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Dka Symptoms

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in 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 >>

Symptoms Of Diabetic Ketoacidosis

Symptoms Of Diabetic Ketoacidosis

Diabetic ketoacidosis, or simply DKA, is one of the complications of diabetes mellitus. It occurs suddenly, is severe and can be life-threatening if neglected. The diabetic ketoacidosis is a complex metabolic state comprising of increased blood glucose levels (hyperglycemia), increased production and presence of ketone acids in the blood (ketonemia) and acidic changes in the internal environment of the body (acidosis). These changes together constitute the diabetic ketoacidosis. Diabetic ketoacidosis is more common in persons with type – 1 as compared to type – 2 diabetes mellitus. Sometimes, it may be the first sign of diabetes mellitus in patients with no previous diagnosis of diabetes. In normal individuals, insulin hormone is produced and secreted by an organ called pancreas. Insulin is necessary for the entry of blood glucose into our cells. Insulin works like a key and unlocks the cellular gates to help glucose enter the cells. The cells use entered glucose to produce energy. In type – 1 diabetes mellitus, the pancreatic cells producing insulin are destroyed. This lack of insulin prevents the entry of blood glucose into our cells as the cellular gates are closed, increasing the blood glucose levels (hyperglycemia). Our body cells starve and cannot utilize glucose for energy despite increased amounts of glucose in our blood. In this starving state, our body burns fats and produces ketones for energy purposes. Ketones have an advantage that they do not need insulin to enter into cells but the ketones also have a disadvantage that they are acidic in nature and when produced in excessive amounts, they change our body environment and make it acidic, which can be life-threatening. The patients often develop ketoacidosis when: They have missed their insulin doses T 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 >>

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 >>

Diabetic Ketoacidosis Explained

Diabetic Ketoacidosis Explained

Twitter Summary: DKA - a major complication of #diabetes – we describe what it is, symptoms, who’s at risk, prevention + treatment! One of the most notorious complications of diabetes is diabetic ketoacidosis, or DKA. First described in the late 19th century, DKA represented something close to the ultimate diabetes emergency: In just 24 hours, people can experience an onset of severe symptoms, all leading to coma or death. But DKA also represents one of the great triumphs of the revolution in diabetes care over the last century. Before the discovery of insulin in 1920, DKA was almost invariably fatal, but the mortality rate for DKA dropped to below 30 percent within 10 years, and now fewer than 1 percent of those who develop DKA die from it, provided they get adequate care in time. Don’t skip over that last phrase, because it’s crucial: DKA is very treatable, but only as long as it’s diagnosed promptly and patients understand the risk. Table of Contents: What are the symptoms of DKA? Does DKA occur in both type 1 and type 2 diabetes? What Can Patients do to Prevent DKA? What is DKA? Insulin plays a critical role in the body’s functioning: it tells cells to absorb the glucose in the blood so that the body can use it for energy. When there’s no insulin to take that glucose out of the blood, high blood sugar (hyperglycemia) results. The body will also start burning fatty acids for energy, since it can’t get that energy from glucose. To make fatty acids usable for energy, the liver has to convert them into compounds known as ketones, and these ketones make the blood more acidic. DKA results when acid levels get too high in the blood. There are other issues too, as DKA also often leads to the overproduction and release of hormones like glucagon and adrenaline 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 >>

Pardon Our Interruption...

Pardon Our Interruption...

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Diabetic Ketoacidosis In Dogs

