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Canagliflozin Euglycemic Dka

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Please watch: "(905) Mitochondria: Central Role in Aging 2018 (and how to reverse it)( warning - geeky)- FORD BREWER " https://www.youtube.com/watch?v=mTKM0... --~-- Join the PrevMed Community: https://mailchi.mp/1224fb9e00e7/prevm... ford brewer md mph PrevMedHeartRisk.com How can you tell whether you are resistant to insulin or just don't make enough? There is a technique called the euglycemic clamp or the Whole Body Insulin Resistance Index. It involves intravenous insulin. (This can be dangerous. Don't try it at home.) Glucose is also given intravenously to counteract hypoglycemia. People ( or animals) with insulin resistance require higher infusion rates of insulin and lower infusion rates of glucose to maintain a normal glucose level ( euglycemia). About Dr. Brewer - Ford Brewer is a physician that started as an Emergency Doctor. After seeing too many patients coming in dead from early heart attacks, he went to Johns Hopkins to learn Preventive Medicine. He went on the run the post-graduate training program (residency) in Preventive Medicine at Hopkins. From there, he made a career of practicing and managing preventive medicine and primary care clinics. His later role in this area was Chief Medical Officer for Premise, which has over 500 primary care/ prevention clinics. He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, stroke, and diabetes prevention clinic. At PrevMed, we focus on heart attack and stroke and Type 2 diabetes prevention by reducing or eliminating risk through attentive care and state-of-the-art genetic testing, imaging, labs and telemedicine options. We serve patients who have already experienced an event as well as those have not developed a diagnosis or event. Our team of senior clinicians includes internationally recognized leaders in the research and treatment of cardiovascular disease, preventive medicine and wellness. We also provide preventive medicine by telemedicine technology to over 30 states. Contact Dr. Brewer at [email protected] or visit http://prevmedheartrisk.com.

Euglycemic Dka: It’s Not A Myth

Background: Diabetic ketoacidosis (DKA) is traditionally defined as a triad of hyperglycemia (>250mg/dL), anion gap acidosis, and increased plasma ketones. There is another entity that providers must be aware of known as euglycemic DKA (euDKA), which is essentially DKA without the hyperglycemia (Serum glucose <200 mg/dL). Euglycemic DKA is a rare entity that mostly occurs in patients with type 1 diabetes, but can possibly occur in type 2 diabetes as well. The exact mechanism of euDKA is not entirely known, but has been associated with partial treatment of diabetes, carbohydrate food restriction, alcohol intake, and inhibition of gluconeogenesis. euDKA, can also be associated with sodium-glucose cotransporter 2 (SGLT-2) inhibitor medications. These medications first came onto the market in 2013 and are FDA approved for the treatment of type 2 diabetes, however many physicians use them off-label for type I diabetes due to their ability to improve average glucose levels, reduce glycemic variability without increasing hypoglycemia, and finally promote weight loss. Does euDKA Exist even in Patients not Using SGLT-2 Inhibitors? The short answer is YES. Munro JF et al [5] reviewed a case Continue reading >>

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  1. SoxGirl02

    Its been a interesting 1.5 weeks. Last Last Frday 3/27, I thought I might have a kidney stone. I am prone to stones, so I know the sympoms etc. Friday it bothered me, Saturday it bothered me, Monday it bothered me. I went to the Urologist on this past Friday 4/3. He said there were large blood cells in my urine blah blah and I was to get a CT scan on Monday (yesterday). I get this call yesterday morning from the nurse in his office stating that I need to start Cipro immediatly becuase I deffinatly have a bladder infection, and a slight kidney infection (slight? its either infected or not infected!).
    I was exhausted yesterday, had the CT scan, came home and just crashed. 8pm woke up ate..something in my brain had me check the ketones about 9:30 last night. LARGE ketones. I start freaking because ive never had large ones....I call the doc on call and she tells me not to worry about it, its dehydration keep drinking and check in 2 hours. 2 hours it was fine.
    Today..they are back again! Am I over reacting to think that the 2 are related?

  2. gsmama

    Ketones and infection, yes!
    Are these urine ketones or blood ketones?
    Yes, you can get them from dehydration too. Very possible.
    Leslie

  3. andrea

    I agree that these can definately be related... hope you feel better soon.

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What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS 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 ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin. Depending on the severity, insulin may be given intravenously or by injection under the skin. Usually potassium is also needed to prevent the development of low blood potassium. Throughout treatment blood sugar and potassium levels should be regularly checked. Antibiotics may be required in those with an underlying infection. In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended. Rates of DKA vary around the world. About 4% of people with type 1 diabetes in United Kingdom develop DKA a year, while in Malaysia the condition affects about 25% a year. DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost universally fatal. The risk of death with adequate and timely treatment is currently around 1–4%. Up to 1% of children with DKA develop a complication known as cerebral edema. The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. Those who measure their glucose levels themselves may notice hyperglycemia (high blood sugar levels). In severe DKA, breathing becomes labored and of a deep, gasping character (a state referred to as "Kussmaul respiration"). The abdomen may be tender to the point that an acute abdomen may be suspected, such as acute pancreatitis, appendicitis or gastrointestinal perforation. Coffee ground vomiting (vomiting of altered blood) occurs in a minority of people; this tends to originate from erosion of the esophagus. In severe DKA, there may be confusion, lethargy, stupor or even coma (a marked decrease in the level of consciousness). On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, tachycardia (a fast heart rate) and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity", often compared to the smell of pear drops whose scent is a ketone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.....

