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11 Things You Need To Know About Diabetic Ketoacidosis

11 Things You Need To Know About Diabetic Ketoacidosis

What is diabetic ketoacidosis? It's a very serious condition in both types of diabetes that stems from a combination of high blood glucose and low levels of insulin, which prompts your body to produce an overload of ketones, something that can be toxic to your organs. Learn about the big differences between type 1 and type 2 diabetes. Who's at risk Among people with diabetes, diabetic ketoacidosis (DKA) is most frequently seen in people who have type 1 diabetes. "After a while in type 1, the body essentially produces no insulin," says Louis Philipson, MD, PhD, director of the Kovler Diabetes Center at the University of Chicago. When insulin is low, it makes your liver and other tissues think that you're starving. "Your liver tries to step in and save the day by making ketones," he continues. Your body uses these ketones in an effort produce energy, and when insulin drops as in the case with type 1 diabetes, your liver keeps generating more and more ketones. DKA can also, though less commonly, happen in patients with type 2 diabetes if they have severe insulin resistance. Check out this step-by-step plan to reverse type 2 diabetes. It can be life-threatening Because ketones are acids, your blood becomes more and more acidic as ketones build up. If you develop it, you may experience diabetic ketoacidosis symptoms like stomach pain, nausea, vomiting, and a fruity odor to your breath. The condition can progress, eventually making it difficult for your heart to beat, for you to breathe, and causing organ failure, says Dr. Philipson. "Severe DKA is an emergency," he says. Make sure you know what to do in a diabetic emergency. DKA can happen before a diabetes diagnosis Diabetic ketoacidosis can come on quickly—even in people who are still developing type 1 diabetes but haven Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis, sometimes called DKA, is a condition caused when you have a high blood sugar level, and not enough insulin in your body to break it down to use for energy. As a result, the body starts burning its stores of fat for energy instead. This process produces by-products called ketones. As the level of ketones in the body increases, it can lead to dehydration and confusion. If not treated, people with ketoacidosis can become unconscious. DKA usually occurs in people with type 1 diabetes. It is rare in type 2 diabetes. The symptoms of diabetic ketoacidosis include high blood glucose, high levels of ketones in the urine, and: quick breathing flushed cheeks breath that smells like sweet acetone (similar nail polish remover) dehydration. DKA is a serious condition that requires immediate assessment. If someone you know has diabetes and becomes confused or unconscious, or has the symptoms listed above, call triple zero (000) for an ambulance. If you have diabetes and you find your blood sugar level is higher than it should be, it’s important that you follow the advice provided by your doctor or diabetes nurse or educator. You may also find it useful to read the advice provided in the article on hyperglycaemia (high blood sugar). Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Tweet Diabetic ketoacidosis (DKA) is a dangerous complication faced by people with diabetes which happens when the body starts running out of insulin. DKA is most commonly associated with type 1 diabetes, however, people with type 2 diabetes that produce very little of their own insulin may also be affected. Ketoacidosis is a serious short term complication which can result in coma or even death if it is not treated quickly. Read about Diabetes and Ketones What is diabetic ketoacidosis? DKA occurs when the body has insufficient insulin to allow enough glucose to enter cells, and so the body switches to burning fatty acids and producing acidic ketone bodies. A high level of ketone bodies in the blood can cause particularly severe illness. Symptoms of DKA Diabetic ketoacidosis may itself be the symptom of undiagnosed type 1 diabetes. Typical symptoms of diabetic ketoacidosis include: Vomiting Dehydration An unusual smell on the breath –sometimes compared to the smell of pear drops Deep laboured breathing (called kussmaul breathing) or hyperventilation Rapid heartbeat Confusion and disorientation Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period if blood glucose levels become and remain too high (hyperglycemia). Causes and risk factors for diabetic ketoacidosis As noted above, DKA is caused by the body having too little insulin to allow cells to take in glucose for energy. This may happen for a number of reasons including: Having blood glucose levels consistently over 15 mmol/l Missing insulin injections If a fault has developed in your insulin pen or insulin pump As a result of illness or infections High or prolonged levels of stress Excessive alcohol consumption DKA may also occur prior to a diagnosis of type 1 diabetes. Ketoacidosis can occasional Continue reading >>