Diabetic Ketoacidosis In Dogs

My dog is diabetic. He has been doing pretty well overall, but recently he became really ill. He stopped eating well, started drinking lots of water, and got really weak. His veterinarian said that he had a condition called “ketoacidosis,” and he had to spend several days in the hospital. I’m not sure I understand this disorder. Diabetic ketoacidosis is a medical emergency that occurs when there is not enough insulin in the body to control blood sugar (glucose) levels. The body can’t use glucose properly without insulin, so blood glucose levels get very high, and the body creates ketone bodies as an emergency fuel source. When these are broken down, it creates byproducts that cause the body’s acid/base balance to shift, and the body becomes more acidic (acidosis), and it can’t maintain appropriate fluid balance. The electrolyte (mineral) balance becomes disrupted which can lead to abnormal heart rhythms and abnormal muscle function. If left untreated, diabetic ketoacidosis is fatal. How could this disorder have happened? If a diabetic dog undergoes a stress event of some kind, the body secretes stress hormones that interfere with appropriate insulin activity. Examples of stress events that can lead to diabetic ketoacidosis include infection, inflammation, and heart disease. What are the signs of diabetic ketoacidosis? The signs of diabetic ketoacidosis include: Excessive thirst/drinking Increased urination Lethargy Weakness Vomiting Increased respiratory rate Decreased appetite Weight loss (unplanned) with muscle wasting Dehydration Unkempt haircoat These same clinical signs can occur with other medical conditions, so it is important for your veterinarian to perform appropriate diagnostic tests to determine if diabetic ketoacidosis in truly the issue at hand Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic acidosis is a life-threatening condition that can occur in people with type 1 diabetes. Less commonly, it can also occur with type 2 diabetes. Term watch Ketones: breakdown products from the use of fat stores for energy. Ketoacidosis: another name for diabetic acidosis. It happens when a lack of insulin leads to: Diabetic acidosis requires immediate hospitalisation for urgent treatment with fluids and intravenous insulin. It can usually be avoided through proper treatment of Type 1 diabetes. However, ketoacidosis can also occur with well-controlled diabetes if you get a severe infection or other serious illness, such as a heart attack or stroke, which can cause vomiting and resistance to the normal dose of injected insulin. What causes diabetic acidosis? The condition is caused by a lack of insulin, most commonly when doses are missed. While insulin's main function is to lower the blood sugar level, it also reduces the burning of body fat. If the insulin level drops significantly, the body will start burning fat uncontrollably while blood sugar levels rise. Glucose will then begin to show up in your urine, along with ketone bodies from fat breakdown that turn the body acidic. The body attempts to reduce the level of acid by increasing the rate and depth of breathing. This blows off carbon dioxide in the breath, which tends to correct the acidosis temporarily (known as acidotic breathing). At the same time, the high secretion of glucose into the urine causes large quantities of water and salts to be lost, putting the body at serious risk of dehydration. Eventually, over-breathing becomes inadequate to control the acidosis. What are the symptoms? Since diabetic acidosis is most often linked with high blood sugar levels, symptoms are the same as those for diabetes Continue reading >>

Diabetes: Diabetic Ketoacidosis

Diabetes: Diabetic Ketoacidosis

www.CardioSmart.org When you have diabetes (especially type 1 diabetes), you are at risk for diabetic ketoacidosis (DKA). This is a dangerous illness that happens when the body does not have enough insulin to use sugar for fuel, and so it breaks down fat and muscle instead. This process breaks down fat into fatty acids, which are turned into another type of acid called ketones. The ketones build up in your blood and change the chemical balance in your body. If not treated, DKA can lead to a coma or even death. DKA can happen if you have little or no insulin in your body and your blood sugar level gets too high. This can happen when you do not take enough insulin or when you have an infection or other illness such as the flu. Being severely dehydrated can also cause it. DKA occurs mostly in people with type 1 diabetes. It occurs less often in people with type 2 diabetes. Symptoms of DKA Symptoms include: • You have flushed, hot, dry skin. • You have a strong, fruity breath odor. • You have loss of appetite, belly pain, and vomiting. • You feel restless. • You have rapid, deep breathing. • You feel confused. • You feel very sleepy, or you have trouble waking up. Young children may not care about doing their normal activities. How to prevent DKA You can help prevent DKA if you: • Take your insulin and other diabetes medicines on time and in the right dose. • Test your blood sugar before meals and at bedtime. Or test as often as your doctor tells you to. This is the best way to know when your blood sugar is high so you can treat it early.Watching for symptoms is not as good. You may not notice them until you have already started making ketones and your blood sugar is very high. • Teach others at work, home, or scho Continue reading >>

Understanding The Presentation Of Diabetic Ketoacidosis

Understanding The Presentation Of Diabetic Ketoacidosis

Hypoglycemia, diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) must be considered while forming a differential diagnosis when assessing and managing a patient with an altered mental status. This is especially true if the patient has a history of diabetes mellitus (DM). However, be aware that the onset of DKA or HHNS may be the first sign of DM in a patient with no known history. Thus, it is imperative to obtain a blood glucose reading on any patient with an altered mental status, especially if the patient appears to be dehydrated, regardless of a positive or negative history of DM. In addition to the blood glucose reading, the history — particularly onset — and physical assessment findings will contribute to the formulation of a differential diagnosis and the appropriate emergency management of the patient. Pathophysiology of DKA The patient experiencing DKA presents significantly different from one who is hypoglycemic. This is due to the variation in the pathology of the condition. Like hypoglycemia, by understanding the basic pathophysiology of DKA, there is no need to memorize signs and symptoms in order to recognize and differentiate between hypoglycemia and DKA. Unlike hypoglycemia, where the insulin level is in excess and the blood glucose level is extremely low, DKA is associated with a relative or absolute insulin deficiency and a severely elevated blood glucose level, typically greater than 300 mg/dL. Due to the lack of insulin, tissue such as muscle, fat and the liver are unable to take up glucose. Even though the blood has an extremely elevated amount of circulating glucose, the cells are basically starving. Because the blood brain barrier does not require insulin for glucose to diffuse across, the brain cells are rece Continue reading >>

