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Clinical Manifestations Of Dka

Diabetes Warning: Do Not Ignore These Signs Of Type 1 And Type 2 Diabetes

Diabetes Warning: Do Not Ignore These Signs Of Type 1 And Type 2 Diabetes

Diabetes symptoms include urinating more than normal Type 1 and 2 symptoms are similar Having an unquenchable thirst and feeling more tired than usual are also symptoms Untreated diabetes could lead to diabetic ketoacidosis Type 1 and type 2 diabetes are different conditions, but they present similar symptoms. However the majority of people with type 1 diabetes are diagnosed in childhood and early adulthood. The signs of type 1 and type 2 diabetes should never be ignored. If they are not treated, the condition can lead to serious and complex health conditions, such as diabetic ketoacidosis. Untreated type 2 diabetes can affect the heart, blood vessels, nerves, eyes and kidneys. The common symptoms of diabetes include: Going to the toilet a lot, especially at night Excessive urination can be triggered by excess glucose in the blood which interferes with the kidney’s ability to concentrate urine. Being really thirsty The medical term for increased thirst is puldisia. Feeling thirsty all the time, or having a stronger thirst than usual, which continues after drinking can be a sign of diabetes Feeling more tired than usual Feeling tired can be a symptom of low blood sugar. Losing weight without trying to Although type 2 diabetes commonly occurs in people who are overweight - undiagnosed type 1 diabetes can make people lose weight. Being overweight can cause type 2 diabetes because the body has more pressure to use insulin properly to manage blood sugar levels. Genital itching or thrush Thrush is more common in people with diabetes. This is because high sugar levels can cause yeast to grow. A dry mouth - also a symptom of the condition - can also increase the risk of the infection Cuts and wounds take longer to heal This occurs because diabetes can affect the immune system Continue reading >>

Management Of Diabetic Ketoacidosis In Adults

Management Of Diabetic Ketoacidosis In Adults

Diabetic ketoacidosis is a potentially life-threatening complication of diabetes, making it a medical emergency. Nurses need to know how to identify and manage it and how to maintain electrolyte balance Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

List Clinicopathologic features that might be present with DKA? Elevation in liver enzymes (hepatic lipidosis, pancreatitis) Hyperlipidemia Hyperlipasemia Hyperamylasemia Metabolic Acidosis Serum Hyperosmolality Azotemia (usually pre-renal) Hemeturia, pyuria, bactiuria (always submit cysto for culture an dsensitivity) Ketonuria Continue reading >>

[frequency And Clinical Manifestation Of Diabetic Ketoacidosis In Children Withnewly Diagnosed Type 1 Diabetes].

[frequency And Clinical Manifestation Of Diabetic Ketoacidosis In Children Withnewly Diagnosed Type 1 Diabetes].

1. Pediatr Endocrinol Diabetes Metab. 2013;19(4):143-7. [Frequency and clinical manifestation of diabetic ketoacidosis in children withnewly diagnosed type 1 diabetes]. Chumicki M, Prokopowicz Z, Deja R, Jarosz-Chobot P. INTRODUCTION: Diabetic ketoacidosis (DKA) is still the most dangerous acutecomplication of type 1 diabetes mellitus (T1DM). It is a life-threateningcondition requiring intensive treatment. DKA may be the first symptom ofpreviously undiagnosed diabetes, especially in children.AIM OF THE STUDY: Assessment of the incidence and clinical manifestation ofdiabetic ketoacidosis in children with newly diagnosed type 1 diabetes.MATERIAL AND METHODS: We analyzed 535 medical files of children (aged 9 months to17 years, mean age 4.41-9.96, 261 girls (48%)) hospitalized from 2006 to 2009because of the newly diagnosed type 1 diabetes mellitus. DKA was diagnosed(according to ISPAD) in children with pH <7.3, blood glucose level >11 mmol/L(>200 mg/dL) and/or blood concentration of bicarbonate <15 mmol/L with ketonuria.Severe DKA was diagnosed in children with pH <7.2.RESULTS: DKA was diagnosed in 123 patients (23%) (63 girls (51%)). The mean ageof children with DKA was significantly lower than the age of the children withoutDKA (9.05-4.45 vs 9.48-4.39 years; p<0.001). Mean pH was 7.21-1.03 (min. 6,82;max. 7,30). In 32.5% of children with DKA severe ketoacidosis (pH -7.2) wasobserved. The prevalence of acidosis was higher in the 0-4 age group compared to children over 4 years (28 vs. 22%, p<0.001). Neither sex, nor symptoms durationwere associated with the development of DKA. Polyuria (95%), polydipsia (95%),weight loss (85%) and abdominal pain (50%) were the most common symptoms reportedby patients.CONCLUSIONS: Despite the typical symptomatology of type 1 diabetes melli Continue reading >>