Diabetic Ketoacidosis (dka): Symptoms And Treatment

Diabetic Ketoacidosis (dka): Symptoms And Treatment

DKA usually occurs in people who are suffering from type I diabetes (insulin-dependent). In this, the body is affected by hyperglycemia, a condition in which the blood glucose level becomes abnormally high, because the body is unable to use this glucose due to lack of insulin. Instead, the body starts breaking down fat as an alternative source of fuel in place of glucose (sugar). This results in a build-up of a by-product called ketones, and the condition is called ketosis. It further leads to acidosis in which the blood becomes acidic due to the aggregation of ketones and organic acids. This condition is known as DKA. Hence, the body shifts from its normal metabolism of using carbohydrates as fuel to a state of using fat as fuel. This causes increased urination and dehydration due to which nearly 10% of the total body fluids may be lost. Along with this, significant loss of potassium through urination is also common. Infection, missing insulin, and newly-diagnosed diabetes in a patient are some of the prominent causes of ketoacidosis. Other causes may include heart attack, stroke, stress, trauma, and surgery. Ketoacidosis Symptoms The initial DKA symptoms develop slowly when the body detects that ketones are being produced. Sometimes, these indicants can be mistaken for other illnesses as well. Feeling tired or fatigued Excessive thirst and urination Nausea and vomiting Abdominal pain Signs of dehydration, such as dry mouth and skin Rapid, deep, and labored breathing (Kussmaul breathing) Fever and unconsciousness Loss of appetite or eating disorder General weakness and confusion Increased heart rate and low blood pressure Emanation of a distinctive fruity odor in the breath Acute pancreatitis, appendicitis, or gastrointestinal perforation Small children suffering from Continue reading >>

Type 1 Diabetes Complications

Type 1 Diabetes Complications

Type 1 diabetes is complicated—and if you don’t manage it properly, there are complications, both short-term and long-term. “If you don’t manage it properly” is an important if statement: by carefully managing your blood glucose levels, you can stave off or prevent the short- and long-term complications. And if you’ve already developed diabetes complications, controlling your blood glucose levels can help you manage the symptoms and prevent further damage. Diabetes complications are all related to poor blood glucose control, so you must work carefully with your doctor and diabetes team to correctly manage your blood sugar (or your child’s blood sugar). Short-term Diabetes Complications Hypoglycemia: Hypoglycemia is low blood glucose (blood sugar). It develops when there’s too much insulin—meaning that you’ve taken (or given your child) too much insulin or that you haven’t properly planned insulin around meals or exercise. Other possible causes of hypoglycemia include certain medications (aspirin, for example, lowers the blood glucose level if you take a dose of more than 81mg) and alcohol (alcohol keeps the liver from releasing glucose). There are three levels of hypoglycemia, depending on how low the blood glucose level has dropped: mild, moderate, and severe. If you treat hypoglycemia when it’s in the mild or moderate stages, then you can prevent far more serious problems; severe hypoglycemia can cause a coma and even death (although very, very rarely). The signs and symptoms of low blood glucose are usually easy to recognize: Rapid heartbeat Sweating Paleness of skin Anxiety Numbness in fingers, toes, and lips Sleepiness Confusion Headache Slurred speech For more information about hypoglycemia and how to treat it, please read our article on hy Continue reading >>

Ketosis Vs. Ketoacidosis (dka): What Is The Difference?

Ketosis Vs. Ketoacidosis (dka): What Is The Difference?

