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Canagliflozin Euglycemic Dka

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What is DIABETIC CARDIOMYOPATHY? What does DIABETIC CARDIOMYOPATHY mean? DIABETIC CARDIOMYOPATHY meaning - DIABETIC CARDIOMYOPATHY definition - DIABETIC CARDIOMYOPATHY explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic cardiomyopathy is a disorder of the heart muscle in people with diabetes. It can lead to inability of the heart to circulate blood through the body effectively, a state known as heart failure, with accumulation of fluid in the lungs (pulmonary edema) or legs (peripheral edema). Most heart failure in people with diabetes results from coronary artery disease, and diabetic cardiomyopathy is only said to exist if there is no coronary artery disease to explain the heart muscle disorder. One particularity of DCM is the long latent phase, during which the disease progresses but is completely asymptomatic. In most cases, DCM is detected with concomitant hypertension or coronary artery disease. One of the earliest signs is mild left ventricular diastolic dysfunction with little effect on ventricular filling. Also, the diabe

A Case Of Euglycemic Diabetic Ketoacidosis Due To Canagliflozin Complicated By Takotsubo Cardiomyopathy

A Case of Euglycemic Diabetic Ketoacidosis due to Canagliflozin Complicated by Takotsubo Cardiomyopathy Muzammil Khan , Shaza Khalid, Asghar Marwat, Hassan Mehmood American Journal of Medical Case Reports. 2018, 6(1), 1-3. DOI: 10.12691/ajmcr-6-1-1 Sodium-glucose co-transporter-2 (SGLT-2) inhibitor is the latest class of anti diabetic medication that improves glycemic control in insulin independent fashion by increasing urinary loss of filtered glucose. Since its introduction in 2013, several cases of euglycemic DKA have been reported in patients being treated with SGLT-2 inhibitors. Blood glucose levels in range lower than expected for DKA makes the diagnosis challenging if clinical suspicion for euglycemic DKA is not high. We report a case of a patient being treated with canagliflozin who presented with DKA, AKI and mild hyperglycemia that was complicated by stress-induced cardiomyopathy. Keywords: sodium-glucose co-transporter-2 (SGLT-2) inhibitor euglycemic DKA In March 2013, first Sodium-glucose co-transporter-2 (SGLT-2) inhibitor, canagliflozin, was approved for the treatment of type 2 diabetes mellitus by the US food and drug agency (FDA) (1). SGLT-2 inhibitors reversibly i Continue reading >>

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  1. Stephanie A.

    Help!
    I love PB and will lose steadily in ketosis... but I suffer from terrible insomnia. It takes a long time to fall asleep, I don't sleep soundly and wake up multiple times a night getting only around 4 hours of sleep. This will go on for weeks... until I eat more carbohydrate, kick myself out of ketosis and weight loss stalls.
    How do I continue to lose weight, get the great benefits of PB and sleep? It only takes about 80g - 100g of carbs a day for me to stop losing. Plus, it is hard to get that much from veggies. Adding in more than 1/2 cup of berries a day or adding starch brings the binge monster out. For me the carbs are more of an all or nothing proposition. I feel great at 40-50 net a day from one small fruit serving and the rest from veggies.
    Background: 46, female, BMI just fell below 30 last week (yay!). I have lost 70+ pounds over the last 14 months or so with another 40-50 to go. I am extremely carb sensitive both relative to weight and food reward/binge cycle eating.
    Is anyone else experiencing the same thing? Has anyone figured out the answer? After about 10 days of poor sleep, I get pretty cranky and have trouble focusing at work.
    Thanks much!

  2. quelsen

    magnesium, vitamin d, sodium. check those

  3. namelesswonder

    Have you tried non-fruit options to increase carbs, like the occasional serving of white rice or some starches like sweet potato? Plenty of winter squash options as well, as those are fairly high-carb. Maybe this will not trigger a binge as much, since there's less sugar than fruit.

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A Can't Miss Ed Diagnosis: Euglycemic Dka

The FDA has approved these three SGLT2 inhibitors for Type 2 diabetics, and at times, they are prescribed off-label for Type 1. The mechanism involves decreasingglucose reabsorption in the nephrons proximal tubule (via inhibition of the sodium-glucose linked cotransporter-2 protein). This results in increased urinary excretion of glucose that is independent of the bodys insulin secretion.1 Other potential benefits of this class of medications include:13 In 2015 the FDA issued a warning, however, that SGLT2 inhibitors may cause ketoacidosis, urinary tract infections, and urosepsis.4 Since then, multiple case reports have been published showing an association between SGLT2 inhibitors and the development of euglycemic DKA. Euglycemic DKA is an uncommon and likely under-diagnosed phenomenon, best defined as DKA with alower than expected blood glucose (less than 250 mg/dL according to the American Diabetes Association).46 Potential precipitants, in addition to SGLT2 inhibitors, include:7 EPs may delay diagnosis, given the modest glucose levels at the time of presentation. This, however, is false reassurance because DKA is not defined by an absolute blood glucose. Interestingly, patient Continue reading >>

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  1. HannahMarie

    Hey guys! I am a newbie to the Whole30 and I am on my day 9 and doing pretty well. Except I have noticed that my urine is very, very yellow. (This is my biggest concern + the clammy taste in my mouth).
    Obviously I know the childhood adage that I am probably not getting enough water, so this post may be moot. But I was wondering if the Whole30 veterans could shed some light? Is this is a sign that I am not hydrating enough? I have uped my water dosage, but its still happening.
    I have never been one of those people that's glued to their water bottle. And I am drinking sparkling water to jazz it up at the moment.
    Any thoughts? suggestions? I really need help with this. I am trying to train my brain to drink water instead of snack, but that is hard as well. Any advice would be great!