Clinical Signs

Clinical Signs

Go to site For Pet Owners Clinical signs exhibited by diabetic cats reflect the underlying pathological mechanisms of the disease and aid diagnosis. Of course, laboratory tests are needed to confirm diagnosis (see Diagnosis and Management Overview). Three distinct clinical pictures may develop in cats suffering from diabetes mellitus: Uncomplicated diabetes Complicated by ketoacidosis Hyperosmolar syndrome Clinical signs of uncomplicated diabetes The 4 classic clinical signs of diabetes mellitus in cats include: Polyuria Polyphagia Polydipsia Increased susceptibility to infections (eg, urinary tract infections) Owners may also notice weight loss in affected cats. Signs of diabetes mellitus complicated by ketoacidosis If feline diabetes is undetected and left untreated, it will shorten a cat’s lifespan. A dangerous, sometimes fatal metabolic acidosis or diabetic ketoacidosis (DKA) may develop. In untreated diabetic cats, excessive ketones are produced, resulting in ketonuria and DKA accompanied by electrolyte imbalances. Ketoacidosis is a serious condition that can ultimately lead to an acidotic coma and death. In addition to the classic clinical signs of diabetes, cats affected by DKA may present with: Loss of appetite Lethargy and depression Vomiting Diarrhea Weakness Dehydration Dyspnea Collapse or coma Signs of hyperosmolar syndrome Hyperosmolar syndrome is an uncommon complication of untreated diabetes mellitus. In animals in which target tissue resistance to insulin plays a role in the disease, insulin levels can be elevated. In these cases, ketosis is suppressed and plasma glucose concentrations can become very high. Hyperosmolar syndrome represents an emergency situation. Affected cats will become progressively weaker, anorexic, lethargic, and drink less. Ultim Continue reading >>

What Are The 3 P's Of Diabetes?

What Are The 3 P's Of Diabetes?

The 3 classic symptoms of diabetes mellitus are polyuria, polydipsia and polyphagia -- also known as the 3 P's. Polyuria, polydipsia and polyphagia are defined as an increase in urination, thirst and hunger, respectively. The presence of the 3 P’s is a good indication that your blood sugar may be too high. With type 1 diabetes (T1DM), these symptoms typically develop relatively quickly and are more obvious, often leading to diagnosis of the condition. With type 2 diabetes (T2DM), the 3 P's are often more subtle and develop more gradually. As a result, people with type 2 diabetes may overlook these symptoms, leading to a delay in diagnosis. Video of the Day The 3 P’s of diabetes are typically among the first symptoms to occur in T1DM, but they can occur with other conditions. Polyuria, or excessive urine production, can be identified by needing to urinate during the night, frequent bathroom trips or accidents in potty-trained children. Polydipsia, a consequence of polyuria, is characterized by excessive thirst. An increase in fluid intake due to polydipsia can also contribute to increased urination. Polyphagia is the term for excessive or increased hunger. It occurs with diabetes because blood sugar is fails to enter body tissues normally, leaving them short of fuel to produce energy. To compensate, fat and muscle are broken down and used for energy resulting in weight loss, lack of energy and fatigue, which are most often seen with T1DM. Signs of long-term high blood sugar, such as blurred vision and tingling or numbness in hands and feet, are more common at diagnosis with T2DM. High Blood Sugar and the 3 P's The 3 P's of diabetes all stem from high blood sugar levels. Blood sugar is normally filtered by the kidneys but then reabsorbed into the blood. When blood sug Continue reading >>