Euglycemic Diabetic Ketoacidosis With Persistent Diuresis Treated With Canagliflozin

Diabetic ketoacidosis is characterized by hyperglycemia, anion-gap acidosis, and increased plasma ketones. After the resolution of hyperglycemia, persistent diuresis is rare. We herein report the case of a 27-year-old Asian woman with type 2 diabetes who was treated with a sodium-glucose cotransporter 2 (SGLT2) inhibitor (canagliflozin) who developed euglycemic diabetic ketoacidosis and persistent diuresis in the absence of hyperglycemia. Physicians should consider euglycemic diabetic ketoacidosis in the differential diagnosis of patients treated with SGLT2 inhibitors. Continue reading >>

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  1. Timothy

    I recently told my friend, a professor of medicine at a large university, about my six-week-old PB eating habits (now largely carnivorous). He advised me that it's not good to keep your body "carb-starved" and in ketosis all the time, and that eating so much protein strains the liver's ability to produce urea and the kidneys' ability to process and excrete it. The long-term effects can include liver and kidney damage, he said.
    I've heard something like this before, but it seems to run counter to the research on MDA as well as the experiences of real-life carnivores.
    Do you know anyone who has sustained kidney/liver damage from eating too much protein? Is Tarlach on course for renal failure? Or is this just CW run amok again?

  2. Athena

    1
    Ive heard it from bodybuilders who eat ungodly amounts of protein (mostly from powders) that they have kidney problems. I always heard as long as you keep hydrated your kidneys shouldnt have an issue, especially if u get your protein from meat sources. Although I can't back that up with anything other than broscience. Im interested to see some evidence though

  3. Prowler

    1
    Absolute bull.
    1. What is the incidence of liver or kidney damage among the Inuit practicing their traditional diet?
    2. What is the incidence of liver or kidney damage among the Masai practicing their traditional diet?
    3. The venerable Dr. Atkins himself used ketosis to treat thousands of patients at his clinic over the course of several decades, and he challenged anyone to show one case where ketosis caused kidney damage. Not one case has ever been documented.
    Case closed. Ketosis is a safe and natural state, and any speculation about potential harm is just that: pure unfounded speculation.

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Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor Inhibitors of sodiumglucose cotransporter 2 (SGLT2) decrease plasma glucose by blocking the reabsorption of glucose at the proximal tubule.1,2 Case reports have suggested that SGLT2 inhibitors may be associated with an increased risk of diabetic ketoacidosis, which led to a warning from the Food and Drug Administration (FDA) in May 2015.3,4 The objective of our study was to assess the risk of diabetic ketoacidosis after the initiation of an SGLT2 inhibitor. https://www.youtube.com/channel/UCsqm...

Sglt2 Inhibitor Diabetes Drugs May Cause Ketoacidosis: Fda

SGLT2 Inhibitor Diabetes Drugs May Cause Ketoacidosis: FDA The US Food and Drug Administration (FDA) warned today that sodium-glucose cotransporter-2 (SGLT2) inhibitors used to treat type 2 diabetes may lead to ketoacidosis requiring hospitalization. The warning includes the SGLT2 inhibitors canagliflozin (Invokana, Johnson & Johnson), dapagliflozin (Farxiga, AstraZeneca), and empagliflozin (Jardiance, Lilly/Boehringer), as well as three combination products that include an SGLT2 inhibitor: canagliflozin plus metformin (Invokamet, Johnson & Johnson), dapagliflozin plus metformin extended release (Xigduo XR, AstraZeneca), and empagliflozin plus linagliptin (Glyxambi, Lilly/Boehringer). A search of the FDA Adverse Event Reporting System database identified 20 cases of acidosis reported as diabetic ketoacidosis (DKA), ketoacidosis, or ketosis in patients treated with SGLT2 inhibitors from March 2013 to June 6, 2014, the FDA said . Ketoacidosis is not typically observed in patients with type 2 diabetes, the FDA notes, and the DKA case presentations were "atypical in that glucose levels were only mildly elevated at less than 200 mg/dL in some reports, while patients with type 1 diabete Continue reading >>

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  1. realsis77

    does being in pain raise blood glucose numbers?

    I was wondering about if pain actually raises BG numbers? I had some spinal injections two days ago and in total I has ten. I have a failed spinal fusion. Well I've noticed after the shots my BG levels have been through the roof! I'm having to use my insulin 3xs a day as opposed to once a day (sliding scale). I've been in a tremendous amount of pain from the procedure I've had and wonder can pain make our BG levels rise? I would love to hear your opinions on this! Thank you family! Your all the best!

  2. Pappywills

    I have been in severe pain because of bone on bone knee, my BG has been way too high and I have not changed my diet. I am eating as I had been before and keeping my sugar levels in perfect shape. Since the pain has gotten severe my BG has stayed 250 - over 300. Totally not normal for me. So yes, pain can effect BG.

  3. mas14years

    I have a condition of chronic stomach pain and yes it makes my blood sugar very high at times. I hate taking pain medication but if i dont i can not get it down. What kind of shots did you have, if they used a steroid that will also raise your sugar.

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