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Can You Get Brain Damage From Ketoacidosis?

Brain Changes May Accompany Type 1 Diabetes Diagnosis In Kids

Brain Changes May Accompany Type 1 Diabetes Diagnosis In Kids

Complication called ketoacidosis can affect memory, thinking for six months, reports study Please note: This article was published more than one year ago. The facts and conclusions presented may have since changed and may no longer be accurate. And "More information" links may no longer work. Questions about personal health should always be referred to a physician or other health care professional. HealthDay Reporter FRIDAY, May 23, 2014 (HealthDay News) -- A serious complication of type 1 diabetes called diabetic ketoacidosis (DKA) can cause temporary changes to the brain matter of children newly diagnosed with the disease, researchers say. What's more, those changes may cause a decrease in memory and attention that persists for at least half a year following the diagnosis of type 1 diabetes, the new study reports. "Children and adolescents diagnosed with type 1 diabetes with diabetic ketoacidosis have evidence of brain gray matter shrinkage and white matter swelling," said the study's lead author, Dr. Fergus Cameron, head of diabetes services at Royal Children's Hospital in Victoria, Australia. "While these changes resolve within the first week, there are associated residual cognitive changes -- memory and attention -- that are present six months after diagnosis." Even if they're subtle, these variations "have the potential to affect higher-level learning tasks," he added. Each year, approximately 30,000 U.S. adults and children are diagnosed with type 1 diabetes, according to JDRF (formerly the Juvenile Diabetes Research Foundation). And the incidence of type 1 diabetes has increased dramatically in recent years. Type 1 diabetes occurs when the immune system mistakenly destroys the insulin-producing cells in the body. This leaves the person with type 1 diabetes with Continue reading >>

What Happens During A Diabetic Coma

What Happens During A Diabetic Coma

A diabetic coma results from either very high or very low blood glucose levels. This is a life-threatening complication which causes the patient to fall into a state of unconsciousness. The coma is reversible if treated immediately, but if left untreated they may receive permanent brain damage or potentially die. There are three main types of diabetic comas: severe hypoglycemia, diabetic ketoacidosis and diabetic hyperosmolar. Each type of coma can be brought on by excessive food intake, failure to take the proper doses of medication, trauma, illegal drug use, alcohol consumption or infection. Hypoglycemia occurs when the body has insufficient glucose. If the brain does not have enough glucose, it cannot function properly which later causes you to pass out. Diabetic Ketoacidosis is common amongst people with type 1 diabetes and is triggered by the build-up of ketones. Ketones build up when sugar levels are too low and the body begins to burn fat for energy. Diabetic hyperosmolar occurs when your blood sugar is dangerously high, causing your blood to get thick and syrupy. Your body will try to get rid of the excess sugar by passing it in urine. This will cause frequent urination that can lead to dehydration. There are several symptoms that will alert you if your sugar levels are dangerously high or low: Fatigue Sudden and extreme hunger Frequent urination Fruity-smelling breath Shaking or nervousness Irregular heartbeat Confusion If you are experiencing these symptoms check your blood glucose levels right away and seek immediate medical attention. The best way to avoid diabetic comas is through prevention and managing your diabetes. You can manage your diabetes by checking your blood sugar regularly, exercising, sticking to your recommended diet, staying hydrated and tak Continue reading >>

Diabetic Coma Symptoms, What You Need To Know

Diabetic Coma Symptoms, What You Need To Know

Diabetic coma symptoms are something we should all be aware of. It is true that type 1 diabetics are more likely to experience them than type 2, but as diabetics are living longer, the chance of experiencing symptoms is greater. One statistic is that up to 15% of diabetics will go into diabetic coma because of severe hypoglycemia. Coma is another word for unconscious. A diabetic is in a coma if he cannot be wakened and can't respond to sounds and sights. It does not mean the person in a coma will die. These days, with swift blood test results and treatment, a diabetic will come out of a coma very fast. Diabetic medical alert bracelets and necklaces keep us from being misdiagnosed as drunk or epileptic when we cannot speak. But just knowing you are a diabetic is not enough. If you are taken to an emergency room, the doctors look for diabetic alert charms. But diabetic coma symptoms still need to be diagnosed correctly so the proper treatment is started, because there are three different types of coma, and the complications of all three are brain damage and death. Oddly, either chronic high blood sugar or sudden low blood sugar can trigger diabetic coma symptoms. That's why it's good to know how we react to both of them. With high blood sugar, or hyperglycemia, you feel thirsty and have to urinate more often. You feel fatigue, and there is always nausea and vomiting, often for days. You can feel short of breath and have stomach pain. There is a fruity or acetone smell to your breath and a fast heartbeat. The symptoms are not sudden. But low blood sugar comes on very swiftly and can wake you out of a sound sleep. You feel shaky, nervous, tired and either hungry or nauseated. You sweat a lot and your heart races. You can get irritated and even aggressive for no reason, and 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

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 >>

What Can Happen To My Body If My Sugar Is Higher Than 600 For Many Hours?