Diabetes Complications In Dogs And Cats: Diabetes Ketoacidosis (dka)

Diabetes Complications In Dogs And Cats: Diabetes Ketoacidosis (dka)

Unfortunately, we veterinarians are seeing an increased prevalence of diabetes mellitus in dogs and cats. This is likely due to the growing prevalence of obesity (secondary to inactive lifestyle, a high carbohydrate diet, lack of exercise, etc.). So, if you just had a dog or cat diagnosed with diabetes mellitus, what do you do? First, we encourage you to take a look at these articles for an explanation of the disease: Diabetes Mellitus (Sugar Diabetes) in Dogs Once you have a basic understanding of diabetes mellitus (or if you already had one), this article will teach you about life-threatening complications that can occur as a result of the disease; specifically, I discuss a life-threatening condition called diabetes ketoacidosis (DKA) so that you know how to help prevent it! What is DKA? When diabetes goes undiagnosed, or when it is difficult to control or regulate, the complication of DKA can occur. DKA develops because the body is so lacking in insulin that the sugar can’t get into the cells -- resulting in cell starvation. Cell starvation causes the body to start breaking down fat in an attempt to provide energy (or a fuel source) to the body. Unfortunately, these fat breakdown products, called “ketones,” are also poisonous to the body. Symptoms of DKA Clinical signs of DKA include the following: Weakness Not moving (in cats, hanging out by the water bowl) Not eating to complete anorexia Large urinary clumps in the litter box (my guideline? If it’s bigger than a tennis ball, it’s abnormal) Weight loss (most commonly over the back), despite an overweight body condition Excessively dry or oily skin coat Abnormal breath (typically a sweet “ketotic” odor) In severe cases DKA can also result in more significant signs: Abnormal breathing pattern Jaundice Ab Continue reading >>

A Study Of The Clinical Manifestations, Biochemical Findings, Precipitating Factors And Complications In 56 Episodes Of Diabetic Ketoacidosis

A Study Of The Clinical Manifestations, Biochemical Findings, Precipitating Factors And Complications In 56 Episodes Of Diabetic Ketoacidosis

A STUDY OF THE CLINICAL MANIFESTATIONS, BIOCHEMICAL FINDINGS, PRECIPITATING FACTORS AND COMPLICATIONS IN 56 EPISODES OF DIABETIC KETOACIDOSIS Keywords: Diabetic ketoacidosis, Precipitating factors, Fifty six episodes of DKA occurred in 33 patients during the period between 1998 -96. These patients were admitted and treated in Bahrami children hospital, a Tehran University teaching medical center. The most frequent clinical manifestations consisted of polyuria and polydipsia (66%), nausea and vomiting (64%), reduction in consciousness (53%), and Kussmaul respiration (53.5%). 54.6% of DKA episodes showed a pH below 7.1. There was a relationship between the severity of acidosis and the time needed for its correction. Complications during treatment appeared in 47.5% of DKA attacks, hypokalemia (18.8%), hyperkalemia (16%) , hypoglycemia (10%) were the most common. No brain edema or death occurred in our patients. The most common precipitating factors of DKA include unavailability of insulin or syringes (39.4%), infections (32%), and unknown causes (28.6%). The patients were divided in two different groups. The first group experienced 31 episodes of DKA in known patients suffering from diabetes mellitus and receiving insulin treatment. 25 episodes of DKA occurred in the second group with no previous history of diabetes; of interest is the finding that in 75% of recurrent attacks in group 1, the unavailability of insulin or syringes was the precipitating factor. The clinical, laboratory and complications of these two groups of patients were studied and the results obtained were compared with similar studies in other countries. Continue reading >>

