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Diabetic Ketoacidosis And Hyperosmolar Hyperglycemic State In Adults: Epidemiology And Pathogenesis

INTRODUCTION Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS, also called hyperosmotic hyperglycemic nonketotic state) are two of the most serious acute complications of diabetes. They each represent an extreme in the hyperglycemic spectrum. The epidemiology and the factors responsible for the metabolic abnormalities of DKA and HHS in adults will be discussed here. The clinical features, evaluation, diagnosis, and treatment of these disorders are discussed separately. (See "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis" and "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment".) EPIDEMIOLOGY Diabetic ketoacidosis (DKA) is characteristically associated with type 1 diabetes. It also occurs in type 2 diabetes under conditions of extreme stress such as serious infection, trauma, cardiovascular or other emergencies, and, less often, as a presenting manifestation of type 2 diabetes, a disorder called ketosis-prone diabetes mellitus. (See "Syndromes of ketosis-prone diabetes mellitus".) DKA is more common in young (<65 years) patients, whereas hyperosmolar hyperglycemic s Continue reading >>

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  1. Sideways17

    Taking a break from keto to break through plateau...Will it work

    Let me start by saying, I love keto. I've been on this diet for almost 5 months and have lost 40 lbs. However, I have been stalled for 5 to 6 weeks. I have lowered calories, upped cardio....nothing. I have been stalled at 195lbs. I still have quite a bit of fat to lose. Still can't see the 6 pack and I still have slight love handles. I decided to take a 1 to 2 week break from the diet. Anyone else ever do this? Thanks.

  2. queloque

    Originally Posted by Sideways17
    Let me start by saying, I love keto. I've been on this diet for almost 5 months and have lost 40 lbs. However, I have been stalled for 5 to 6 weeks. I have lowered calories, upped cardio....nothing. I have been stalled at 195lbs. I still have quite a bit of fat to lose. Still can't see the 6 pack and I still have slight love handles. I decided to take a 1 to 2 week break from the diet. Anyone else ever do this? Thanks.

    Well you know I have. When I go back to keto I won't have such a large deficit this time. I'm sticking to the 10 to 20 percent deficit that Lyles recommends.

  3. Sideways17

    Originally Posted by queloque
    Well you know I have. When I go back to keto I won't have such a large deficit this time. I'm sticking to the 10 to 20 percent deficit that Lyles recommends.

    Yeah, Im just looking for more opinions. What will 10 to 20% put you at?

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DKA diabetic ketoacidosis nursing management pathophysiology & treatment. DKA is a complication of diabetes mellitus and mainly affects type 1 diabetics. DKA management includes controlling hyperglycemia, ketosis, and acdidosis. Signs & Symptoms include polyuria, polydipsia, hyperglycemia greater than 300 mg/dL, Kussmaul breathing, acetone breath, and ketones in the urine. Typically DKA treatment includes: intravenous fluids, insulin therapy (IV regular insulin), and electrolyte replacement. This video details what the nurse needs to know for the NCLEX exam about diabetic ketoacidosis. I also touch on DKA vs HHS (diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome (please see the other video for more details). Quiz on DKA: http://www.registerednursern.com/diab... Lecture Notes for this video: http://www.registerednursern.com/diab... Diabetes NCLEX Review Videos: https://www.youtube.com/playlist?list... Subscribe: http://www.youtube.com/subscription_c... Nursing School Supplies: http://www.registerednursern.com/the-... Nursing Job Search: http://www.registerednursern.com/nurs... Visit our website RegisteredNurseRN.com for free quizzes, nursing care plans, salary

Spilleautomater Dka Management Uptodate

dka management - uptodatecom Related Video "Spilleautomater Dka Management Uptodate" (647 movies): You Want Something Special About dka management uptodate? It solves the. @ Diabetes Management Uptodate Diabetic Foot Care Handout The 3 Step Trick that Reverses Diabetes Permanently in As Little as 11 Days. SIGN UP FOR THE DIABETES SELFMANAGEMENT. Diabetes Management Uptodate Diabetic Diary The 3 Step Trick that Reverses Diabetes Permanently in As Little as 11 Days. DIABETES MANAGEMENT UPTODATE The. Diabetes Management Uptodate: : The 3 Step Trick that Reverses Diabetes Permanently in As Little as 11 Days. DIABETES MANAGEMENT UPTODATE. Diabetic Ketoacidosis Diabetic Ketoacidosis 2 American Family Physician Volume 87, Number 5 March 1, 2013 Management of DKA in Adults SIGN UP FOR treatment of dka uptodate THE treatment of dka uptodate DIABETES SELFMANAGEMENT NEWSLETTER! The REAL cause of dka management uptodate! Why Do Not Click To Get it. dka management uptodate, The Secret of Nature. Stop wasting your time with unanswered searches. Continue reading >>