Let’s break it down so that you can understand exactly what ketosis is and how it differs from ketoacidosis. But the states they refer to are nothing alike. In this case, maybe mistakes are understandable. Many people who believe that ketosis is dangerous are mixing it up with another state called "ketoacidosis." The two words do sound very similar. And some people simply make mistakes. Profit motives tend to muddy up the works when it comes to getting clear, factual information about your health. Well, there are a lot of individuals and companies which all have their own goals and motivations. Where do these misperceptions come from? Here’s the thing though … that is all misinformation. You then Googled something like, "low carb dangerous" and found a list of link-bait articles informing you that low-carb is a ketogenic diet, and ketosis is a dangerous metabolic state which can be fatal. And then maybe someone said something to you like, "What are you thinking? Low-carb is a dangerous diet." If you are thinking about starting a low-carb diet, maybe you have mentioned it to some of your family or friends. By the time you finish reading this article, you will understand why low-carb is a safe diet. Continue reading >>

What You Should Know About Diabetic Ketoacidosis

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too. It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system. People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction. DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration. Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes. Call your doctor or go to the emergency room right away if that doesn't work, if you have any of the symptoms below and your ketones aren't normal, or if you have more than one symptom. You've been throwing up for more than 2 hours. You feel queasy or your belly hurts. Your breath smells fruity. You're tired, confused, or woozy. You're having a hard time breathing. Continue reading >>

First Aid For Diabetic Ketoacidosis (dka)

First Aid For Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (DKA) is a medical emergency which occurs when there is a lack of insulin in the body. Insulin is a hormone which is released by the pancreas which allows our cells to use sugar (glucose) thus reducing the levels in the blood. When there is a lack of insulin (such as in type 1 diabetes) the cells in the body are unable to take up glucose from the blood stream. This causes the blood sugar levels to rise. Despite high blood sugar levels, the body’s cells are unable to use this sugar because they can’t absorb it from the blood without insulin. This causes the cells to switch into ‘starvation mode’ and start breaking down fats. The break down of fat (ketogenesis) results in ketones. Ketones are acidic and cause the blood to become more acidic than usual (acidosis). This is Diabetic Ketoacidosis (DKA). In this blog post we discuss basic first aid for Diabetic Ketoacidosis and your role as a first aider. How to recognise DKA It is important for a first aider to be able to recognise the signs and symptoms of Diabetic Ketoacidosis: Thirst Excessive urination Nausea & vomiting Fatigue / tiredness Abdominal pain Reduced level of consciousness Rapid, deep breathing There may be a history of diabetes, however remember not all patients will have a diagnosis of diabetes yet. First aid treatment of DKA The first aid treatment for DKA is very simple – the patient needs urgent medical assistance! The most important consideration is being able to spot and piece together the signs and symptoms of DKA. Symptoms often develop slowly over days to weeks so can be easily missed or “brushed off”. If the patient is unresponsive then follow standard first aid procedure – DR ABC and place them into the recovery position. Did you find this post interesting? Why Continue reading >>

Case Report Diabetic Ketoacidosis As The Presenting Manifestation Of Pancreatic Adenocarcinoma With Cystic Features

Case Report Diabetic Ketoacidosis As The Presenting Manifestation Of Pancreatic Adenocarcinoma With Cystic Features

Abstract The common presenting symptoms of pancreatic cancer are abdominal pain, weight loss, and jaundice. Pancreatic adenocarcinoma presenting with diabetic ketoacidosis is a very rare emergent clinical condition. However, pancreatic ductal cystadenocarcinoma presenting with diabetic ketoacidosis was not reported. We describe a 60-year-old man with pancreatic cystadenocarcinoma presenting with diabetic ketoacidosis as the initial manifestation. It must be kept in mind that in diabetic ketoacidosis cases, the precipitating factor may be pancreatic ductal cystadenocarcinoma. © 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner. Continue reading >>

