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Dka Pathophysiology

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In this video, Dr. Michael Agus discusses the risk factors, signs, symptoms, and treatment of cerebral edema in diabetic ketoacidosis. Please visit: www.openpediatrics.org OPENPediatrics is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: [email protected] Please note: OPENPediatrics does not support nor control any related videos in the sidebar, these are placed by Youtube. We apologize for any inconvenience this may cause.

Cerebral Edema In Children With Diabetic Ketoacidosis

INTRODUCTION Cerebral edema (or cerebral injury) is an uncommon but potentially devastating consequence of diabetic ketoacidosis (DKA). It is far more common among children with DKA than among adults. Young children and those with newly diagnosed diabetes are at highest risk. Symptoms typically emerge during treatment for DKA, but may be present prior to initiation of therapy. The pathophysiology, diagnosis, and treatment of cerebral edema in children with DKA will be discussed here. The diagnosis and treatment of DKA in children is discussed separately. (See "Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents" and "Treatment and complications of diabetic ketoacidosis in children and adolescents".) INCIDENCE Clinically significant cerebral edema occurs in approximately 1 percent of episodes of DKA in children and has a mortality rate of 20 to 90 percent [1-3]. Overall mortality rates for diabetic ketoacidosis (DKA) in children and adolescents range from 0.15 to 0.51 percent in national population studies in Canada, the United Kingdom, and the United States [4-9]; 50 to 80 percent of diabetes-related deaths are caused by cerebral edema [1,2,10]. Oth Continue reading >>

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  1. hippocampus

    What are the potassium level abnormalities associated with DKA (during diagnosis and treatment.)

  2. ahassan

    During DKA, the total body K is low bcz of osmotic diuresis, BUT the serum k conc. is raised bcz of the lack of insulin action, which allows k to shift out of the cells. So hyperkalemia.
    During treatment, k is shifted into the cells, which may lead to profound hypokalemia n death if not treated, so during therapy you have to adjust KCL conc. depending on blood K levels.

  3. tomymajor

    In DKA--> K level may be high or normal so we dont add k from the start of ttt
    But : In HHNKC---> K level is low from the start so we give k from start of ttt

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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.....

Diabetic Ketoacidosis In Type 2 Diabetes Mellitus—pathophysiology And Clinical Presentation

SN Davis is supported by research grants from the NIH. GE Umpierrez is supported by research grants from the NIH, the American Diabetes Association, and the American Heart Association. The authors declare no competing financial interests. Continue reading >>

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Popular Questions

  1. Roark

    Hey Guys,
    I realize I really have no clue what exactly is going on with ketosis or some of the diet in general, so any help in shedding light on it would be greatly appreciated! Please feel free to answer one or any of the following questions:
    1) I always thought ketosis occurred when one severely restricts carb intake, but I also know ketosis is the result of intermittent fasting. Does it happen under both situations independently, or must one both restrict carbs plus incorporate intermittent fasting to enter Ketosis?
    2) How quickly should one be able to enter ketosis? When not in ketosis, does this mean the body is storing fat and burning glucose?
    3) If while in ketosis the body is burning fat for fuel, wouldn't a high fat diet make available so much dietary fat that the body never needs to burn already stored fat for energy?
    4) What color should be targeted when using Ketostix, as I tend to get between small and medium after a week of less than 30 carbs daily. When is the best time of day to test with ketostix?
    5) When eating too many carbs to enter ketosis, does this mean that the body will naturally burn glucose before burning any fat? Is dietary fat stored when not in ketosis?
    6) If one eats regularly and stays bulletproof, but does not use intermittent fasting, does this mean the body does not enter ketosis and therefore the body never starts burning fat for energy, but instead stores eat? If not - what happens to all the dietary fat in the BP diet when not in ketosis?
    7) Is it safe for a friend who is not on the BP diet to consume high fat BP foods like BP Ice Cream - or will that lead to more fat storage than if they were to just eat regular, lower fat, higher sugar ice cream?
    I've been following and tweaking the diet for myself, but realize I really don't know what happens and why, so thanks in advance for all your help!

  2. Valentinoff

    1) I believe being in ketosis and IF are independent events. You can be in ketosis without IF'ing (by being low carb) and you can IF but not be in Ketosis (high carb when not fasting)
    7) I've read that you ought to give your friend some kind of supplement to aid with the fat digestion with 'Get Some' ice cream. A long timer on the forum would have to expand on this with the exact supplement/ingredient...
    I'm not so sure about the rest as I'm also at the beginning of my Bulletproof journey =D

  3. Roark

    1) I believe being in ketosis and IF are independent events. You can be in ketosis without IF'ing (by being low carb) and you can IF but not be in Ketosis (high carb when not fasting)
    7) I've read that you ought to give your friend some kind of supplement to aid with the fat digestion with 'Get Some' ice cream. A long timer on the forum would have to expand on this with the exact supplement/ingredient...

    I'm not so sure about the rest as I'm also at the beginning of my Bulletproof journey =D
    Oh yea, now that you mention it, I do recall hearing Dave talk somewhere about normal diet people needing to somehow supplement the high fat consumption.
    I'm not so sure about #1, as I remember hearing Dave talk about why the consumption of BP Coffee doesn't break the ketosis because of the high MCT, but possibly other foods, even eggs and beef might not work in the same way, since the liver would still be required to start working again? I could be way off, but if someone can remain in ketosis even while eating BP food very often, what would the point be of fasting? Furthermore, I've noticed in myself that even on a strict BP diet, without intermittent fasting, I tend to gain weight slowly, which makes no sense if I'm in fat burning mode...unless it has to do with my question #3 above, and you eat more fat than the body can burn?

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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

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus.[1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness.[1] A person's breath may develop a specific smell.[1] Onset of symptoms is usually rapid.[1] In some cases people may not realize they previously had diabetes.[1] DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances.[1] Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids.[1] DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies.[3] DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine.[1] The primary treatment of DKA is with intravenous fluids and insulin.[1] Depending on the severity, insulin may be given intravenously or by injection under the skin.[3] Usually potassium is also needed to prevent the development of low blood potassium.[1] Th Continue reading >>

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Popular Questions

  1. wbvmg

    Hi, I just completed week 2 and am down 13lbs. I love how I feel, other than heart palpitations. Seems like they started around the beginning of week 2 and have become more frequent. After research, I began taking magnesium and potassium supplements 4 days ago, in addition to my normal multi vitamin and fish oil. Palpitations frequency isn't improving though.
    Is this normal? Will it subside eventually? BP is fine and after rapid heart rate during week 1, it is now back to normal.
    Any feedback is greatly appreciated. I would prefer to keep the keto lifestyle, but not sure that I can if this continues.
    Thanks,
    Virginia

  2. DessieO909

    This is also a fat soluble vitamin but like vitamin E it can be broken down easily. In addition to its anti-oxidant properties, vitamin A helps eliminate dryness and flakiness to the skin. The toxins in our air to the water we drink, we need to protect ourselves and enjoy the best possible health.
    Here is my site ... 100 Aloe Vera Gel Pure - Hrcfbkdt.Soup.Io,

  3. CAP

    If you are concerned call around and find a keto friendly doc and discuss it. You might put yourself in his/her care if it's something that needs monitoring. You wouldn't want to forego all the benefits of Keto over what could be a simple fix or vice-versa.

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