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Complications Of Dka In Pediatrics

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In this video, Dr. Michael Agus discusses the risk factors, signs, symptoms, and treatment of cerebral edema in diabetic ketoacidosis. Please visit: www.openpediatrics.org OPENPediatrics is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: [email protected] Please note: OPENPediatrics does not support nor control any related videos in the sidebar, these are placed by Youtube. We apologize for any inconvenience this may cause.

Risk Factors For Cerebral Edema In Children With Diabetic Ketoacidosis

Cerebral edema is an uncommon but devastating complication of diabetic ketoacidosis in children. Risk factors for this complication have not been clearly defined. In this multicenter study, we identified 61 children who had been hospitalized for diabetic ketoacidosis within a 15-year period and in whom cerebral edema had developed. Two additional groups of children with diabetic ketoacidosis but without cerebral edema were also identified: 181 randomly selected children and 174 children matched to those in the cerebral-edema group with respect to age at presentation, onset of diabetes (established vs. newly diagnosed disease), initial serum glucose concentration, and initial venous pH. Using logistic regression, we compared the three groups with respect to demographic characteristics and biochemical variables at presentation and compared the matched groups with respect to therapeutic interventions and changes in biochemical values during treatment. A comparison of the children in the cerebral-edema group with those in the random control group showed that cerebral edema was significantly associated with lower initial partial pressures of arterial carbon dioxide (relative risk of cer Continue reading >>

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Popular Questions

  1. MyJourney

    > Ketosis and Sugar Alcohols

    I am trying to figure out why sugar alcohols or too many of them knock me out of ketosis?
    I know for a fact that I do not get a blood sugar spike since I have tested it a bunch of times but could my body still be producing a lot of insulin from these products even though my blood sugar doesnt go up?
    I know I am obviously confused and missing something somewhere but I hope someone can please enlighten me.
    From my understanding if my body thought the sugar alcohols were sugar I would get a blood sugar response as well as an insulin response.
    Can one happen without the other? Why is the result so dramatic with sugar alcohols?

  2. Squid

    I'm curious about this as well as I've noticed the same thing with myself. The sugar alcohols and splenda most definitely push me out of ketosis even though the net carbs are below 20.
    I assumed it was because these are carbs but not counted by atkins in the net carb account. It seems they do affect ketosis although maybe not enough to spike blood sugar. Just a thought. Curious what others have to say.
    Squid

  3. toning_up

    I also get knocked out of ketosis by them. I assume that seeing they are treated by the body as alcohols, then ketosis ceases until they are burned just like it would with regular drinking alcohol. That's the only thing I can think of anyway.

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Visit us (http://www.khanacademy.org/science/he...) for health and medicine content or (http://www.khanacademy.org/test-prep/...) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Matthew McPheeters. Watch the next lesson: https://www.khanacademy.org/test-prep... Missed the previous lesson? https://www.khanacademy.org/test-prep... NCLEX-RN on Khan Academy: A collection of questions from content covered on the NCLEX-RN. These questions are available under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States License (available at http://creativecommons.org/licenses/b...). About Khan Academy: Khan Academy offers practice exercises, instructional videos, and a personalized learning dashboard that empower learners to study at their own pace in and outside of the classroom. We tackle math, science, computer programming, history, art history, economics, and more. Our math missions guide learners from kindergarten to calculus using state-of-the-art, adaptive technology that identifies strengths and learning gaps. We've also partnered with institutions like NASA, The Museum of Modern Art, The California Academy of Sciences, and MIT to offer specialized content. For free. For everyone. Forever. #YouCanLearnAnything Subscribe to Khan Academys NCLEX-RN channel: https://www.youtube.com/channel/UCDx5... Subscribe to Khan Academy: https://www.youtube.com/subscription_...

