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Dka Management Algorithm

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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 b

Treatment Of Diabetic Ketoacidosis In The Emergency Department Utilizing A Web Based Insulin Infusion Algorithm

American Association of Clinical Endocrinologists (AACE) Annual Scientific & Clinical Congress Authors Joseph Aloi,1 Raymie McFarland,2 Margaret Bachand,3 Courtenay Harrison3 Ongoing efforts at improving quality metrics in the care of persons with diabetes frequently focus on avoiding unnecessary hospitalizations, decreasing length of stay and avoiding readmission to hospital following discharge. Our prior experience with Glucommander, a web based insulin dosing algorithm, in inpatient insulin protocols suggested that its use in the emergency department (ED) would be safe. We previously studied the effectiveness of the Glucommander system for the treatment of mild to moderate Diabetic Ketoacidosis (DKA) in the ED and reported early data on 15 patients. We now report a full 1 year experience with 35 patients studied. DKA is a frequent cause for hospital admissions – accounting for up to 8% of general medicine admissions in some hospital studies.4 Current standard treatment protocols involves use of intravenous insulin infusions monitored in the intensive care unit (ICU); raising both the cost and complexity of care. Methods 35 Patients seen in the ED diagnosed with DKA during the Continue reading >>

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    Brain Health: Intermittent Fasting or Caloric Restriction

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    Isocaloric MCT-supplemented ketogenic diet may improve cognition in Alzheimer's patients

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My Site - Chapter 15: Hyperglycemic Emergencies In Adults

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) should be suspected in ill patients with diabetes. If either DKA or HHS is diagnosed, precipitating factors must be sought and treated. DKA and HHS are medical emergencies that require treatment and monitoring for multiple metabolic abnormalities and vigilance for complications. A normal blood glucose does not rule out DKA in pregnancy. Ketoacidosis requires insulin administration (0.1 U/kg/h) for resolution; bicarbonate therapy should be considered only for extreme acidosis (pH7.0). Note to readers: Although the diagnosis and treatment of diabetic ketoacidosis (DKA) in adults and in children share general principles, there are significant differences in their application, largely related to the increased risk of life-threatening cerebral edema with DKA in children and adolescents. The specific issues related to treatment of DKA in children and adolescents are addressed in the Type 1 Diabetes in Children and Adolescents chapter, p. S153. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are diabetes emergencies with overlapping features. With insulin deficiency, hyperglycemia causes urinary Continue reading >>

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  1. Skiman

    So I was told that you need to be in the range of 70-80 for glucose and 1.5-3.0 to be in Ketosis and be fat adapted. So what is the difference between fat adapted or being in ketosis the whole time.
    My numbers would rarely get in the 70-80's range but mainly would like to hang out around 85-94 Rane with a Keytone reading of 1.5 and greater. Although I was told on this Facebook group that I'm not fat adapted and perhaps not in Ketosis?
    Also my glucose readings were always higher in the mornings with a few exceptions of being in the high 70's.
    Can anyone shed light on this, I feel that the keto community has different optimal ranges for what they think is correct?

    Thanks in advance.

  2. Barbara_Greenwood

    OK - "in ketosis" simply means your liver is producing ketones from partially metabolised fat. If you are more than 0.5 on your ketone meter, you are in ketosis. That will happen with about 48 hours of fasting or a few days of very low carb intake. It's an ephemeral state - eat more carbs, you'll make less ketones - eat less carbs, you'll make more ketones.
    Fat -adapted means that all the enzymes to do with fat metabolism have ramped up, so you are really good at burning fat. Also, your muscles become less keen to take up glucose because they want to leave it for the brain. Some people who low carb find their fasting glucose actually rises after a few months because of this effect.
    As to glucose levels - do you have diabetes? A normal fasting glucose is between 70 and 110, with 70-90 being preferred. I've seen keto people saying that blood glucose above 110 will prevent you being in ketosis. Well, according to my meters, that's a pile of poo, because I've seen 2+ on my ketone meter and 7 (126) on my glucose meter at the same time. But I have diabetes. Maybe in people without diabetes, a blood glucose above 110 only happens if they've eaten a load of carbs, and it's that which prevents ketosis rather than their glucose level per se.
    What enables ketosis is low carb intake. What prevents it is eating more carbs.... and maybe too much protein. More on the difference here:
    tuitnutrition.com
    33

    Being Fat Adapted Versus "In Ketosis" (Pt.1/3)
    “I got kicked out of ketosis.” If I never hear or read those six words, in that order, ever again, I’ll be one happy individual. ...

    Also be aware that, once you are fully fat adapted, your ketone levels may well fall. Richard and Carl have covered this on the podcast - you become more efficient at making enough ketones for your needs, but not too many. I'd been keto about 3 months when I got my ketone meter - my readings were always over 1.5, usually over 2. Another 4 months on, I rarely get above 1 unless I fast for 24 hours - my usual 20-30g carbs per day and 16/8 or 18/6 IF usually has me between 0.3 and 1. Just tested now - after 12+ hour fast, a keto day yesterday and 1 hour run this morning - BG 6.7 (120), ketones 0.5. BG was 6.1 (110) when I got up - exercise can raise it in the short term, but reduces it long term.