What Can Happen To My Body If My Sugar Is Higher Than 600 For Many Hours?

Dangerously high blood sugar levels cause ketoacidosis. A blood sugar level over 600 for many hours is considered extremely dangerous and should be treated at a hospital. Hyperglycemia is the medical term for elevated blood sugar levels. According to the American Diabetes Association, blood sugars more than 240 can cause ketoacidosis – a condition where the body starts using fat for energy. Ketoacidosis can lead to coma and death. Video of the Day Ketones And High Blood Sugar When blood sugar levels are high for prolonged periods of time and the body starts using fat for energy, toxic ketones are produced. The presence of ketones can be measured in the urine. They are the acid byproduct of fat breakdown. Diabetes is the most common cause of high blood sugar levels. Hyperglycemia can also be caused by acute pancreatitis. Early symptoms include frequent urination that leads to dehydration and excessive thirst. Blood sugar more than 600 for many hours could then lead to difficulty breathing, weakness, confusion and decreased level of consciousness. Blood sugar levels become dangerously high when the body does not have enough insulin, which is produced in the pancreas. When ketones develop in the body, the liver produces more glucose to correct the problem, but without insulin, blood sugar levels continue to rise. For patients diagnosed with diabetes, ketoacidosis can develop from missed insulin doses, not enough insulin, infection, trauma or other acute illness. Prolonged high blood sugar levels can cause swelling in the brain – cerebral edema. Children are more susceptible, but adult cases have been documented, according to Elliot J. Crane, MD, Departments of Pediatrics and Anesthesiology, Stanford University Medical Center. Other complications include organ damage fr Continue reading >>

Diabetic Coma Recovery: What You Need To Know

Diabetic Coma Recovery: What You Need To Know

In people with diabetes, a diabetic coma occurs when severe levels of either high or low uncontrolled blood sugar are not corrected. If treated quickly, a person will make a rapid recovery from a diabetic coma. However, diabetic coma can be fatal or result in brain damage. It is important for people with diabetes to control their blood sugars and know what to do when their blood sugar levels are not within their target range. The severe symptoms of uncontrolled blood sugar that can come before a diabetic coma include vomiting, difficulty breathing, confusion, weakness, and dizziness. Recovery from diabetic coma If a diabetic coma is not treated within a couple of hours of it developing, it can cause irreversible brain damage. If no treatment is received, a diabetic coma will be fatal. In addition, having blood sugar levels that continue to be too low or too high can be bad for long-term health. This remains true even if they do not develop into diabetic coma. Recognizing the early signs of low or high blood sugar levels and regular monitoring can help people with diabetes keep their blood sugar levels within the healthy range. Doing so will also reduce the risk of associated complications and diabetic coma. What is diabetes? Diabetes is a long-term condition in which the body is unable to control the level of a sugar called glucose in the blood. Diabetes is caused by either a lack of insulin, the body's inability to use insulin correctly, or both. In people who don't have diabetes, insulin usually ensures that excess glucose is removed from the bloodstream. It does this by stimulating cells to absorb the glucose they need for energy from the blood. Insulin also causes any remaining glucose to be stored in the liver as a substance called glycogen. The production of insul Continue reading >>

Complications Of Diabetic Ketoacidosis (dka) And Septic Shock

Complications Of Diabetic Ketoacidosis (dka) And Septic Shock

Hi Dr T, A few weeks ago a family member of mine in her late 60’s who is a brittle diabetic was found unconscious at her home, while sitting up with feet colored white and purple. Blood sugar over 600 but she was responsive and coherent twenty four hours before. The family doctor thought it was due to pneumonia that would cause her blood sugar too spike. All of a sudden normal breathing stopped and cpr was performed. within like 20 seconds and ambulance called, they were there within 3 minutes. It took paramedica a few minutes to get a pulse and she went into the ICU. If there is brain damage would it have made a difference if she was in the er instead of at home or does septic shock just hit suddenly and unexpectedly? Does septic shock just suddenly cause bp to drop and heart to stop? Even with cpr if the hear stops is the brain deprived until it starts on its own? ———- FOLLOW-UP ———- QUESTION: Can DKA cause a heart to stop immediately say withing 90 of a good BP? Also can Septic shock cause a heart to just stop with an unexcptected quick nosedive in BP, say over 10 minutes These are questions for the ICU docs to answer. Infections as well as other medical conditions can cause diabetes to derail (like in her case) and cause a coma. Associated heart problems can be uncovered during such an episode. I have no way of telling whether severe brain damage occurred. Hope this helps, Dr T Follow-up Answer: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication in patients with diabetes mellitus. In some circumstances it may cause a diabetic coma and severe dehydration. If dehydration is so severe, shock (severely decreased blood pressure with insufficient blood supply to the body’s organs) may be the result. If not treated quickly, it may be Continue reading >>

