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Dka Case Study Ppt

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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.....

Case Study: Hyperglycemia, Concern For Diabetic Ketoacidosis, And Type 1 Diabetes

Case Study: Hyperglycemia, concern for diabetic ketoacidosis, and type 1 diabetes Case Study: Hyperglycemia, concern for diabetic ketoacidosis, and type 1 diabetes The patient presented to the emergency room with hyperglycemia and possible diabetic ketoacidosis after not taking his insulin for 3 days. The patient is a 36-year-old man who has had type 1 diabetes for 15 years. He presents to the emergency room with hyperglycemia and concern for possible diabetic ketoacidosis after not taking his insulin for 3 days. The patient reports that he is currently homeless and has lost his supply of insulin, syringes, glucose meter, and related glucose testing supplies. Diabetes-related comorbidities/complications Hypertension, hyperlipidemia, retinopathy, and bipolar disorder The patient states that at the time of his initial diagnosis with type 1 diabetes , he was hospitalized, with a glucose value >1000 mg/dL, and he was experiencing polyuria, polydipsia, and polyphagia. He reports that he has been on insulin since the time of his diagnosis, and he has never been prescribed oral agents for diabetes management. He recalls that glutamic acid decarboxylase (GAD) antibodies and a C-peptide le Continue reading >>

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  1. evilopinions

    Ketogenic > PSMF > Stalled Progress. Some advice.

    Stats
    Height - 5'10"
    Weight - 118 Kilos - 260 Pounds
    Bodyfat - 35%
    I have done enough research for ketogenic diets and PSMF. I know my stuff as far as the diet is concerned. I try and follow it to the book. However my progress has stalled at 118 kilos.Here is the scenario.
    I started ketogenic diet. I stayed on the diet for 14 days. Lost a total of 20 pounds. Worked great. This loss was in the first 7 days. The next seven days I did not lose a pound.I got sick of it though. Then I decided I needed something more drastic to move things along.
    I looked up Lyle's other book RFL and wanted to try PSMF. I have been on this diet for last 7 days. Gained 1 kilo.
    My diet
    Meal 1 - On Whey Gold Standard Cookies and Cream - 110 Calories Whey Isolate.
    Meal 2 - On Whey Gold Standard Cookies and Cream - 110 Calories Whey Isolate.
    Meal 3 - On Whey Gold Standard Cookies and Cream - 110 Calories Whey Isolate.
    Meal 4 - 250 gram chicken breast cooked in olive oil and Brocolli about 1.5 cups.
    Meal 5 - On Whey Gold Standard Cookies and Cream - 110 Calories Whey Isolate.
    Total Carbs - 16 grams
    Protein - 180 - 200 Grams
    Fat - 10-18 grams
    Problems - Hypothyroid borderline reading of 6
    I workout 5 days a week.
    Cardio 2 days for 30 mins rotate between jogging , elliptical.
    Weights 3 days from videos on BB
    I am frustrated as I have stopped losing weight. I am obese and I thought losing weight should have been much quicker for me.

  2. NeedANick

    21days and already frustrated? Boy, the issue seems to be patience...

  3. nlite2000

    Originally Posted by evilopinions
    Stats
    Height - 5'10"
    Weight - 118 Kilos - 260 Pounds
    Bodyfat - 35%
    I have done enough research for ketogenic diets and PSMF. I know my stuff as far as the diet is concerned. I try and follow it to the book. However my progress has stalled at 118 kilos.Here is the scenario.
    I started ketogenic diet. I stayed on the diet for 14 days. Lost a total of 20 pounds. Worked great. This loss was in the first 7 days. The next seven days I did not lose a pound.I got sick of it though. Then I decided I needed something more drastic to move things along.
    I looked up Lyle's other book RFL and wanted to try PSMF. I have been on this diet for last 7 days. Gained 1 kilo.
    My diet
    Meal 1 - On Whey Gold Standard Cookies and Cream - 110 Calories Whey Isolate.
    Meal 2 - On Whey Gold Standard Cookies and Cream - 110 Calories Whey Isolate.
    Meal 3 - On Whey Gold Standard Cookies and Cream - 110 Calories Whey Isolate.
    Meal 4 - 250 gram chicken breast cooked in olive oil and Brocolli about 1.5 cups.
    Meal 5 - On Whey Gold Standard Cookies and Cream - 110 Calories Whey Isolate.
    Total Carbs - 16 grams
    Protein - 180 - 200 Grams
    Fat - 10-18 grams
    Problems - Hypothyroid borderline reading of 6
    I workout 5 days a week.
    Cardio 2 days for 30 mins rotate between jogging , elliptical.
    Weights 3 days from videos on BB
    I am frustrated as I have stopped losing weight. I am obese and I thought losing weight should have been much quicker for me.

