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Can Ketoacidosis Kill You

Diabetic Ketoacidosis

Diabetic Ketoacidosis

A Preventable Crisis People who have had diabetic ketoacidosis, or DKA, will tell you it’s worse than any flu they’ve ever had, describing an overwhelming feeling of lethargy, unquenchable thirst, and unrelenting vomiting. “It’s sort of like having molasses for blood,” says George. “Everything moves so slow, the mouth can feel so dry, and there is a cloud over your head. Just before diagnosis, when I was in high school, I would get out of a class and go to the bathroom to pee for about 10–12 minutes. Then I would head to the water fountain and begin drinking water for minutes at a time, usually until well after the next class had begun.” George, generally an upbeat person, said that while he has experienced varying degrees of DKA in his 40 years or so of having diabetes, “…at its worst, there is one reprieve from its ill feeling: Unfortunately, that is a coma.” But DKA can be more than a feeling of extreme discomfort, and it can result in more than a coma. “It has the potential to kill,” says Richard Hellman, MD, past president of the American Association of Clinical Endocrinologists. “DKA is a medical emergency. It’s the biggest medical emergency related to diabetes. It’s also the most likely time for a child with diabetes to die.” DKA occurs when there is not enough insulin in the body, resulting in high blood glucose; the person is dehydrated; and too many ketones are present in the bloodstream, making it acidic. The initial insulin deficit is most often caused by the onset of diabetes, by an illness or infection, or by not taking insulin when it is needed. Ketones are your brain’s “second-best fuel,” Hellman says, with glucose being number one. If you don’t have enough glucose in your cells to supply energy to your brain, yo Continue reading >>

Is Ketosis Dangerous?

Is Ketosis Dangerous?

Duck Dodgers October 14, 2014 Peter, An article by Per Wikholm was published in this month’s LCHF Magasinet, where Per demonstrates that the Inuit could not have been in ketosis given that the scientific literature is abundantly clear, over and over again, that the Inuit consumed too much protein, and more importantly, Per debunks Stefansson’s claims for high fat with writing from his own books—Stef admitted in the pemmican recipes that Arctic caribou was too lean to make pemmican that supported ketosis. The most popular LCHF bloggers in Sweden, Andreas Eenfeldt/Diet Doctor and Annika Dahlquist have reluctantly agreed with Per’s findings—admitting that the Inuit were likely not ketogenic from their diet. I’ve put together a comprehensive review of the scientific literature regarding the Inuit, encompassing over two dozen studies, spanning 150 years, with references from explorers, including Stefansson. In the comments section of that post, Per gives a brief overview of how he was able to prove Stefansson’s observations on high fat intake were flawed. The post is a review of all the available literature that I could find (over two dozen studies). But, the literature certainly does not in any way support ketosis from the Inuit diet due to such high protein consumption. As Per (and Stefansson) points out, the caribou is too lean and as the many quotes show, the Inuit were saving their blubber and fat for the long dark Winter to power their oil lamps and heat their igloos. Again and again, we see that in the literature, as even Stefansson admits this. As far as glycogen is concerned, their glycogen intake is probably not worth scrutinizing given the well-documented high protein consumption in every published study. It really is besides the point. But, interest Continue reading >>

How To Lower Your Blood Sugar When It's Really High

How To Lower Your Blood Sugar When It's Really High

​This article is written for type 2 diabetics who need help coming down from a very high blood sugar during a single, isolated high blood sugar event. If you want to try an stabilize your baseline, consider signing up for my Baseline Blood Sugar Challenge course. ​THIS ARTICLE IS NOT A SUBSTITUTE FOR REAL MEDICAL ADVICE. If you're a type 2 diabetic and your blood sugar is high right now (greater than 300mg/dL for at least 6 hours), the first thing you should do is call your doctor. So, if you haven't called anyone for help yet, please stop reading this article and call your doctor. If your doctor is able to help, then you need not read on. Also, if you are having symptoms of Diabetic Ketoacidosis, stop reading this article and go to the hospital immediately. Diabetic Ketoacidosis can kill you if left untreated. But. If you're in a situation where your blood sugar has been high for an extended period of time, you could perhaps consider taking the following steps to solve your blood sugar problem. Disclaimer: This is friendly, non-medical advice from a random diabetic person you don't even know, which is a very (very) poor substitute for real, actual medical advice. Use at your own risk. First, you should try and lower your blood sugar without injectable insulin by completing the following steps: 1. Check your blood sugar. Write down the time and your blood sugar level. 2. Drink water (this doesn't actually lower blood sugar, but it helps flush sugar and ketones from your body, if you have them). Continue drinking water, but please don't make yourself sick. 3. Move. As in, walk. Walk around the block or walk in place or haul your ass up and down the stairs for 30-60 minutes. Walking helps your cells become less insulin resistant, which is what you need right now. Do N Continue reading >>

