble seeing Dizziness Loss of balance Double vision Severe headache Sometimes people may experience a stroke without being fully aware that they have had one. This kind of stroke is called a transient ischaemic attack (TIA) and is sometimes referred to 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 >>

More in ketosis