Diabetic Ketoacidosis: Clinical Practice Guidelines

Diabetic Ketoacidosis: Clinical Practice Guidelines

1. Introduction Diabetic ketoacidosis (DKA), the most common endocrinal emergency remains a life-threatening condition despite improvements in diabetes care [1]. The mortality and morbidity rates remain high worldwide, especially in developing countries and among non-hospitalized patients [2,3], which highlight the importance of early diagnosis and implementation of effective preventive and management strategies. The adage "The child is not a miniature adult" is most appropriate when considering DKA. The fundamental pathophysiology of DKA is the same in children as in adults; however, the child differs from the adult in a number of characteristics which raise some important considerations in management [2]. The purpose of this chapter is to briefly review the pathophysiology of DKA and discuss recommended treatment protocols and current standards of care pertaining to children, adolescents and adults with type 1 or 2 diabetes presenting with DKA. The information provided is based on evidence from published studies and internationally accepted guidelines whenever possible and, when not, supported by expert opinion or consensus [1-5]. Current concepts of cerebral edema, recommendations and strategies for the prediction and prevention of DKA and hence its complications are finally presented. The considerations and recommendations included are in agreement with those endorsed by the American Diabetes Association (ADA), Lawson Wilkins Pediatric Endocrine Society (LWPES), European Society for Pediatric Endocrinology (ESPE), and the International Society for Pediatric and Adolescent Diabetes (ISPAD) [2-5]. Thus, this book chapter will provide easy and practical information to guide healthcare professional who manage DKA in all age groups. 2. Definition of Diabetic Ketoacidosis Continue reading >>

Diabetic Ketoacidosis: Diagnosis And Management.

Diabetic Ketoacidosis: Diagnosis And Management.

Abstract The objective of this manuscript is to review the clinical manifestations, diagnosis and management of diabetic ketoacidosis, one of the most common acute complications of diabetes mellitus. We performed a medline search of the English-language literature using a combination of words (diabetic ketoacidosis, hyperglycemic crises) to identify original studies, consensus statements and reviews on diabetic ketoacidosis published in the past 15 years. Emphasis was placed on clinical manifestations of diabetic ketoacidosis, its diagnosis and treatment.Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus that can be life-threatening if not treated properly. Once thought to occur only in patients with type 1 diabetes, diabetic ketoacidosis has also been observed in patients with type 2 diabetes under certain conditions. The basic underlying mechanism for diabetic ketoacidosis is insulin deficiency coupled with elevated levels of counterregulatory hormones, such as glucagon, cortisol, catecholamines, and growth hormone. Diabetic ketoacidosis can be the initial presentation of diabetes mellitus or precipitated in known patients with diabetes mellitus by many factors, most commonly infection. The management of diabetic ketoacidosis involves careful clinical evaluation, correction of metabolic abnormalities, identification and treatment of precipitating and co-morbid conditions, appropriate long-term treatment of diabetes, and plans to prevent recurrence. Many cases of DKA can be prevented by better access to medical care, proper education, and effective communication with a health care provider during intercurrent illness. Provision of guidelines will also reduce mortality. Resources need to be redirected towards prevention by funding better access to Continue reading >>