Episode 63 – Pediatric Dka

Episode 63 – Pediatric Dka

Pediatric DKA was identified as one of key diagnoses that we need to get better at managing in a massive national needs assessment conducted by the fine folks at TREKK – Translating Emergency Knowledge for Kids – one of EM Cases’ partners who’s mission is to improve the care of children in non-pediatric emergency departments across the country. You might be wondering – why was DKA singled out in this needs assessment? It turns out that kids who present to the ED in DKA without a known history of diabetes, can sometimes be tricky to diagnose, as they often present with vague symptoms. When a child does have a known history of diabetes, and the diagnosis of DKA is obvious, the challenge turns to managing severe, life-threatening DKA, so that we avoid the many potential complications of the DKA itself as well as the complications of treatment – cerebral edema being the big bad one. The approach to these patients has evolved over the years, even since I started practicing, from bolusing insulin and super aggressive fluid resuscitation to more gentle fluid management and delayed insulin drips, as examples. There are subtleties and controversies in the management of DKA when it comes to fluid management, correcting serum potassium and acidosis, preventing cerebral edema, as well as airway management for the really sick kids. In this episode we‘ll be asking our guest pediatric emergency medicine experts Dr. Sarah Reid, who you may remember from her powerhouse performance on our recent episodes on pediatric fever and sepsis, and Dr. Sarah Curtis, not only a pediatric emergency physician, but a prominent pediatric emergency researcher in Canada, about the key historical and examination pearls to help pick up this sometimes elusive diagnosis, what the value of serum Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

As fat is broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis. Diabetic ketoacidosis (DKA) is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to DKA in people with type 1 diabetes. People with type 2 diabetes can also develop DKA, but it is less common. It is usually triggered by uncontrolled blood sugar, missing doses of medicines, or a severe illness. Continue reading >>

Diabetes With Ketone Bodies In Dogs

Diabetes With Ketone Bodies In Dogs

Diabetes Mellitus with Ketoacidosis in Dogs Diabetes is a medical condition in which the body cannot absorb sufficient glucose, thus causing a rise the blood sugar levels. The term “ketoacidosis,” meanwhile, refers to a condition in which levels of acid abnormally increased in the blood due to presence of “ketone bodies”. In diabetes with ketoacidosis, ketoacidosis immediately follows diabetes. It should be considered a dire emergency, one in which immediate treatment is required to save the life of the animal. This condition typically affects older dogs as well as females. In addition, miniature poodles and dachshunds are predisposed to diabetes with ketoacidosis. Symptoms and Types Weakness Lethargy Depression Lack of appetite (anorexia) Muscle wasting Rough hair coat Dehydration Dandruff Sweet breath odor Causes Although the ketoacidosis is ultimately brought on by the dog's insulin dependency due to diabetes mellitus, underlying factors include stress, surgery, and infections of the skin, respiratory, and urinary tract systems. Concurrent diseases such as heart failure, kidney failure, asthma, cancer may also lead to this type of condition. Diagnosis You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then perform a complete physical examination, as well as a biochemistry profile and complete blood count (CBC). The most consistent finding in patients with diabetes is higher than normal levels of glucose in the blood. If infection is present, white blood cell count will also high. Other findings may include: high liver enzymes, high blood cholesterol levels, accumulation in the blood of nitrogenous waste products (urea) that are usually excreted in the urine (azo Continue reading >>

What Is Dka?

What Is Dka?