Predictors Of Acute Complications In Children With Type 1 Diabetes

No significant age effect in boys. In girls, increasing incidencewith age (P<.001 for trend). Pairwise comparisonssubject to Bonferroni correction, ie, significant at the = .017. Figure 2. Predictors of Diabetic Ketoacidosis Relative risk estimates and the 95% confidence intervals for significantand independent predictors derived from age-stratified (<13 vs 13 years)and sex-adjusted Poisson regression with all variables simultaneously in themodel. Hb indicates hemoglobin. Figure 3. Incidence of Severe Hypoglycemia In females, decreasing incidence with age (P<.001for trend). Pairwise comparisons subject to Bonferroni correction, ie, significantat the = .017 level. Figure 4. Predictors of Severe Hypoglycemia Relative risk estimates and the 95% confidence intervals for significantand independent predictors derived from age-stratified (<13 vs 13 years)and sex-adjusted Poisson regression with all variables simultaneously in themodel. Table 1. Characteristics of Patients WithDiabetic Ketoacidosis* Predictors of Acute Complications in Children With Type 1 Diabetes ContextDiabetic ketoacidosis and severe hypoglycemia are acute complicationsof type 1 diabetes that are related, respectively Continue reading >>

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Popular Questions

  1. beemerbeeper

    How to get rid of ketosis smell?

    My friend says I stink. She says it smells like ketosis. How do I get rid of it? I sure can't smell it. It isn't gas.
    How do you start adding carbs back without freaking out about gaining?
    How embarrasing.
    b

  2. MajorMom

    Water, water, water and more water.
    You don't want to add carbs back in. I'm confused. Why do you want to add carbs in?

  3. beemerbeeper

    I thought the ketosis smell was from too few carbs? I haven't been counting my water altho it seems like I am constantly drinking. I will start counting my ounces tomorrow and see if I can increase it by quite a bit.

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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.....

Cerebrovascular Complications Of Diabetic Ketoacidosis In Children

CLINICAL CASE REPORT Complicações cerebrovasculares da cetoacidose diabética em crianças Luis Felipe Mendonça de Siqueira Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG); Department of Pediatrics, Faculty of Medicine, UFMG, Belo Horizonte, MG, Brazil SUMMARY Neurological deterioration in children with diabetic ketoacidosis (DKA) is commonly caused by cerebral edema. However, subtle cerebral injuries including strokes should also be suspected, since children with hyperglycemia and DKA are prone to thrombosis. In this paper, a case involving a 2 month-old patient that presented cerebral edema and stroke as complications of DKA is reported. In the discussion, the literature on neurological complications of DKA in children is briefly reviewed, emphasizing the prothrombotic tendency of these patients. SUMÁRIO Alterações neurológicas em crianças com cetoacidose diabética (CAD) são comuns, sobretudo em decorrência de edema cerebral. Contudo, lesões cerebrais agudas, como acidente vascular cerebral (AVC), também devem ser investigadas, já que as crianças com hiperglicemia e cetoacidose têm maior chance de apresentar essa complicação. Neste relato, de Continue reading >>

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Popular Questions

  1. Skie

    Can You Use Ketone Sticks to "Diagnose"?

    I'm not on a low carb diet as far as I know, so having these in the urine would be a possible diabetes sign, right? Is it a safe idea to get a package and see what my results are? Or is this just a silly idea? I'm still working out arrangements to go see a doctor and get tested, but in the mean time while I figure that out with my friends, I figure something like this might be useful to get an idea of where I stand in the matter... Course I wish I could borrow a meter too, but alas... Don't know anyone who'd let me...

  2. Shanghaied Guy

    I think your blood sugars have to be extremely high before ketones would show up in your urine if you have not been on ketogenic diet (very low carb) for several days.
    You can get a free meter here: https://www.onetouchgold.com/simplestart/, but you will still need to buy the strips.
    Where do you live? If you live in Shanghai, I will buy you a cup of coffee some morning and test your BG. We diabetics are always curious about the blood sugar of other people and sometimes try to cajole our family and friends into testing their morning fasting blood sugar. If you want to disclose where you live, maybe somebody here at DD can help you out with the use of a meter.
    Tell us a bit about yourself. Do you have a family history of diabetes? How old are you? Are you overweight? Have you ever had high blood glucose on a test? What symptoms do you have that lead you to suspect diabetes?
    Be well.

  3. hannahtan

    i wouldn't dx yourself with just a ketostix... if there are sugar and ketones in the urine... it is a sign of diabetes... if ketones alone... i'm not sure... that is why i will not simply just assume i'm a diabetic based on a ketostix result...
    if you can't borrow a meter... can you just go to a pharmacy and get a simple finger bg test done? if it is high... and from the ketostix result which shows ketones as positive... please go see a doc immediately... but if bg is good...i wouldn't worry a lot... but still see a doc to get a proper diagnosis

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