Pediatric Diabetic Ketoacidosis

Pediatric Diabetic Ketoacidosis

Practice Essentials Diabetic ketoacidosis, in pediatric and adult cases, is a metabolic derangement caused by the absolute or relative deficiency of the anabolic hormone insulin. Together with the major complication of cerebral edema, it is the most important cause of mortality and severe morbidity in children with diabetes. Signs and symptoms Symptoms of acidosis and dehydration include the following: Symptoms of hyperglycemia, a consequence of insulin deficiency, include the following: Patients with diabetic ketoacidosis may also have the following signs and symptoms: Cerebral edema Most cases of cerebral edema occur 4-12 hours after initiation of treatment. Diagnostic criteria of cerebral edema include the following: Major criteria include the following: Minor criteria include the following: See Clinical Presentation for more detail. Laboratory studies The following lab studies are indicated in patients with diabetic ketoacidosis: Imaging studies Head computed tomography (CT) scanning - If coma is present or develops Chest radiography - If clinically indicated Electrocardiography Electrocardiography (ECG) is a useful adjunct to monitor potassium status. Characteristic changes appear with extremes of potassium status. See the images below. Consciousness Check the patient’s consciousness level hourly for up to 12 hours, especially in a young child with a first presentation of diabetes. The Glasgow coma scale is recommended for this purpose. See Workup for more detail. Management Replacement of the following is essential in the treatment of diabetic ketoacidosis: Insulin - Continuous, low-dose, intravenous (IV) insulin infusion is generally considered the safest and most effective insulin delivery method for diabetic ketoacidosis Potassium - After initial resuscitatio Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening condition caused by a build-up of waste products called ketones in the blood. It occurs in people with diabetes mellitus when they have no, or very low levels of, insulin. DKA mostly occurs in people with type 1 diabetes, but it can also occur in some people with type 2 diabetes and pregnant women with gestational diabetes. Causes Glucose is an essential energy source for the body's cells. When food containing carbohydrates is eaten, it is broken down into glucose that travels around the body in the blood, to be absorbed by cells that use it for energy. Insulin works to help glucose pass into cells. Without insulin, the cells cannot absorb glucose to use for energy. This leads to a series of changes in metabolism that can affect the whole body. The liver attempts to compensate for the lack of energy in the cells by producing more glucose, leading to increased levels of glucose in the blood, also known as hyperglycaemia. The body switches to burning its stores of fat instead of glucose to produce energy. This leads to a build-up of acidic waste products called ketones in the blood and urine. This is known as ketoacidosis, and it can cause heart rhythm abnormalities, breathing changes and abdominal pain. The kidneys try to remove some of the excess glucose and ketones. However, this requires taking large amounts of fluid from the body, which leads to dehydration. This can cause: Increased concentration of ketones in the blood, worsening the ketoacidosis; Loss of electrolytes such as potassium and salt that are vital for the normal function of the body's cells, and; Signs and symptoms Symptoms of DKA can develop over the course of hours. They can include: Increased thirst; Increased frequency Continue reading >>