One of the many complications of diabetes is something called diabetic ketoacidosis (DKA). It most commonly occurs with Type 1 diabetes and is often the first symptom of Type 1 diabetes. DKA is caused when the body has little or no insulin to use and, as a result, blood sugars rise to dangerous levels and the blood becomes acidic. How Does This Occur? Insulin is a hormone that helps transport sugar or glucose into the body's cells so that it can be used for energy. When you have no insulin, sugar remains in the blood and blood sugar rises to dangerous levels. It causes severe hyperglycemica (high blood sugar), resulting in an emergency situation. As the blood glucose continues to increase, the body goes into an "energy crisis" and starts to break down stored fat as an alternate energy source. When fat is used for energy, ketones are produced and as the ketone levels rise, the blood becomes more and more acidic. High blood sugars can progress to ketosis (build-up of ketones) in the body. Ketosis can lead to acidosis, which is a condition in which the blood has too much acid. When this happens it is known as diabetic ketoacidosis. This is a medical emergency and must be treated immediately by medical professionals. What Causes DKA? The sudden start of Type 1 diabetes. Common infections like pneumonia or urinary tract infections. Infection raises the level of "stress" hormones, such as cortisol and epinephrine, which raise the glucose levels in the blood. When someone doesn't do the things necessary to control blood glucose or can't afford their insulin or other medications they can also be at risk for DKA. Insulin pump failure can lead to DKA. If a person is unaware that their pump has stopped administering insulin, blood glucose levels can rise quickly. Kids who are goin Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (DKA) Diabetic ketoacidosis (DKA) occurs when the body does not have enough insulin. Insulin is what breaks down sugar into energy. When insulin is not present to break down sugars, our body begins to break down fat. Fat break down produces ketones which spill into the urine and cause glucose build up in the blood, thus acidifying the body. Because sugar is not entering into our body’s cells for energy breakdown, the sugar is being processed by the kidneys and excreted through the urine; as a result, we become dehydrated and our blood becomes even more acidic. This leads to sickness and hospitalization if not treated. If a person’s blood sugar is over 240, they should start checking their blood for ketones. If you have diabetes, or love someone who does, being aware of warning signs of diabetic ketoacidosis (DKA) can help save a life. Early Symptoms of DKA: High blood glucose level, usually > 300 High volume to ketones present in blood or urine Frequent urination or thirst that lasts for a day or more Dry skin and mouth Rapid shallow breathing Abdominal pain (especially in children) Muscle stiffness or aches Flushed face As DKA Worsens: Decreases alertness, confusion – brain is dehydrating Deep, labored, and gasping breathing Headache Breath that smells fruity or like fingernail polish remover Nausea and/or vomiting Abdomen may be tender and hurt if touched Decreased consciousness, coma, death If you think you might have DKA, test for ketones. If ketones are present, call your health care provider right away. To treat high blood sugar, hydrate with water or sugar free, caffeine free drinks. Sugar free popsicles and snacks are also good alternatives. Always call the doctor if vomiting goes on for more than two hours. Symptoms can go from mild Continue reading >>

Lecture 3 Dka Symptoms & Treatment

Lecture 3 Dka Symptoms & Treatment

Sort osmotic diuresis increased secretion of urine. direct cause of polyuria glucose and ketones raise osmolarity in tubules, waste flows out with urine causes severe:dehydration, hyponatremia, cellular edema 1) decreased solute reabsorption 2) decreased water reabsorption 3) increased solute excretion glucose the form of sugar that circulates in the blood and provides the major source of energy for body tissues glucose has a high osmotic pull insulin therapy needs to continue until ketoacidosis is resolved - but- prolong insulin therapy cause HYPOGLYCEMIA, because: blood glucose resolve faster then than the acidosis hyperkalemia excessive vitamin k levels; >5.5 mEq/L can be caused by insulin therapy interferes with depolarization by lowering the resting potential; peak T wave, wide QRS may lead to heart block and cardiac arrest., renal failure MCC; acidosis, ß-blocker, digitalis toxicity; peaked T wave hyponatremia decreased sodium in the blood A condition caused by excess water intake, sometimes referred to as "water intoxication," that can cause loss of electrolytes, water pulled from intracellular fluid and placed in the extracellular compartment, causing dilution of serum sodium OSMOTIC diuresis contribute to hyponatremia pt's can either be hypotonic, isotonic, or hypertonic with regard to osmolarity. this may be caused by prolonged vomiting, diarrhea, sweating, burns, or gastric or intestinal suctioning and SIADH. Can be life threatening. (Not dehydration) --High osmolality = hyperglycemia or hypertonic infusion. --Normal osmolality = Pseudohyponatremia, hyperlipidema, hyperproteinemia. --Low osmolality = hypotonic hyponatremia. metabolic acidosis decreased pH in blood and body tissues as a result of an upset in metabolism -decreased acidosis and bicarbonate conc Continue reading >>

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