  3. Skiman

    Nope no diabetes on my end, I'm pretty active my events are bodybuilding and powerlifting, I have about 8% bf weighing around 155-160lbs, 39 years of age.
    This is what I read in today fasted.
    85 glucose and 3.3 Keytones this morning.

    Wondering what is the norm for being in ketosis and also fat adapted. I think what I've heard is that you have to be in a sweet spot of 70-80 glucose and 1.5-3.0 Keytones in order to be fat adapted.

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What is INFUSION PUMP? What does INFUSION PUMP mean? INFUSION PUMP meaning - INFUSION PUMP definition - INFUSION PUMP explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. An infusion pump infuses fluids, medication or nutrients into a patient's circulatory system. It is generally used intravenously, although subcutaneous, arterial and epidural infusions are occasionally used. Infusion pumps can administer fluids in ways that would be impractically expensive or unreliable if performed manually by nursing staff. For example, they can administer as little as 0.1 mL per hour injections (too small for a drip), injections every minute, injections with repeated boluses requested by the patient, up to maximum number per hour (e.g. in patient-controlled analgesia), or fluids whose volumes vary by the time of day. Because they can also produce quite high but controlled pressures, they can inject controlled amounts of fluids subcutaneously (beneath the skin), or epidurally (just within the surface of the central nervous system a very popular local spinal anesthesia for childbirth).

Use Of A Computer-based Insulin Infusion Algorithm To Treat Diabetic Ketoacidosis In The Emergency Department

Diabetes Technology & Therapeutics Authors Jagdeesh Ullal,1 Raymie McFarland,2 Margaret Bachand,3 Joseph Aloi4 Abstract Background Efforts at improving quality metrics in diabetes focus on minimizing adverse events and avoiding re-admissions to the hospital. Our experience with Glucommander (Glytec, Greenville, SC), a cloud-based insulin management software system, suggested that its use in the emergency department (ED) would be useful in treating patients with mild diabetic ketoacidosis (DKA). Materials and Methods Thirty-five patients seen in the ED with hyperglycemic crises and diagnosed with DKA during one calendar year were reviewed. A retrospective chart review was performed on patients who were placed on Glucommander for DKA management. We excluded patients with significant acidosis or concomitant medical illnesses. Results Initial average capillary glucose level was 487 + 68mg/dL, average time to target glucose was 5 h 11min, and rate of hypoglycemia (blood glucose level < 70mg/dL) was less than 0.3%. Sixteen patients treated with the protocol were discharged from the ED directly, and 19 were admitted. Patients were maintained for an average of 14 + 1 h on the Glucommander Continue reading >>

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  1. savannahceleste

    Trace amount of ketones in urine, constantly!

    So I'm sitting here, typing with one hand while I attempt to feed my son, Dakota with the other lol. At 18 years old, I keep finding myself looking down amazed at what perfection he is that I made! And then feel such an intense fear from the thought of me not living long enough to see him graduate or even see his 10th birthday! :(
    (I'm scared for myself, too…)
    I'm so glad I found a website that looks full of support/people that understand! I'm hoping I can get either an answer to why this is happening, or at least reassurance. :/
    Since I had Dakota (October. 8, 2010) via emergency c-section due to severe preeclampsia, I've had health problems. Unexplained 99% of the time because my blood work comes back "normal". Today, I'm fine. Besides occasional positional vertigo. What worries me though, is the fact that I've been running a trace amount of ketones since I've had Dakota. I'm able to flush them with water, but they come back. I eat enough, my blood sugars are under control, and I'm not sick. I blamed it at first on the c-section (surgery causing trauma to the insides and my body recovering from just having a baby) well it's been two and a half months and I'm STILL running ketones. I know what ketones are. I don't understand why I'm running them though. Why I can't get rid of them. I'm hoping to get an answer. Is this dangerous??? I'm really worried…
    Help please !!!

  2. tomecom

    The body is constantly producing small amounts of keytones naturally. Keytones are a byproduct of breaking down proteins. Small amounts are not a bad thing. In fact your heart will thank you because your heart prefers keytones over glucose as a fuel source.
    Typically, higher keytones are the result of eating too many proteins, and too few carbohydrates. Don't confuse keytones with ketoacidosis. Ketoacidosis is the result of a sedimentary lifestyle, overweight, low insulin levels, and poor diet.

  3. kdroberts

    I have to question some of your info since it appears to be very wrong. Ketones are produced when fatty acids are broken down, as far as I know protein has nothing to do with it. Ketoacidosis has nothing to do with weight, poor diet or lifestyle. Diabetic ketoacidosis is purely from a lack of insulin which is why it's a fairly common problem for type 1's and why many type 1's are diagnosed with ketoacidosis. Dehydration can also cause it because the body starts to panic and starts uncontrollably burning fat for energy.
    Ketosis can happen with a low carb, high fat (like the ketogenic diet which is about 80% fat or to some extent, atkins) diet since the body switches over to ketones as it's primary energy source. If you can control ketosis then it's arguably safe, although that's still hotly contested. If you can't control it then the ketosis will turn to ketoacidosis.

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