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Dka Diagnosis

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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.....

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious condition that can occur in diabetes. DKA happens when acidic substances, called ketones, build up in your body. Ketones are formed when your body burns fat for fuel instead of sugar, or glucose. That can happen if you don’t have enough insulin in your body to help you process sugars. Learn more: Ketosis vs. ketoacidosis: What you should know » Left untreated, ketones can build up to dangerous levels. DKA can occur in people who have type 1 or type 2 diabetes, but it’s rare in people with type 2 diabetes. DKA can also develop if you are at risk for diabetes, but have not received a formal diagnosis. It can be the first sign of type 1 diabetes. DKA is a medical emergency. Call your local emergency services immediately if you think you are experiencing DKA. Symptoms of DKA can appear quickly and may include: frequent urination extreme thirst high blood sugar levels high levels of ketones in the urine nausea or vomiting abdominal pain confusion fruity-smelling breath a flushed face fatigue rapid breathing dry mouth and skin It is important to make sure you consult with your doctor if you experience any of these symptoms. If left untreated, Continue reading >>

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  1. furball64801

    Actually my thin 85 lb aunts lived to 88 with being diabetic. Yes you can but I never knew what it ran, my mom also very thin and it was cancer that killed her she never ingested anything harmful unless ice tea is in that. I do get your thinking but its your life your numbers, to me its about preventing damage I am 68 as of last month, I dodged a lot of bullets and for me being in control is important got to see all the grand kids graduate and get marries then see great grand kits oh my I am getting old.

  2. jwags

    A non diabetic will usually have numbers under 100 most of the day. I have tested my nonndiabetic family members and they are always under 100 even after eating. As diabetic's we are asked to keep our bgs between 100-140 which is not easy for a lot of us. It is said that blood vessel damage starts when bgs go above 140.

  3. sangdoux

    At this point, I don't think it really matters if stress was a proximate cause of your autoimmune diabetes. Whatever initiated the process, nothing that I know of is going to reverse it. My speculation is that my autoimmune response went haywire after I had a bout with the flu. If that's the case, I didn't develop obvious symptoms until several years later. Once the process started, I don't I could have done anything to change the outcome, certainly not after I showed up at a GP's office with BG of 425, A1c of 11.2, and various obvious indications of blood sugar out of control. I was misdiagnosed as Type 2 (I was 60 years old). I started on Lantus a week after diagnosis and managed OK for 5 years. Once I was on Lantus, my BG stayed under 200 and, as I recall, my next A1c was under 6.5. It took me a few weeks to feel "normal" when my BG was, in fact, "normal," and I had some pain and numbness in my lower extremities (probably from nerve damage) that eventually went away.
    After five years, when I began to lose control with once daily shots of Lantus, I finally got a GAD-65 autoantibody test to prove to my GP that I was Type 1 (LADA). I was referred to an endo, who added MDI Humalog.
    In any event, if you are a LADA, you are going to have to use insulin. If your BG regularly stays above 200, you're much more likely to develop complications than if you have decent control. For some excellent advice on managing diabetes with insulin, check out Gary Scheiner's book "Think Like a Pancreas."

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Moof's Medical Biochemistry Video Course: http://moof-university.thinkific.com/... In this video, I describe how Ketone Bodies are oxidized for energy. The liver makes ketone bodies that travel through the blood to extrahepatic tissues, where they are oxidized in the mitochondrial matrix to give energy. The pathway begins with D--Hydroxybutyrate, as it is oxidized to Acetoacetate by the same D--Hydroxybutyrate Dehydrogenase reaction (except in reverse). The Acetoacetate is then activated to Acetoacetyl-CoA by -Ketoacyl-CoA Transferase (also known as Thiophorase); this second step takes a Coenzyme A from Succinyl-CoA (an intermediate of the Krebs Cycle). The Acetoacetyl-CoA is then cleaved into two Acetyl-CoA molecules that can go through the Krebs Cycle to be oxidized, resulting in energy that cell can use. Ultimately, the liver is basically sending Acetyl-CoA that it isnt metabolizing to other tissues (by way of Ketone Bodies in the blood) so that those other tissues can utilize the Acetyl-CoA. However, sometimes, the extrahepatic tissues do not oxidize the ketone bodies rapidly enough to keep up with the pace at which they are arriving from the blood. This is a problem described in more detail in the next video in the series. For a suggested viewing order of the videos, information on tutoring, personalized video solutions, and an opportunity to support Moof University financially, visit MoofUniversity.com, and follow Moof University on the different social media platforms. Don't forget to LIKE, COMMENT, and SUBSCRIBE: http://www.youtube.com/subscription_c...

