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Dka Criteria

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Diabetic Emergencies — Ketoacidosis, Hyperglycaemic Hyperosmolar State And Hypoglycaemia

Diabetic ketoacidosis (DKA), hyperglycaemic hyperosmolar state (HHS) and hypoglycaemia are serious complications of diabetes mellitus that require prompt recognition, diagnosis and treatment. DKA and HHS are characterized by insulinopaenia and severe hyperglycaemia; clinically, these two conditions differ only by the degree of dehydration and the severity of metabolic acidosis. The overall mortality recorded among children and adults with DKA is <1%. Mortality among patients with HHS is ∼10-fold higher than that associated with DKA. The prognosis and outcome of patients with DKA or HHS are determined by the severity of dehydration, the presence of comorbidities and age >60 years. The estimated annual cost of hospital treatment for patients experiencing hyperglycaemic crises in the USA exceeds US$2 billion. Hypoglycaemia is a frequent and serious adverse effect of antidiabetic therapy that is associated with both immediate and delayed adverse clinical outcomes, as well as increased economic costs. Inpatients who develop hypoglycaemia are likely to experience a long duration of hospital stay and increased mortality. This Review describes the clinical presentation, precipitating cau Continue reading >>

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  1. birdshaw

    DKA for weight loss?

    ok, here's my confession. i have gained about 20lbs in the last 8 years and it's all FAT. i hate it and i'm obsessed with getting rid of it. my doc said the better controlled i am, the more weight i'll gain. also, there's the lovely fact that insulin makes fat! i'm exercising, just can't do enough to agressively attack the problem (two young kids must come first). here's my temptation: just a few days, maybe a week of "managed" DKA to burn the fat. any thoughts? has anyone tried this? any lessons to share? am i the only person to think of this?? i'm too embarassed to ask my doc about it. i KNOW what the skinny non-diabetic would say.

  2. soso

    uhhh... ypu DO have 2 kids that come first, right?
    DKA=bad, danger possibly orphaned kids..... don't play with the bull, you will get it's horns up your arse....
    Or are you alking about a mild state of ketosis brought about by very low carbs for a while?
    check out Dr Richard Bernstein and please...don't play silly buggers with your own and your families lives......
    btw
    welcome to DD!
    support can help a lot with these battles

  3. birdshaw

    Dr Richard Bernstein ?? who is this and where can i find him?

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Refining The Diagnostic Criteria For Diabetic Ketoacidosis

Refining the Diagnostic Criteria for Diabetic Ketoacidosis Current consensus criteria for Current consensus criteria for a diagnosis of diabetic ketoacidosis (DKA) include the presence of ketonuria/ketonemia, a serum bicarbonate (HCO3) [le] 18 mEq/L, a pH [le] 7.30, and a glucose [gt] 250 mg/dL. These diagnostic criteria have limitations, however. Measurement of ketone bodies (KB) by the conventional nitroprusside method is not quantitative. Moreover, HCO3 and pH lack sensitivity and specificity due to coexisting acid-base disturbances (e.g., lactic acidosis, renal acidosis, and/or metabolic alkalosis due to HCl loss from vomiting) and variable respiratory compensation. On the other hand, plasma KB anion concentration is a specific indicator of DKA because it is a direct reflection of KB production, which is accompanied by equimolar production of hydrogen ion. In the present study, we sought to develop a diagnostic criterion for DKA using a laboratory-based [beta]-hydroxybutyrate ([beta]OHB) assay, and to evaluate the degree of diagnostic discordance between [beta]OHB and HCO3. Data were retrieved electronically by ICD-9 code and for simultaneous measurement of [beta]OHB and HCO3. Continue reading >>

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  1. TommyWoodland

    Optimal health calls for around 4700mg of potassium per day. The average American may hit half of this, while those on a LCHF diet likely struggle to cross 3000mg even when mindful. Some theorize that most cases of hypertension may actually be due to a potassium deficiency (along with Mg, Ca, and possibly vitamin D, vitamin K2) as opposed to sodium surplus.
    It is very difficult to hit this potassium goal on a ketogenic diet. As I crunch numbers I'm seeing it's next to impossible. For those who track their intake, how are you hitting your potassium goals? I can approach 4700 with the addition of cold potatoes (a resistance starch; 1600mg K, at ~50 net carbs) and lentil beans (~ 700 mg at ~20 net carbs). (Spinach, almonds, eggs, meats, and avocados provide the remainder). While I could remain below 100g carbs a day without a problem, I would likely no longer achieve ketosis, even with the daily intermittent fasting and resistance training. Any thoughts?
    For what it's worth, I was hardcore keto for about 2 years but ventured into more of TKD (targeted ketogenic) approach when I noticed my workouts suffering along with the cold hands/feet and sleep problems. That said, not sure if I have really been in ketosis during this period since I have not measured blood ketone levels.

  2. artketolay

    Avocado, kale and spinach are my 3 main sources of 'fruit and veg'. Plenty of potassium in all 3.

  3. a_complete_cock

    Nah, 37 cups of coffee seems more achievable.

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Diagnostic Criteria And Classification Of Dka

diagnostic criteria The diagnostic criteria for diabetic ketoacidosis are: ketonaemia 3 mmol /l and over or significant ketonuria (more than 2 + on standard urine sticks) blood glucose over 11 mmol /l or known diabetes mellitus venous bicarbonate (HCO3 ) ) below 15 mmol /l and /or venous pH less than 7.3 (1) The American Diabetes Association diagnostic criteria for DKA are as follows: elevated serum glucose level (greater than 250 mg per dL [13.88 mmol per L]) an elevated serum ketone level a pH less than 7.3 and a serum bicarbonate level less than 18 mEq per L (18 mmol per L) (2) classification of diabetic ketoacidosis DKA can be classified according to the severity into mild, moderate and severe (2) criterion mild (serum glucose > 250 mg/dL [13.88 mmol/L]) moderate (serum glucose > 250 mg/dL) severe (serum glucose > 250 mg/dL) anion gap > 10 mEq/L (10 mmol/L) > 12 mEq/L (12 mmol/L) > 12 mEq/L (12 mmol/L) arterial pH 7.24 to 7.30 7.00 to < 7.24 < 7.00 effective serum osmolality variable variable variable mental status alert alert/drowsy stupor/coma serum bicarbonate 15 to 18 mEq/L (15 to 18 mmol/L) 10 to < 15 mEq/L (10 to < 15 mmol/L) < 10 mEq/L (10 mmol/L) serum ketone positive p Continue reading >>

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  1. RunAndPunch

    How much sleep do you get on keto?

    Before starting keto, I slept around 8-9 hours a night. I've been doing a keto diet for about 2 months now, with the following results:
    --way more energy throughout the day
    --having to eat less
    --improved physical stamina
    --better mental clarity
    --only need about 5-6 hours of sleep per night
    The last one is what I'm researching right now.
    So for those on keto right now, how's your sleep schedule compared to non-keto?

  2. alexwynveen

    I tend to get 5-6 hours, except on the weekends where I drug myself with sleep aids to force myself to get ~8. I don't really choose to sleep so little, but as soon as I hit those times my body is all like "GET THE HELL UP" and I cant get back to bed (usually happens at 4:30am, so I eat and lift at 6). I would say that my sleeping hasn't really had much of a change on my sleep, but I definitely wouldn't need to sleep as much as before, due to the stability of energy I have. I never really go to bed "beat".

  3. sambshep

    Keto hasn't affected my sleep, it's the same as it is on a non-keto diet.

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