  2. Samphire

    On April 9, 2013 at 7:42 PM, Samphire said:

    B vitamins make your wee bright yellow. Have you increased the amount of meet you're eating, or recently eaten liver?
    Or even taken a multivitamin?
    B vitamins make your wee bright yellow. Have you increased the amount of meat you're eating, or recently eaten liver?
    Or even taken a multivitamin?

  3. Kirsteen

    The only reasons I know for it to be bright yellow are either it's too concentrated i.e. you're not drinking enough, or you've taken something with B vitamins in it. Outwith that, I have no idea.

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There is no shortage of treatments available for the treatment of type 2 diabetes, but a new medication could change the way some patients manage their disease and could have even further reaching effects in the future.

A Case Of Canagliflozin Induced Euglycemic Diabetic Ketoacidosis: Rare But Significant

Keywords: Canagliflozin , Dka , Euglycemic DKA , Invokana , SGLT2 Inhibitor Case Presentation: A 54 year-old woman with a past medical history of hypertension and Type 2 diabetes mellitus treated with metformin and canagliflozin presented to the hospital with lethargy and malaise. She reported that her blood glucose was stable over the past 2 weeks with fingerstick glucoses ranging from 100-130mg/ dL. She had been vomiting the day prior to presentation with decreased oral intake. She denied alcohol use. Physical exam was significant for tachycardia, tachypnea, and lethargy. Her fingerstick glucose was 245 mg/dL and labs were notable for leukocytosis to 20.91 k/uL, sodium 121mmol/L, and high anion gap metabolic acidosis with bicarbonate of 11mmol/L, blood pH of 6.9, and elevated beta-hydroxybutyrate to 9.4 mmol/L. Her HgbA1c was 8.8%. Respiratory viral panel was positive for enterovirus. She was intubated for airway protection due to worsening lethargy and admitted to the intensive care unit for euglycemic diabetic ketoacidosis (DKA). The patient was treated with dextrose-based IV fluids, insulin drip and bicarbonate drip until her anion gap closed. She was then transitioned to bas Continue reading >>

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  1. Stefan fG

    Hi there,
    I looseley follow a few "Fitness and Muscle" - Guys on Youtube etc.
    They are into intermittent fasting etc. but their main theme for "getting lean" is always the often discussed "calorie deficit"..
    This is not too important for my question but gives you and idea about their philosophy.
    NOW... one of them stated that he is AGAINST low carb/ketogenic diets for building muscle/leaning down because
    low carbohydrate intake reduces testosterone by ~30%
    plus obvious downsides like lower libido, lower muscle-building-capacity etc.
    ---
    Is this true? Has anyone a well diversed opinion on this? Are there good studies you know of?
    Kind regards

  2. jmh

    a lot of general good testosterone info in this thread already,
    http://forum.bulletproofexec.com/index.php?/topic/15262-low-testosterone-and-low-lutenizing-hormone/
    to answer your question, yes free T goes down on low carb diet, since insulin is inversely related to SHBG
    funny it was just discussed in this podcast
    http://chriskresser.com/the-keys-to-longevity-with-peter-attia/
    http://www.anabolicmen.com/carbohydrates-testosterone/
    http://www.anabolicmen.com/testosterone-plan/
    http://www.testshock.com/forget-about-atkins-why-carbs-are-essential-for-testosterone-production/

  3. Stefan fG

    Thx a lot!
    Now - the "reference study" for all the "low carb diets are bad because they lower testosterone"-guys (pulled from your link: http://www.anabolicmen.com/carbohydrates-testosterone/)seems to be this one:
    http://www.ncbi.nlm.nih.gov/pubmed/3573976
    which states that: "Testosterone concentrations in seven normal men were consistently higher after ten days on a high carbohydrate diet (468 +/- 34 ng/dl, mean +/- S.E.) than during a high protein diet (371 +/- 23 ng/dl, p less than 0.05) and were accompanied by parallel changes in sex hormone binding globulin (32.5 +/- 2.8 nmol/l vs. 23.4 +/- 1.6 nmol/l respectively, p less than 0.01)."
    What I find VERY curious is that the conclusion is supposed to be that "low carbohydrate diets lower testosterone" instead of
    "high protein diets lower testosterone"....?!
    Also the author of the blog states that:
    "Fortunately the above is a load of bullshit, because weight loss is all about energy balance. If you consume more calories than you burn, you gain weight. If you consume less calories than you burn, you lose weight. There’s a mounting pile of scientific evidence to prove this fact, and anyone who tells you that you could bend this law of physics by tricking around with macro nutrients, is a nutcracker."
    which is, as all avid Bulletproof-fanboys know, WRONG ... considering all the studies/knowledge related to gut microbes/antibiotics/microbiome/insulin etc. pp.
    I find it curious that even interested guys like the blog author have not gotten this, even though its THE new thing right now in the podcast/health landscape that everybody is talking about: your body is a chemistry lab and not a bank account regarding calories.
    Furthermore all of these studies are likely done with non-fat-adapted people whose test results may be scewed by them being in the TRANSITION phase from sugar burner to fat burner, right?
    I see where the low-T guys are coming from but I am not totally convinced to be honest.

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