Diabetes With Ketone Bodies In Dogs

Studies show that female dogs (particularly non-spayed) are more prone to DKA, as are older canines. Diabetic ketoacidosis is best classified through the presence of ketones that exist in the liver, which are directly correlated to the lack of insulin being produced in the body. This is a very serious complication, requiring immediate veterinary intervention. Although a number of dogs can be affected mildly, the majority are very ill. Some dogs will not recover despite treatment, and concurrent disease has been documented in 70% of canines diagnosed with DKA. Diabetes with ketone bodies is also described in veterinary terms as diabetic ketoacidosis or DKA. It is a severe complication of diabetes mellitus. Excess ketone bodies result in acidosis and electrolyte abnormalities, which can lead to a crisis situation for your dog. If left in an untreated state, this condition can and will be fatal. Some dogs who are suffering from diabetic ketoacidosis may present as systemically well. Others will show severe illness. Symptoms may be seen as listed below: Change in appetite (either increase or decrease) Increased thirst Frequent urination Vomiting Abdominal pain Mental dullness Coughing Continue reading >>

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  1. furball64801

    Actually my thin 85 lb aunts lived to 88 with being diabetic. Yes you can but I never knew what it ran, my mom also very thin and it was cancer that killed her she never ingested anything harmful unless ice tea is in that. I do get your thinking but its your life your numbers, to me its about preventing damage I am 68 as of last month, I dodged a lot of bullets and for me being in control is important got to see all the grand kids graduate and get marries then see great grand kits oh my I am getting old.

  2. jwags

    A non diabetic will usually have numbers under 100 most of the day. I have tested my nonndiabetic family members and they are always under 100 even after eating. As diabetic's we are asked to keep our bgs between 100-140 which is not easy for a lot of us. It is said that blood vessel damage starts when bgs go above 140.

  3. sangdoux

    At this point, I don't think it really matters if stress was a proximate cause of your autoimmune diabetes. Whatever initiated the process, nothing that I know of is going to reverse it. My speculation is that my autoimmune response went haywire after I had a bout with the flu. If that's the case, I didn't develop obvious symptoms until several years later. Once the process started, I don't I could have done anything to change the outcome, certainly not after I showed up at a GP's office with BG of 425, A1c of 11.2, and various obvious indications of blood sugar out of control. I was misdiagnosed as Type 2 (I was 60 years old). I started on Lantus a week after diagnosis and managed OK for 5 years. Once I was on Lantus, my BG stayed under 200 and, as I recall, my next A1c was under 6.5. It took me a few weeks to feel "normal" when my BG was, in fact, "normal," and I had some pain and numbness in my lower extremities (probably from nerve damage) that eventually went away.
    After five years, when I began to lose control with once daily shots of Lantus, I finally got a GAD-65 autoantibody test to prove to my GP that I was Type 1 (LADA). I was referred to an endo, who added MDI Humalog.
    In any event, if you are a LADA, you are going to have to use insulin. If your BG regularly stays above 200, you're much more likely to develop complications than if you have decent control. For some excellent advice on managing diabetes with insulin, check out Gary Scheiner's book "Think Like a Pancreas."

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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.

Diabetic Ketoacidosis

Initial Evaluation Initial evaluation of patients with DKA includes diagnosis and treatment of precipitating factors (Table 14–18). The most common precipitating factor is infection, followed by noncompliance with insulin therapy.3 While insulin pump therapy has been implicated as a risk factor for DKA in the past, most recent studies show that with proper education and practice using the pump, the frequency of DKA is the same for patients on pump and injection therapy.19 Common causes by frequency Other causes Selected drugs that may contribute to diabetic ketoacidosis Infection, particularly pneumonia, urinary tract infection, and sepsis4 Inadequate insulin treatment or noncompliance4 New-onset diabetes4 Cardiovascular disease, particularly myocardial infarction5 Acanthosis nigricans6 Acromegaly7 Arterial thrombosis, including mesenteric and iliac5 Cerebrovascular accident5 Hemochromatosis8 Hyperthyroidism9 Pancreatitis10 Pregnancy11 Atypical antipsychotic agents12 Corticosteroids13 FK50614 Glucagon15 Interferon16 Sympathomimetic agents including albuterol (Ventolin), dopamine (Intropin), dobutamine (Dobutrex), terbutaline (Bricanyl),17 and ritodrine (Yutopar)18 DIFFERENTIAL DI Continue reading >>

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  1. amsmith

    I understand that the guidelines state "uncontrolled" should be coded as hyperglycemia. What about the DKA type 2 portion? We have 2 opinions in our office and I am just looking for the correct way to code it.
    I suspect for my scenario E11.65, E11.69 and E87.2. Please help.
    There really should be an E11.1X...LOL!!
    Thank you,
    Anna

  2. mitchellde

    Ketoacidosis is actually rare in a type 2 diabetic so that may be the reason for no specific code for it. So use the E11.69 with the E87.2

  3. amsmith

    Oddly, our physician's document it frequently. I will check with one of them to find out why we tend to have a higher volume.

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