Ch. 21 - Nursing 500a With Ritter At University Of Arizona - Studyblue

Ch. 21 - Nursing 500a With Ritter At University Of Arizona - Studyblue

Diabetes insipidus is caused by insufficient secretion of insulin Giantism occurs only in children and adolescents. A person with syndrome of inappropriate antiduretic hormone (SIADH) usually craves fluids. Abnormal immunologic mechanisms producing autoantibodies are responsible for Graves disease as well as hypothyroidism. Thyroid carcinoma, although rare, is the most common endocrine malignancy. Myxedema coma is caused by severe hypoparathyroidism. Type 2 diabetes mellitus is more common than type 1. The most common cause of hypoparathyroidism is damage to the glands during surgery. Individuals with type 2 diabetes mellitus have a greater degree of pancreatic changes than individuals with type 1 diabetes. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by increased levels of antidiuretic hormone (ADH) Glucose levels are considerably lower in hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) than in diabetic ketoacidosis (DKA) The effects of syndrome of inappropriate antidiuretic hormone (SIADH) include solute: The most common cause of elevated levels of antidiuretic hormone (ADH) secretion is Which of the following laboratory values would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)? a. hypernatremia and urine hypo-osmolality c. Serum Na+120 and serum hypo-osmolality c. Serum Na+120 and serum hypo-osmolality a. antidiuretic hormone (ADH) hyposecretion. b. antidiuretic hormone (ADH) hypersecretion. a. antidiuretic hormone (ADH) hyposecretion. Man w/ closed head injury urine output = 6 - 8 L/day. Electrolytes w/in normal limits; ADH level low. Although he has had no intake for 4 hours, there is no change in polyuria. These indicate: Visual disturbances are a result of a pituitar Continue reading >>

Clinical Signs Of Diabetes Mellitus In Dogs And Cats

Clinical Signs Of Diabetes Mellitus In Dogs And Cats

Clinical signs are useful in the diagnosis and monitoring of canine and feline diabetes. Other laboratory tests are also necessary for diagnosis of diabetes mellitus and the monitoring of treated diabetic pets. There are three distinct clinical pictures in diabetes mellitus: Uncomplicated diabetes mellitus The classical signs are Polyuria, Polydipsia, Polyphagia, Cachexia and increased susceptibility to infections (e.g. urinary tract infections). In long term diabetes, effects due to protein glycosylation can be seen: cataracts (mainly in dogs) and peripheral neuropathy (mainly in cats). Diabeties complicated by ketoacidosis DKA develops due to long standing undiagnosed diabetes mellitus, insufficient insulin dose in treated diabetics and impaired insulin action and/or resistance, caused by obesity, concurrent illness or drugs. This is the cause of more than two thirds of cases of DKA. Due to the lack of insulin, glucose cannot be used as an energy source. Fats are broken down to provide energy. During lipolysis, high levels of ketones are produced. Ketosis and acidosis develop and are accompanied by electrolyte imbalances. Ketosis causes anorexia, nausea and lethargy. Diagnosis The diagnosis of DKA is based on the presence of ketonuria along with signs of systemic illness. Treatment DKA is an emergency and treatment must be started as soon as possible. The goals of treatment are to correct fluid deficits, acid-base balance and electrolyte balance, lower blood glucose and ketone concentrations and recognize and correct underlying and precipitating factors. Therapy includes intravenous fluid therapy with isotonic fluids, e.g. 0.9% saline, and intravenous administration of rapid-acting insulin. If possible the electrolyte concentrations and acid-base balance should be mea Continue reading >>

Clinical Characteristics Of Diabetic Ketoacidosis In Children With Newly Diagnosed Type 1 Diabetes In Addis Ababa, Ethiopia: A Cross-sectional Study

Clinical Characteristics Of Diabetic Ketoacidosis In Children With Newly Diagnosed Type 1 Diabetes In Addis Ababa, Ethiopia: A Cross-sectional Study

Abstract Diabetic ketoacidosis (DKA) is one of the most serious acute complications of type 1 diabetes (T1D) and the leading cause of morbidity and mortality in children with T1D. This study was aimed at assessing the prevalence and associated factors of DKA in children with newly diagnosed T1D in Addis Ababa. Methods A hospital based cross-sectional study was conducted in selected hospitals in Addis Ababa. Children below the age of 12 years with DKA who were admitted to the pediatric ward in the selected hospitals between January 2009 and December 2014 and the residence of Addis Ababa were included. DKA was defined as children below the age of 12 years who have blood glucose level ≥250mg/dl, ketonuria, and ketonemia and diagnosed being T1D patient for the first time. Descriptive statistics was performed using frequency distribution, mean, median, tables, and graphs. Logistic regression analysis was used to identify independent factors associated with the prevalence of DKA in children with newly diagnosed T1D. Of 395 DKA patients who were hospitalized during the five-year period, 142(35.8%) presented with DKA at first diagnosis of diabetes. On the other hand 253 (64.2%) children with DKA had longstanding T1D. Independent factors associated with DKA include: Age category 2–4.49years, 7–9.49 years and ≥9.5years (Adjusted odd ratio (AOR) = 3.14[1.21,8.06]), 3.44(1.39,8.49) and 4.02(1.68,9.60), respectively); parents’ knowledge on the sign and symptoms of DKA (AOR = 0.51[0.27, 0.95]); sign and symptoms of DKA before the onset of DKA (AOR = 0.35[0.21, 0.59]) and infection prior to DKA onset (AOR = 3.45[1.97, 6.04]). The overall proportion of children diagnosed with DKA and new onset of T1D in Addis Ababa was high. In particular, children between 9–12 years of age Continue reading >>