My Encounter With Diabetic Ketoacidosis

My Encounter With Diabetic Ketoacidosis

The Truth Behind My Encounter With Diabetic Ketoacidosis: A day like any other, can turn into a day you’ll never forget) With diabetes comes the good and the bad. When it’s good, it can be REALLY good. But when it’s bad…it can be life-threatening. I’ve certainly had my share of bad days. Trying to battle the high and the lows, and trying to stay as close to normal without losing my sanity. With having diabetes I’ve experienced many symptoms. But one day came symptoms like no other… chills – nausea – vomiting – back pain – weakness – blurred vision … and lots of ketones I had DKA (Diabetic Ketoacidosis) This was years ago, after a night of drinking with friends. Wanting to live a free, independent young adult life. Knowing, yet not knowing how destructive being the slightest bit careless could affect my diabetes. I just felt terrible. To the point where I questioned where to take insulin or not. I thought to myself … Well I don’t really plan on eating today, and I don’t want to worry about dropping “low”. I thought I was saving myself from having to fix my blood sugar. So I missed my morning dose… (Boy, was that a mistake – NEVER – would I do this again) I didn’t know at the time that insulin is needed (with or without food) Even on sick days! Without insulin in my body, my body couldn’t receive the energy to function properly. I kept close eyes on my blood sugar for a few hours that day, which was only in the mid 200’s. I thought that due to the fact I wasn’t eating, my blood sugar would come down eventually anyways. But the symptoms progressed. I couldn’t keep anything down … not even water. To be honest, DKA never came to mind. I’ve always taken my insulin. The only other time was when I was diagnosed, and was mo Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic Ketoacidosis (DKA) is a frightening term for any diabetic. This condition can rapidly kill a diabetic if treatment is not administered immediately. Ketoacidosis can occur in any person for a number of reasons such as alcoholism or starvation, but diabetic ketoacidosis is only found in diabetics, primarily uncontrolled type 1 diabetics. Often times a diabetic is first diagnosed with diabetes when rushed to the ER in severe ketoacidosis. In general ketoacidosis is when the body produces too much ketones, it breaks down fatty acids and these build up in the blood and quite literally the blood becomes toxic and poisonous making the body deathly ill. The build up of acetone in the blood is marked by a sweet almost fruity smell on the breath and sometimes in the sweat. Exactly what causes ketoacidosis in diabetics? When a diabetic is uncontrolled and their blood sugar runs too high over an extended length of time the body recognizes that it is being starved for insulin, so it begins to breakdown fat for energy. This breakdown of fat causes acid to build up in the blood and this leads to ketoacidosis. Oftentimes diabetic ketoacidosis is triggered by illness and/or dehydration. If you are diabetic and have, say, a cold or the flu and your blood sugar has been running higher for a while, you are at high risk of developing ketoacidosis. Always drink plenty of water to avoid becoming dehydrated and ending up sick. Hydration is good for everyone, especially diabetics. What are the symptoms of ketoacidosis? Frequent urination, unquenchable thirst/dry mouth, nausea, vomiting, muscle aches/cramps, dehydration, fruity smell on the breath, high blood sugar, shortness of breath (an uncontrollable fast, shallow breathing). Before the early 1900’s diabetic ketoacidosis was the e Continue reading >>