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  1. humbled

    I present to you here a bunch of information I have assimilated/catalogued on this subject.
    The ketogenic diet is an effective weight loss tool, but it does not guarantee that you will move from fat to thin without complications. It simply allows your body to regulate its fat cells better, and should your body choose a destination that is fatter than you like, you may find yourself stuck there. This then becomes the homeostatic weight that your body prefers to maintain, for whatever reason.
    Possible Scientific Mechanisms for Plateau
    G - Glucose tolerance: when we initially put on our weight, we likely did so in an environment of chronically elevated blood sugar. We are all likely to have a problem with our glucose tolerance, thanks to the standard grain-focused, carbohydrate-laden diet. There are two aspects to this issue. First is the glucose sensitivity of cells. We need our cells to be eager to use blood glucose when it is available, rather than rely heavily on insulin to force it. The other side of the coin is in the pancreas, in how much insulin we secrete when carbohydrates pass through the upper GI tract, or when we think about eating sweet food or place sweet food on the tongue (artificial sweeteners included). These problems can be described as insulin resistance, insulin sensitivity, insulin oversecretion, etc. We may reach a homeostatic weight, even with small amounts of carbohydrate in the diet, due to the various ways in which our glucose tolerance may be impaired.
    V - Visceral fat: insulin-driven fat storage seems to deposit fat more in the abdomen than in other locations. This is the so called apple/pear body shape talk you may have heard. Interestingly, visceral fat is more hormonally active than other types of fat and may resist collection, even when the metabolism has been restored to normal function via the cessation of carbohydrate intake. These fat cells secrete hormones called adipokines that interfere with proper glucose tolerance. They are the zombie fat cells that want to eat the brains of your properly-functioning metabolism.
    O - Overnutrition: there are some who say that eating too many calories will cause a plateau. Here is a sample from Dr. Eades' blog on the subject. I believe this hypothesis, but it may not happen as frequently as one would expect. Lowering calories may lower carbohydrate intake. If one oversecretes insulin, even a slight lowering of carbs will aid metabolic regulation and may set the homeostatic point back some amount. But for the cases where our metabolism is healthy and we are overeating, the body will likely not dip too deeply into any of its fat stores. Another form of overnutrition may be an overconsumption of protein. Again, if we have problems with glucose tolerance, the protein may tap into those issues as our body converts it to glucose.
    K - Keto adaptation: your body will gradually use ketones more efficiently (see some comments here). There may even come a time when you cannot make your ketostix turn purple at all. This is not a bad thing and it does not mean you cannot lose weight, or that the health advantages of low-carb are gone. The Inuit thrive on this diet their whole lives, after all. It means that you may have to watch calories a little more closely than in the years prior, although it should still be extremely difficult to gain fat.
    L - Leptin signaling: fat is hormonally active. It sends out leptin, a satiety hormone whose job is to say "hey, come eat me." As you lose non-visceral fat, there will be less fat cells around sending this signal to your metabolism. This is one possible answer to the tapering off of weight loss (on any diet, in fact). I sincerely hope it isn't the case, but some obesetologists theorize that being obese for the long term can permanently burn out leptin receptors. And to add to your misery, insulin interferes with leptin reception - but that is something keto helps solve.
    C - Carb creep, cheating, and other "user error": we get comfortable with our diets and experiment with expanding our palate. We lose some of the rigor that we applied when starting. The end result is that we are eating more carbohydrate than we expect.
    What to Do About It
    Before you take action to fight your plateau, make sure you are actually stuck. Don't rely on your scale alone; use body tape, calipers, a tight pair of paints, number of belt loops, or whatever tools you might have where you can verify that nothing is changing. There are times on keto where you may drop a size without losing weight. Now that we have that out of the way, you may have noticed the individual letters prefixed to the mechanisms above. I will use those letters to indicate how the methods and mechanisms are related.
    When you undertake any action, test it for a fixed period (2-4 weeks) to see if it is effectual, and if not, you needn't bother yourself with integrating it into your lifestyle. You may be able to try some of this occasionally to kickstart the weight loss process, which will then go again even if you discontinue the behavior. Some of these tools can be used as an ongoing adjunct to keto.
    (G) Employ an endurance exercise program. I personally recommend HIIT (or SIT, in this study), but it seems that any sort of endurance training improves glucose tolerance. It's not about burning calories.
    (G,V) Give intermittent fasting a shot, either a gentle 16/8 schedule, or even up to a more aggressive ADF (alternate day feeding) schedule. This is not necessarily a means of calorie restriction, since some IF practitioners call for completely making up for the missed meal period. Hence, this is a way of redistributing your calories in your schedule such that you are relying on fat reserves more often.
    (G,O) Eat a nearly zero-carb diet that is 90% fat, and optionally restrict yourself to little more than 1,000 calories per day. (Atkins called this "The Fat Fast.")
    (C) Make sure carb counts are correct and that you're attaining your goals.
    (O,C,K) Reduce caloric intake. (Last resort IMO.)
    (G,V,L) Wait. It takes a number of years for all the cells in your body to replace themselves. The cells that grow while on the ketogenic diet will hopefully be more insulin sensitive than your old cells, and over time your homeostatic weight may drop.
    (C) Oy! Don't do that.
    I think that's everything for now. I will update this to reflect quality tidbits that anyone wants to contribute.
    Update 1: fix some wording.
    Update 2: reword end of leptin section.