Medical Pharmacology: Diabetes

Medical Pharmacology: Diabetes

Free fatty acids from fat stores are primary substrates for ketone body formation High plasma free fatty acid levels are required for significant ketogenesis Normally the concentration of plasma free fatty acids are lowered by the liver where fatty acids are reesterified and stored as hepatic triglyceride or converted into VLDL -- unless the system for hepatic oxidation of fatty acids becomes activated. Release of free fatty acids is increased by insulin deficiency; accelerated hepatic fatty acid oxidation is caused by glucagon-- by acting on carnitine palmitoyltransferase enzymes (CPT) Activation of carnitine palmitoyltransferase I (CPT I), normally inactive, is activated by uncontrolled diabetes (or starvation) Activation of carnitine palmitoyltransferase I (CPT I) allows long-chain free fatty acids to reach beta-oxidative enzymes localized in the mitochondrial matrix where ketone body production occurs. Significant acetoacetate and beta-hydroxybutyrate production by the liver require: (a) Enough free fatty acid substrate and (b) Activation of fatty acid oxidation. Lipolysis is enhanced by insulin deficiency. Immediate signal for oxidation is a fall in malonyl-CoA concentration. figure above adapted from: Figure 334-4 Foster, D. W., Diabetes Mellitus, In Harrison's Principles of Internal Medicine 14th edition, (Isselbacher, K.J., Braunwald, E., Wilson, J.D., Martin, J.B., Fauci, A.S. and Kasper, D.L., eds) McGraw-Hill, Inc (Health Professions Division), 1998, p 2072. Continue reading >>

Ketosis Vs. Ketoacidosis: What You Should Know

Ketosis Vs. Ketoacidosis: What You Should Know

Despite the similarity in name, ketosis and ketoacidosis are two different things. Ketoacidosis refers to diabetic ketoacidosis (DKA) and is a complication of type 1 diabetes mellitus. It’s a life-threatening condition resulting from dangerously high levels of ketones and blood sugar. This combination makes your blood too acidic, which can change the normal functioning of internal organs like your liver and kidneys. It’s critical that you get prompt treatment. DKA can occur very quickly. It may develop in less than 24 hours. It mostly occurs in people with type 1 diabetes whose bodies do not produce any insulin. Several things can lead to DKA, including illness, improper diet, or not taking an adequate dose of insulin. DKA can also occur in individuals with type 2 diabetes who have little or no insulin production. Ketosis is the presence of ketones. It’s not harmful. You can be in ketosis if you’re on a low-carbohydrate diet or fasting, or if you’ve consumed too much alcohol. If you have ketosis, you have a higher than usual level of ketones in your blood or urine, but not high enough to cause acidosis. Ketones are a chemical your body produces when it burns stored fat. Some people choose a low-carb diet to help with weight loss. While there is some controversy over their safety, low-carb diets are generally fine. Talk to your doctor before beginning any extreme diet plan. DKA is the leading cause of death in people under 24 years old who have diabetes. The overall death rate for ketoacidosis is 2 to 5 percent. People under the age of 30 make up 36 percent of DKA cases. Twenty-seven percent of people with DKA are between the ages of 30 and 50, 23 percent are between the ages of 51 and 70, and 14 percent are over the age of 70. Ketosis may cause bad breath. Ket Continue reading >>

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