Diabetic Ketoacidosis (dka) Myths

Diabetic Ketoacidosis (dka) Myths

Recently, I was asked to give a lecture to both my residents and nurses at the University of Texas Health Science Center at San Antonio (UTHSCSA) on some common DKA myths. Now this topic was originally covered by my good friend Anand Swaminathan on multiple platforms and I did ask his permission to create this blogpost with the idea of improving patient care and wanted to express full disclosure of that fact. I specifically covered four common myths that I still see people doing in regards to DKA management: We should get ABGs instead of VBGs After Intravenous Fluids (IVF), Insulin is the Next Step Once pH <7.1, Patients Need Bicarbonate Therapy We Should Bolus Insulin before starting the infusion DKA Myths Case: 25 y/o female with PMH of Type I DM who presents via EMS with AMS. Per EMS report, the patient ran out of her insulin 3 days ago….. Vital Signs: BP 86/52 HR 136 RR 30 O2Sat 97% on room air Temp 99.1 Accucheck: CRITICAL HIGH EMS was not able to establish IV access, so decided to just bring her to the ED due to how sick she looks. Your nurses are on point today and get you two large bore 18G IVs and start to draw blood work to send to the lab. You state I need a blood gas, and the nurse turns to you and asks do you need an ABG or VBG? Myth #1: We should get ABGs instead of VBGs in DKA So you do a literature review and come across two studies that specifically look at ABG vs VBG in an ED population: Study #1: Kelly AM et al. Review Article – Can Venous Blood Gas Analysis Replace Arterial in Emergency Medical Care. Emery Med Australas 2010; 22: 493 – 498. PMID: 21143397 For pH, 3 studies of patients with DKA (265 patients) were reviewed showing a weighted mean difference of 0.02 pH units. Only one study, which was the largest study (200 patients) reported 95% Continue reading >>

How Does Diabetic Ketoacidosis Kill You? – When Does Diabetes Kill

How Does Diabetic Ketoacidosis Kill You? – When Does Diabetes Kill

When Does Diabetes Kill The fear experience of diabetic ketoacidosis the truth behind my encounter with what is dka? Diabetes daily. In respiratory distress and it is what can kill, according to holly brewer, ms rd cde how the diabetic ketoacidosis you check. Diabetes mellitus How long does diabetes take to kill you if it is not treated? . Doc james (talk email contributions) 02 44, 16 July 2009 (utc). Most body cells mainly burn sugar (glucose) for energy. November 19, 2009 dka occurs when there is insufficient insulin in the body, resulting in high blood glucose and too many ketones are present in the bloodstream, making it acidic. In emergency care with the dangers of severe hypoglycemia why is diabetes so dangerous can you manage your diet with ketogenic? . This can happen if you have type 2 diabetes, ketoacidosis is rare, but you may experience very high failure to reach the site of infection fast enough to gobble and kill bacteria. Illness and diabetes research and wellness foundation. The problem comes when you have diabetes and insufficient insulin to move glucose from your bloodstream into the body's cells. August 30, 2016 is a serious condition that will cause you to violently ill can kill. Diabetic ketoacidosis diabetes self management. Myths of diabetic ketoacidosis (dka) r. How diabetic ketoacidosis kills you for a moment bothered me when I read about a strange guy who has her husband (55) newly diagnosed with adult onset diabetes are happy to be sneaky and see their partner slowly himself; I rebelled against from the age of 12 until I met mr at the age of 17, November 2, 2015 myth # 1 we should get abgs instead vbgs in dkaso do literature review meet two studies that specifically 13 of 2010 patients type 1 hypoglycemia frequent episodes can not only ruin, Continue reading >>

High Alert: The Emergency Complications Of Diabetes

High Alert: The Emergency Complications Of Diabetes

Diabetes has become such a chronic long-term condition that it’s easy to forget about the serious acute complications that can arise, which can lead to a coma or death if not treated. There are only two types of emergencies – having very high glucose and having a very low glucose. The warning signs of an looming coma range from a mild headache to hallucinations.. If not identified or treated both types of emergencies can lead to serious irreversible complications including brain damage, kidney failure and death. When your glucose is very very high The fundamental issue in diabetes is raised blood glucose levels. Medically this is called hyperglycaemia. When glucose rises very rapidly or to very high levels, it can result in a diabetic ketoacidotic coma or a hyperglycaemic coma. Diabetic ketoacidotic coma This happens in type 1 diabetes and the high risk people include children and teens. A person can go into a ketoacidotic coma within a few hours. A person in a ketoacidotic crisis presents with: a complete lack of insulin in the body very high glucose levels dehydration break down of muscle abnormal potassium, sodium and other electrolyte levels. Causes of ketoacidotic crisis or coma A person who hasn’t been diagnosed with diabetes as yet Missing an insulin dose Illness such as gastroenteritis, nausea and vomiting Not adjusting insulin when glucose is high What to look out for if you suspect you may be going into a ketoacidotic crisis or coma Shortness of breath Fruity smelling breath Nausea and vomiting Severe fatigue Abdominal pain and headache Thirst Passing urine more often. Danger signs to watch out for Slurred speech Blurred vision Reduced concentration Coma. What you must do if yoususpect you may be going into a ketoacidotic crisis or coma Get to a casualty Continue reading >>