  2. lessofme

    Tons of useful stuff here, thanks. But this:
    It's not about burning calories.
    ... is the theme of the year for me. Uncoupling exercise from the impulse to ask, "how many calories did I just burn during that workout?" was a huge revelation, and has done more to facilitate improving my fitness than anything else I've done. Realizing that the number of calories I'd burned on a given hike or bike ride or strength workout was basically irrelevant; and that the point was to change how my body functions and how I live in it, made a world of difference to me, both practically and psychologically. Somehow shifting my motivation from, "I have to do this to meet my calorie goal for the day," to "I do this because I like how I feel when I'm doing it" changed everything. Now I exercise far more than I ever did before, enjoy doing it, and am actively looking forward to the day when I can do bigger, more intense, more fun things.
    Also, as far as plateaus and women are concerned, I can't overstate how annoying hormones can be in mimicking a plateau. I've come to learn that there's very little point in getting worried about a two- or three-week stall in weight or volume loss, because my month invariably goes like this:
    week 1: lose a pound
    week 2: maybe lose another pound, maybe nothing (also, may or may not appear to drop out of ketosis in spite of not eating any differently)
    week 3: nada; spend the week fighting the Bolshevik Army*
    week 4: ZOMG lose like nine fucking pounds and two inches off my hip
    In my experience, more than half of the women I've met complaining about a perceived plateau are within a week of starting their periods.
    tl;dr: it's really not about burning calories; also, water retention is a pain in the ass.
    *I love a good communist-themed euphemism for menstruation.

  3. [deleted]

    This is my new favorite euphemism. Thank you.

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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

Management Of Adult Diabetic Ketoacidosis

Authors Gosmanov AR, Gosmanova E, Dillard-Cannon E Accepted for publication 13 May 2014 Checked for plagiarism Yes Peer reviewer comments 2 Aidar R Gosmanov,1 Elvira O Gosmanova,2 Erika Dillard-Cannon3 1Division of Endocrinology, Diabetes and Metabolism, 2Division of Nephrology, Department of Medicine, 3Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA Abstract: Diabetic ketoacidosis (DKA) is a rare yet potentially fatal hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. Due to its increasing incidence and economic impact related to the treatment and associated morbidity, effective management and prevention is key. Elements of management include making the appropriate diagnosis using current laboratory tools and clinical criteria and coordinating fluid resuscitation, insulin therapy, and electrolyte replacement through feedback obtained from timely patient monitoring and knowledge of resolution criteria. In addition, awareness of special populations such as patients with renal disease presenting with DKA is important. During the DKA therapy, complications may arise and app Continue reading >>

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  1. Anonymous

    i'm supposed to test my peepee daily for protein, but they didn't tell me where or what to buy for this. the pharmacist was no help either? i have no idea, does anyone else know?

  2. Anonymous

    Huh? I've never heard of this. I would call your OB. Seems strange to tell you to do something like at home this without any guidance.

  3. Anonymous

    you need urine dip strips. i would call your practice ask speak with a nurse.

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