Electrolyte Imbalance In Diabetic Ketoacidosis

Electrolyte Imbalance In Diabetic Ketoacidosis

If you have diabetes, it's important to be familiar with diabetic ketoacidosis (DKA). DKA is a serious complication of diabetes that occurs when lack of insulin and high blood sugar lead to potentially life-threatening chemical imbalances. The good news is DKA is largely preventable. Although DKA is more common with type 1 diabetes, it can also occur with type 2 diabetes. High blood sugar causes excessive urination and spillage of sugar into the urine. This leads to loss of body water and dehydration as well as loss of important electrolytes, including sodium and potassium. The level of another electrolyte, bicarbonate, also falls as the body tries to compensate for excessively acidic blood. Video of the Day Insulin helps blood sugar move into cells, where it is used for energy production. When insulin is lacking, cells must harness alternative energy by breaking down fat. Byproducts of this alternative process are called ketones. High concentrations of ketones acidify the blood, hence the term "ketoacidosis." Acidosis causes unpleasant symptoms like nausea, vomiting and rapid breathing. Bicarbonate is an electrolyte that normally counteracts blood acidity. In DKA, the bicarbonate level falls as ketone production increases and acidosis progresses. Treatment of DKA includes prompt insulin supplementation to lower blood sugar, which leads to gradual restoration of the bicarbonate level. Potassium may be low in DKA because this electrolyte is lost due to excessive urination or vomiting. When insulin is used to treat DKA, it can further lower the blood potassium by pushing it into cells. Symptoms associated with low potassium include fatigue, muscle weakness, muscle cramps and an irregular heart rhythm. Severely low potassium can lead to life-threatening heart rhythm abnorm Continue reading >>

How Dka Happens And What To Do About It

How Dka Happens And What To Do About It

Certified Diabetes Educator Gary Scheiner offers an overview of diabetic ketoacidosis. (excerpted from Think Like A Pancreas: A Practical Guide to Managing Diabetes With Insulin by Gary Scheiner MS, CDE, DaCapo Press, 2011) Diabetic Ketoacidosis (DKA) is a condition in which the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production. When bodily fluids become acidic, some of the body’s systems stop functioning properly. It is a serious condition that will make you violently ill and it can kill you. The primary cause of DKA is a lack of working insulin in the body. Most of the body’s cells burn primarily sugar (glucose) for energy. Many cells also burn fat, but in much smaller amounts. Glucose happens to be a very “clean” form of energy—there are virtually no waste products left over when you burn it up. Fat, on the other hand, is a “dirty” source of energy. When fat is burned, there are waste products produced. These waste products are called “ketones.” Ketones are acid molecules that can pollute the bloodstream and affect the body’s delicate pH balance if produced in large quantities. Luckily, we don’t tend to burn huge amounts of fat at one time, and the ketones that are produced can be broken down during the process of glucose metabolism. Glucose and ketones can “jump into the fire” together. It is important to have an ample supply of glucose in the body’s cells. That requires two things: sugar (glucose) in the bloodstream, and insulin to shuttle the sugar into the cells. A number of things would start to go wrong if you have no insulin in the bloodstream: Without insulin, glucose cannot get into the body’s cells. As a result, the cells begin burning large amounts of fat for energy. This, of course, Continue reading >>

Lab Values And Dka

Lab Values And Dka

Changes in laboratory values often give us clues to what is happening with our patients. I came across the following resource this morning and thought it was worth sharing. Here’s a handy table to help you identify diabetic ketoacidosis (DKA). The following equation can be used to calculate an anion gap: Anion gap = Na+(mEq/L) – [Cl-(mEq/L) + HCO3-(mEq/L)] You have an important role when caring for a patient with DKA. Thorough physical assessments, careful monitoring of laboratory values, and critical thinking are essential to avoid complications of this complex disorder. Have you cared for a patient with DKA? What are the common presenting signs and symptoms? Reference Donahey, E., Folse, S., Weant, K. (2012). Management of Diabetic Ketoacidosis. Advanced Emergency Nursing Journal, 34(3). Continue reading >>

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