When You Need To Go To The Emergency Room With High Blood Sugars

When You Need To Go To The Emergency Room With High Blood Sugars

My uncle, like all his family, was a bit of a cheapskate. He hated to spend money unless it was absolutely necessary. He was thin and active, having only recently given up a career as a singer and dancer performing weekly on a nationally televised variety show. So when he felt unwell one weekend night, he turned down his wife's suggestion that she drive him to the emergency room and told her he'd wait til Monday when he could see his family doctor. Why waste all that money on an ER visit that was probably unnecessary? As it turned out, he didn't need to see his doctor on Monday. He died that night. He was a few years younger than I am now and the fatal heart attack he experienced was the first symptom he had of our family's odd form of inherited diabetes. But this is why, even though I've inherited the family "cheap" gene, if there's any possibility something dangerous is going on, I head for the ER. Usually it is a waste of money. I was in a small car accident a few weeks ago that left me with nerve pain running up and down my arms and legs. I sat for four hours at our local ER, saw the doctor for five minutes, and was sent home. The diagnosis, whiplash. The treatment, wait and see if it gets worse. The bill? Over $900. I went to the ER because I'd called my family doctor's office and they told me to. Whiplash usually resolves on its own, but occasionally it can cause swelling in your neck that can kill you. I'm not equipped to judge what kind I had, and unlike my uncle, I wasn't about to gamble. So with this in mind, you can understand my reaction when a stranger contacted me recently, after reading my web page, and told me that his blood sugar, which had been normal until very recently, was testing in the 500s on his meter except when his meter wasn't able to give hi Continue reading >>

Transcript: Dr. Joseph Aloi On Treating Diabetic Ketoacidosis With Glucommander Software

Transcript: Dr. Joseph Aloi On Treating Diabetic Ketoacidosis With Glucommander Software

This interview is also available as a video: click here to view. Dr. Joseph Aloi, Wake Forest Baptist Medical Center, Winston-Salem, NC. Steve: This is Steve Freed with Diabetes in Control and we’re here at AACE 2016 and we have with us a special guest who’s been working on some unique projects that we’d like to share with you. Maybe you can start off and tell us a little bit about your background, where you’re at and what kind of practice you have. Dr. Aloi: I’ve been in academic medicine for the last 25 years. I worked in three hospital systems. I started at the University of Virginia and then migrated to Eastern Virginia Medical School, which a lot of the data we’re presenting came through that relationship. And most recently I’m now at Wake Forest where I’m chief of the endocrine section there. But I’ve been working in the area of in-patient glycemic management for about the last 10 years. Steve: Because I noticed on one of your posters that you’re using this new software, fairly new software, to help treat diabetic ketoacidosis. Dr. Aloi: Correct. Steve: How does that work? Dr. Aloi: Patients coming in with diabetic ketoacidosis generally are treated with IV insulin. That’s standard of care. There are some other models for that. And what we were doing at Eastern Virginia Medical School was looking at treating patients coming in with Glucommander, which is a computer dosing algorithm for IV insulin and we had good experience with using Glucommander both in decreasing length of stay and decreasing rates of hypoglycemia. So we had a small group of information and then we combined that with looking at other medical centers. We partnered with Emory, Atlantic Diabetic Consultants, Sentara Healthcare system and then we were able to pull out almost 2, Continue reading >>

How Does Diabetic Ketoacidosis Kill You

How Does Diabetic Ketoacidosis Kill You

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Dka Diabetic Ketoacidosis Can Kill

Dka Diabetic Ketoacidosis Can Kill

Diabetic Ketoacidosis (DKA) Diabetic ketoacidosis (DKA) is a life-threatening complication in patients with untreated diabetes mellitus. Here are some resources about DKA: -DKA Wikipedia Page: -DKA Medline Plus page: Continue reading >>

Can Diabetes Kill You?

Can Diabetes Kill You?