Diabetic Ketoacidosis: Information On Causes, Diagnosis & Treatments

Diabetic Ketoacidosis: Information On Causes, Diagnosis & Treatments

Diabetic ketoacidosis (DKA) is a potentially life-threatening diabetes complication caused by the buildup of acids in the bloodstream when cells are unable to retrieve glucose (sugar) required for energy. DKA is often the result of the body not producing sufficient levels of insulin that allows sugar to transfer into the cells. Instead, the glucose builds up in the bloodstream producing dangerous levels of acid. The Cause of DKA Typically, diabetic ketoacidosis is caused when the body does not produce enough insulin and the body is unable to transfer glucose energy from the bloodstream into cells. Instead, the body burns fat for fuel. However, this process causes ketones (acids made by burning fat) to build up in the bloodstream. The high levels of acid can significantly change the chemical balance of the bloodstream and disrupt normal body functioning. Infections can also result in the development of diabetic ketoacidosis because the infectious bacteria can cause the body to produce excessive levels of cortisol, adrenaline and other hormones that affect the production of insulin. These include urinary tract infections and pneumonia. Preventing DKA Who Gets Diabetic Ketoacidosis? Typically, individuals suffering from Type I diabetes have the highest potential risk of developing ketoacidosis. This is because the condition causes the body to make insulin. Instead, the development of ketones can occur when the individual misses a meal, become stressed or sick and or has experiences of insulin reaction. Any problem associated with insulin therapy can trigger diabetic ketoacidosis as can other events including a heart attack, emotional or physical trauma, drug use, alcohol abuse, and taking certain drugs including diuretics and corticosteroids. Additionally, individual suffe Continue reading >>

How To Help Someone In A Coma

How To Help Someone In A Coma

Author's Sidebar: Every once in a while, I'll get a phone call or an email message from a person, who has a relative in the hospital in a diabetic coma. I can usually tell by the tone in their voice that they are desperate, afraid and uncertain what to do. These types of phone calls are difficult, because there's nothing that I can do to help them. Usually, I suggest that the person make sure that they share as much information that they can about the person's health with the doctors and nurses. The more that you know about the person's health, the better it can help the doctors understand what is happening. Another thing that I usually suggest is to keep a notebook or journal of what's going on and ask questions, but be respectful to the medical staff. Use the notebook for taking notes when the doctors tell you things about the patient's condition, etc. Otherwise, you will never remember what was said to relay to other family members. When a large family is involved it gets tiring to keep repeating the same information -- so they can read your notebook. Also, write down all the pertinent phone numbers and emails of people who would need to be contacted when changes in condition occur. There are usually a lot of people who want this information and having email addresses makes it easier than trying to call everyone. Keeping notes is also a good way to keep busy. A journal may not only serve as a method for coping with grief, it may also be helpful for the patient when they come out of the coma -- to realize what happened to them. If the person has a smartphone or similar device, usually I'll suggest that they google phrases like "diabetic coma" to better understand what is going on. If the hospital allows it, bring a small CD player or tape player and play some of the p 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 >>

Diabetic Ketoacidosis And Brain Function

Diabetic Ketoacidosis And Brain Function

Diabetic Ketoacidosis (DKA) is a life-threatening consequence of diabetes. DKA occurs when there is a lack of insulin in the body causing hyperglycemia. As a result of the inability of glucose to enter the cells, the body must find other means to obtain energy. As such, fat breakdown occurs resulting in the accumulation of fatty acids. The fatty acids are metabolized to ketones that cause the blood to become acidotic (pH less than7.3). Because glucose remains in the blood, there is an increase in thirst and drinking to eliminate the solute load of glucose, which also results in increased urination (polyuria and polydipsia). Thus, the combination of increased serum acidity, weight loss, polyuria, and polydipsia may lead to extreme dehydration, coma, or brain damage. Without a doubt, the most severe acute complication of DKA is cerebral edema. Many cases of new onset type 1 diabetes present DKA (15-70 percent depending on age and geographic region, according to multiple studies), hence the importance of an early diagnosis of diabetes in order to avoid potential consequences. Much research is being conducted to predict the development of severe complications of DKA, most notably on brain herniation, the swelling of the brain that causes it to push towards the spinal cord, as well as other neurological consequences. Fulminant cerebral edema, or swelling of the brain, is relatively rare and has an incidence rate of 0.5-0.9 percent. However, what about the subtler, less severe alterations in brain functions that occur after DKA? Indeed, a recent paper published in Diabetes Care 2014; 37: 1554-1562by Cameron, Scratch, Nadebaum, Northum, Koves, Jennings, Finney, Neil, Wellard, Mackay, and Inder on behalf of the DKA Brain Injury Study Group entitled "Neurological Consequences of Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

The Facts Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, most often in those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a fatal coma. DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. It can also occur in people already diagnosed with type 1 diabetes that have missed an insulin dose, have an infection, or have suffered a traumatic event or injury. Although much less common, DKA can occasionally occur in people with type 2 diabetes under extreme physiologic stress. Causes With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take in glucose from the blood. In the case of type 2 diabetes, the pancreas is unable to make sufficient amounts of insulin in order to take in glucose from the blood. Glucose, a simple sugar we get from the foods we eat, is necessary for making the energy our cells need to function. People with diabetes can't get glucose into their cells, so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL) while insulin levels are very low. Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood, causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able Continue reading >>

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