    You had the drastic weight loss at first on keto because you dropped a bunch of water weight, you switched to another ketogenic diet, you're not gonna get that water flush again. Also, one of the things they beat over your head in the RFL handbook is that you shouldn't workout more than twice in a week, and that it should be a fullbody weight routine with no cardio. Exercising too much under that severe a deficit, paradoxically, stalls weight loss. This is andecdotally confirmed by people who have exercised too much while on that crazy ass diet. People who follow the training protocols haven't had the problem you're havin; so that's more anecdotal evidence I've seen that supports the training protocols in the book as it pertains to the results of the diet.
    Stop reading if you don't want some sanctimony
    You've done the crash diet thing, and you lost a fair bit of weight. Isn't time to develop heatlthy, normal eating habits, of a person who isn't obese? Eating a moderate deficit, coupled with the necessary training is going to get you where you need to go, and it's going to make you look good when you get there.

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What is KETOACIDOSIS? What does KETOACIDOSIS mean? KETOACIDOSIS meaning - KETOACIDOSIS definition - 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... Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and ß-hydroxybutyrate. Ketoacidosis is a pathological metabolic state marked by extreme and uncontrolled ketosis. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased. In extreme cases ketoacidosis can be fatal. Ketoacidosis is most common in untreated type 1 diabetes mellitus, when the liver breaks down fat and proteins in response to a perceived need for respiratory substrate. Prolonged alcoholism may lead to alcoholic ketoacidosis. Ketoacidosis can be smelled on a person's breath. This is due to acetone, a direct by-product of the spontaneous decomposition of acetoacetic acid. It is often described as smelling like fruit or nail polish remover. Ketosis may also smell, but the odor is usually more subtle due to lower concentrations of acetone. Treatment consists most simply of correcting blood sugar and insulin levels, which will halt ketone production. If the severity of the case warrants more aggressive measures, intravenous sodium bicarbonate infusion can be given to raise blood pH back to an acceptable range. However, serious caution must be exercised with IV sodium bicarbonate to avoid the risk of equally life-threatening hypernatremia. Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively. In diabetic ketoacidosis, a high concentration of ketone bodies is usually accompanied by insulin deficiency, hyperglycemia, and dehydration. Particularly in type 1 diabetics the lack of insulin in the bloodstream prevents glucose absorption, thereby inhibiting the production of oxaloacetate (a crucial molecule for processing Acetyl-CoA, the product of beta-oxidation of fatty acids, in the Krebs cycle) through reduced levels of pyruvate (a byproduct of glycolysis), and can cause unchecked ketone body production (through fatty acid metabolism) potentially leading to dangerous glucose and ketone levels in the blood. Hyperglycemia results in glucose overloading the kidneys and spilling into the urine (transport maximum for glucose is exceeded). Dehydration results following the osmotic movement of water into urine (Osmotic diuresis), exacerbating the acidosis. In alcoholic ketoacidosis, alcohol causes dehydration and blocks the first step of gluconeogenesis by depleting oxaloacetate. The body is unable to synthesize enough glucose to meet its needs, thus creating an energy crisis resulting in fatty acid metabolism, and ketone body formation.

Case Study: Diabetic Ketoacidosis Complications In Type 2 Diabetes

CLINICAL DIABETES VOL. 18 NO. 2 Spring 2000 CASE STUDIES Case Study: Diabetic Ketoacidosis Complications in Type 2 Diabetes Craig D. Wittlesey, MD Presentation A 48-year-old Hispanic woman with a long history of obesity, diabetes, dyslipidemia, and reactive airway disease presented to the hospital emergency department with a 5-day history of weakness, tactile fever, productive cough, nausea, and vomiting. Patient report and chart review confirmed that 2 years before this presentation, her diabetes had been managed with diet alone. In the past year, glipizide (Glucotrol), metformin (Glucophage), and ultralente insulin were added because of poor glycemic control. On examination, her temperature was 99.1° F, blood pressure was 98/64 mmHg, pulse was 136, and respirations were 36. There was a strong smell of ketones in the exam room. The patient was drowsy but cogent. Her head and neck exam revealed poor dentition and periodontal disease. Her lung sounds were clear without wheezes or rhonchi. Her heart sounds were normal. The abdominal exam revealed mild epigastric tenderness to deep palpation but no rebound tenderness or guarding. Extremities were well perfused with symmetric pulses. Continue reading >>

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  1. niah

    So I started a high protein low carb lifestyle exactly 7 days ago. I have cut out all fruit, starches, dairy etc. I will reintroduce fruit at the 14 day mark. Anyway, I feel like a bottomless pit the last two days. I am not craving carbs. It's peanut butters or protein pancakes or meat etc. I am having less of a three meal a day and more eating eating eating. Like I had lunch at 11:25 ish came home ( now 3 o clock ) had beef with tahini and devoured that and three protein pancakes. lol. I feel like I can't get enough...... Am I in ketosis now or something?

  2. j3nn

    Well, ketosis does mimic starvation so maybe your body is freaking out and thinks you're trying to kill it? Lol

  3. Drumroll

    It thinks you're trying to KILL it? Oh come on j3nn, you know better.
    I'm not sure if the OP is in ketosis just yet though, as one of the primary symptoms of ketosis is a blunting of the hunger signals. Also seems like he/she might be eating too much protein to get into ketosis. If that's a goal, some dialing back on protein might be necessary.
    Also, OP, don't let people scare you by telling you ketosis is bad, or stressful, or dangerous or that low-carb is somehow "damaging" to your body. It's a perfectly natural state to be in if that is your goal. Some people do better when in ketosis than others do, it doesn't work for everyone, but that is no reason not to try it out for yourself! Don't let the fearmongerers scare you away from giving it a try if you want to. A key component of the Primal Blueprint is experimenting for yourself and finding out where you feel the best/most healthy.