Here’s what you need to know about the life-threatening diabetes complication called diabetic ketoacidosis. Diabetic ketoacidosis is one of the most serious complications of diabetes. Symptoms can take you by surprise, coming on in just 24 hours or less. Without diabetic ketoacidosis treatment, you will fall into a coma and die. “Every minute that the person is not treated is [another] minute closer to death,” says Joel Zonszein, MD, professor of medicine at Albert Einstein College of Medicine in New York City. Diabetic ketoacidosis occurs when your body doesn’t produce enough insulin. (Diabetic ketoacidosis most often affects people with type 1 diabetes, but there is also type 2 diabetes ketoacidosis.) Without insulin, sugar can’t be stored in your cells to be used as energy and builds up in your blood instead. Your body has to go to a back-up energy system: fat. In the process of breaking down fat for energy, your body releases fatty acids and acids called ketones. Ketones are an alternative form of energy for the body, and just having them in your blood isn’t necessarily harmful. That’s called ketosis, and it can happen when you go on a low-carb diet or even after fasting overnight. “When I put people on a restricted diet, I can get an estimate of how vigorously they’re pursuing it by the presence of ketones in the urine,” says Gerald Bernstein, MD, an endocrinologist and coordinator of the Friedman Diabetes Program at Lenox Hill Hospital in New York City. RELATED: The Ketogenic Diet Might Be the Next Big Weight Loss Trend, But Should You Try It? But too many ketones are a problem. “In individuals with diabetes who have no or low insulin production, there is an overproduction of ketones, and the kidneys can’t get rid of them fast enough,” sa Continue reading >>

Diabetic Ketoacidosis In Cats

Diabetic Ketoacidosis In Cats

Diabetic ketoacidosis requires urgent veterinary treatment. With ketoacidosis, the lack of insulin causes the body to burn fat and muscle creating ketones. The kidneys are unable to filter all of the ketones from the blood. As a result, these ketones build up in the bloodstream, turning the blood extremely acidic. This is a dangerous stage of diabetes that causes blood chemical and blood sugar imbalances, and also impairs brain function. Left untreated, diabetic ketoacidosis can lead to diabetic coma and death. Understanding Diabetes Mellitus Diabetes mellitus is more commonly referred to as diabetes. With this disease, the feline's pancreas fails to properly regulate the flow of insulin within the body. Without the proper levels of insulin, the cat eats more, but fats and protein break down into energy, so the cat loses weight. Sugar levels within the blood skyrocket and are released in the urine. Cats often require insulin injections to maintain healthy blood sugar levels. With non-insulin dependent diabetes, diet, weight loss and exercise may be enough to keep blood sugar levels down. If a cat's blood sugar levels are properly monitored, a cat with diabetes is unlikely to face any serious health issues. If diabetic ketoacidosis does occur, call your vet immediately. Signs of Diabetic Ketoacidosis The most common signs of ketoacidosis in cats are excessive thirst and frequent urination. However, you should also watch for: Breath smells of nail polish remover/acetone Excessive appetite Vision changes/blindness Vomiting Weakness Weight loss Ketoacidosis can occur with an infection or illness. It can also happen if the insulin amounts need altering. Your vet will find a cause and create a new treatment plan you will follow at home. Diagnosis and Treatment When you bring Continue reading >>

Drunk Versus Diabetes: How Can You Tell?

Drunk Versus Diabetes: How Can You Tell?

Dispatch calls your EMS unit to the side of a roadway, where police officers have detained a driver on suspicion of driving under the influence of alcohol intoxication. You find the female driver handcuffed in the back seat of a police cruiser. She is screaming profanities and hitting her head against the side window. An officer tells you that she was weaving in and out of traffic at highway speed, and it took several minutes to pull her over. She was noncooperative and it took several officers to subdue her. She sustained a laceration to her head, which the officers want you to evaluate. The woman continues to swear at you as you open the car door. You note that she is diaphoretic and breathing heavily. You can smell what appears to be the sour, boozy smell of alcohol, even though you are not close to her. You can see that the small laceration near the hairline on her right forehead has already stopped bleeding. Her speech is slurred and she appears to be in no mood to be evaluated. The police officers are ready to take her down to the station to be processed for driving under the influence. Sound familiar? It should — this is a scene that is played out often in EMS systems. While it may seem initially that these incidents are not medical in nature, they really deserve close attention by the EMS personnel. In this article we will focus on the challenges of evaluating a patient who is intoxicated versus a patient who is experiencing an acute diabetic emergency. There have been numerous instances where EMS providers have exposed themselves to serious liability secondary to medical negligence. Let's take a closer look. Diabetes Diabetes is a serious disease that affects nearly 29 million people in the United States [1]. Advances in diabetic care have resulted in an impr Continue reading >>

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