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Dka Pathophysiology Diagram

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Diabetic Ketoacidosis And Hyperosmolar Hyperglycemic State In Adults: Treatment

INTRODUCTION Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS, also known as hyperosmotic hyperglycemic nonketotic state [HHNK]) are two of the most serious acute complications of diabetes. They are part of the spectrum of hyperglycemia, and each represents an extreme in the spectrum. The treatment of DKA and HHS in adults will be reviewed here. The epidemiology, pathogenesis, clinical features, evaluation, and diagnosis of these disorders are discussed separately. DKA in children is also reviewed separately. (See "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis".) (See "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis".) Continue reading >>

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Popular Questions

  1. wlsuser9

    I do a lot of reading about low carb/kenogenic diets, and typically I see people are in ketosis and losing weight between 20-60 net grams of carbs a day. I began my "low carb" (not low enough for some people) with a goal of <100 net grams a day, and I've lost about 2 lbs a week. My current calorie goal is 1200 because that's just what was recommended when I first joined myfitnesspal, and I really eat between 1100-1800 net calories, depending on my exercise and how many low carb snacks I decide to eat. I used ketostrips when I first started my diet, I had small to trace amounts detected and I was losing weight. I haven't used a test strip in a few weeks, but I've been keeping my carbs consistently lower than when I first started, anyway. I am on the cross country team at my college, so exercise is a necessity for me. I used to just eat whatever I wanted around 1200 calories a day, and would lose weight, but I couldn't stick to it and never got results like I have been eating a reduced carb amount.
    To anyone else who eats reduced carbs and exercises around 40 min a day 6 days a week, how many carbs do you eat to lose weight? Heck, even if you don't exercise, please let me know.
    I am probably going to buy more test strips to make sure I'm doing it right, but sometimes I think I might be eating too many carbs, and I just lose weight because of the amount of calories I eat. I just don't know! I hope to find somebody who can eat as many carbs as I do and still be burning fat!

  2. Carnivor0us

    I don't work out everyday, and when I do, it's just vigorous walking. I aim for as close to zero as possible, with no more than 75g in any one day. It's almost always way less than that. Also, a ketogenic diet isn't just low carb, it's also high-fat. If you can do at least 50% of calories from fat, that would help out any ketosis.
    On a personal note, I'd encourage you to not get too caught up focusing on the strips. I was like that for a long time and it frustrated me more than it helped (although it did help a bit).

  3. albertabeefy

    As a diabetic who controls my glucose with diet, I eat a ketogenic diet of 65-70% of my calories from fat, 25-30% from protein and a maximum 5% from carbohydrate. I will occasionally have more carbohydrate on days where I'm doing considerable exercise - such as a 100km bike ride, a 5 hour mountain hike, etc.
    I ONLY have more carbohydrate IF I'm burning it while exercising. IE: I'll eat it within 30-45 minutes prior to exercise.
    To GET ketogenic I did 2 weeks of 20-30g a day. That, combined with exercise, got me into ketosis in a few days, actually. I slowly added more carbohydrate into my diet - but found 5% on normal days was my threshold for good glycemic control. (On high-exercise days I can eat up to 10% with no issues.)
    The amount (in grams) of carb you have that keeps you in ketosis will obviously vary depending on your caloric intake.
    I normally eat up to 3,000 calories a day - as such 40g daily is about 5%. On a 5,000+ calorie day (not uncommon for me when doing endurance exercise) I may eat 120g or more...
    My daughter recently started a ketogenic diet for weight-loss. She doesn't really count calories, just eats reasonably, and keeps her carbohydrate intake about 20g a day. She lost 20lbs in the first 3 weeks.

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