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People always freak out when I tell them I am doing keto. I even have one friend that refers to my diet as "The Ketoacidosis Diet". I can't get him to understand the difference, but maybe this will help you! Find Me On Twitter: www.twitter.com/HeavyKevi Instagram: www.instagram.com/TheHeavyTruthTV Follow My Macros on MyFitnessPal @The HeavyTruth Facebook Group: Facebook.com/Groups/TheHeavyTruthTV Subscribe to my Essential Oils Channel: https://goo.gl/El053Q Send Questions or Testimonials By Mail: Kevin Gillem P.O.Box 291517 Phelan, CA 92329 My Favorite Low Carb Sweetener - http://amzn.to/2smCmDM I recommend Smackfat Ketone Strips - http://amzn.to/2laB9MG I use the Match DNA Milk Frother - http://amzn.to/2klHt4o I use NOW MCT Oil - http://amzn.to/2kOs48S I'm Kevin and I have used a Ketogenic diet, Intermittent Fasting and Extended Fasting to successfully lose 160 pounds and I am still shrinking. I hope to one day be half the man I was at 400 pounds. During this journey I have learned a lot about weight loss, Metabolic syndrome, Insulin Resistance, LCHF dieting and overall health in general. I am greatly interested in continuing to learn about health related topics and sharing what I learn with others so that all of our lives can be improved. Please like and subscribe to my channel so that I can share the things I learn that I think are important for all of our well being. I would also appreciate feedback from you all so I can share it with other subscribers and we can all grow as a community. I am not a doctor. I am not licensed. I do not hold any qualifications for giving medical advice. This is an account of my own experiences and does not apply to anyone else. All information, content, and material of this channel is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. If you have questions about your own personal situation it is recommended that you discuss them with your own licensed healthcare professional. If you think you are having an emergency, dial 911 immediately.

Diabetic Ketoacidosis

Professor of Pediatric Endocrinology University of Khartoum, Sudan Introduction DKA is a serious acute complications of Diabetes Mellitus. It carries significant risk of death and/or morbidity especially with delayed treatment. The prognosis of DKA is worse in the extremes of age, with a mortality rates of 5-10%. With the new advances of therapy, DKA mortality decreases to > 2%. Before discovery and use of Insulin (1922) the mortality was 100%. Epidemiology DKA is reported in 2-5% of known type 1 diabetic patients in industrialized countries, while it occurs in 35-40% of such patients in Africa. DKA at the time of first diagnosis of diabetes mellitus is reported in only 2-3% in western Europe, but is seen in 95% of diabetic children in Sudan. Similar results were reported from other African countries . Consequences The latter observation is annoying because it implies the following: The late diagnosis of type 1 diabetes in many developing countries particularly in Africa. The late presentation of DKA, which is associated with risk of morbidity & mortality Death of young children with DKA undiagnosed or wrongly diagnosed as malaria or meningitis. Pathophysiology Secondary to insulin Continue reading >>

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  1. metalmd06

    Does acute DKA cause hyperkalemia, or is the potassium normal or low due to osmotic diuresis? I get the acute affect of metabolic acidosis on potassium (K+ shifts from intracellular to extracellular compartments). According to MedEssentials, the initial response (<24 hours) is increased serum potassium. The chronic effect occuring within 24 hours is a compensatory increase in Aldosterone that normalizes or ultimatley decreases the serum K+. Then it says on another page that because of osmotic diuresis, there is K+ wasting with DKA. On top of that, I had a question about a diabetic patient in DKA with signs of hyperkalemia. Needless to say, I'm a bit confused. Any help is appreciated.

  2. FutureDoc4

    I remember this being a tricky point:
    1) DKA leads to a decreased TOTAL body K+ (due to diuresis) (increase urine flow, increase K+ loss)
    2) Like you said, during DKA, acidosis causes an exchange of H+/K+ leading to hyperkalemia.
    So, TOTAL body K+ is low, but the patient presents with hyperkalemia. Why is this important? Give, insulin, pushes the K+ back into the cells and can quickly precipitate hypokalemia and (which we all know is bad). Hope that is helpful.

  3. Cooolguy

    DKA-->Anion gap M. Acidosis-->K+ shift to extracellular component--> hyperkalemia-->symptoms and signs
    DKA--> increased osmoles-->Osmotic diuresis-->loss of K+ in urine-->decreased total body K+ (because more has been seeped from the cells)
    --dont confuse total body K+ with EC K+
    Note: osmotic diuresis also causes polyuria, ketonuria, glycosuria, and loss of Na+ in urine--> Hyponatremia
    DKA tx: Insulin (helps put K+ back into cells), and K+ (to replenish the low total potassium
    Hope it helps

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