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Dka Treatment Guidelines 2015

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Diabetic Ketoacidosis In Children And Adolescents Raghupathy P - Indian J Endocr Metab

Diabetic ketoacidosis (DKA) is considered to be a common presentation of type 1 diabetes mellitus (T1DM) and occasionally, type 2 diabetes mellitus (T2DM) in children and adolescents. DKA arises due to lack of adequate insulin in the body. Insulin stops the use of fat as an energy source by inhibiting the peptide hormone glucagon. Without insulin, glucagon levels rise resulting in the release of free fatty acids from adipose tissue, as well as amino acids from muscle cells. The biochemical criteria for DKA diagnosis include hyperglycemia (blood glucose [BG] higher than 11 mmol/L or 200 mg/dL) with a venous pH of <7.3 and/or a bicarbonate (HCO 3 ) level of <15 mmol/L; ketonemia and ketonuria. Although not universally available, blood -hydroxybutyrate concentration should be measured whenever possible, and a level of 3 mmol/L is indicative of DKA. Urine ketones, of moderate or large size (typically 2+), are also indicative of DKA. The clinical signs of DKA include dehydration (may be difficult to detect), tachycardia, tachypnoea (may be mistaken for pneumonia or asthma), deep sighing (Kussmaul) respiration with a typical smell of ketones in the breath (variously described as the odo Continue reading >>

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  1. jr_goad

    I was just wondering if you will experience keto flu when you take a CKD approach. I ask this because I've been on keto for about a month and a half now and it took me a while to really adjust. Had a bad case of the keto flu for weeks where I felt extremely cloudy. That being said, I am now fat adapted but was considering doing a reefed day very soon. I know this will kick me out of ketosis but will I experience the keto flu once I get back into the process of ketosis?

  2. BillJay

    jr_goad:


    I was just wondering if you will experience keto flu when you take a CKD approach
    I definitely did when I tried and I didn't like it at all.
    jr_goad:


    I know this will kick me out of ketosis but will I experience the keto flu once I get back into the process of ketosis?

    If it was a short dietary excursion, I didn't experience keto flu, but on the early and rare occasions it was longer, I did have some of those symptoms.

  3. Abrane

    I tried CKD for a couple months and ended up bailing on it. I didn't get keto flu coming off as it got easier. The hard part was cravings through the week. It take me 4 days to get back to where I was the week before and overall wasn't for me. Keto with "high carb" really is 40-50 for me but I rarely go above 15 anymore. It helps control my cravings.

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Management Of Paediatric Diabetic Ketoacidosis: An Audit

Introduction: NICE Guidelines NG18 (published 2015) advocate a more conservative approach to management of diabetic ketoacidosis (DKA) in children and young people up to the age of 18, in an attempt to reduce the risk of cerebral oedema. We aimed to assess if management of DKA in children at Manor Hospital was compliant with hospital guidelines, that were based on BSPED guidelines (issued 2009). We analysed the difference in total fluid administered if the new DKA guidelines were in place, specifically in the case of young people. Method: We retrospectively audited case notes of all patients up to the age of 19 years admitted to Walsall Manor Hospital with DKA between 1st July 2014–31st July 2015 (n=13). A standardised proforma was used to collect data, which was then analysed. Results: Current hospital policy advocates that young people after their 16th birthday are managed by the adult medical team. The adult DKA Guideline is based on recommendations of Joint British Diabetes Societies Inpatient Care Group recommendations (2013). The age range was 10 to 18 years. Ten patients were treated using the paediatric and three were treated using the adult guidelines. There was one sign Continue reading >>

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  1. NicNic

    I was admitted to hospital a few weeks ago with ketoacidosis. It gave me a bit of a shock and I'm now controlling my levels much better than I had been recently. However, this (I think) is making me gain weight. Any ideas on when weight gain might stop?? (I've put on nearly a stone in 4 weeks.) I'm not overweight (at all!) but am a little obsessive about my weight/size. Thanks for help and advice!!

  2. xxlou_lxx

    Might depend on 2 things really, one being how long you had DKA and how much you actually lost through having it. I guess you will put on what you lost because your body is getting back to normal again, but unless you have changed your eating habbits then thats all you should gain i would think?

  3. randomange

    It's apparently quite common to put weight on when your control improves. The reason (to quote my DSN) is that you're no longer peeing a whole load of sugar down the toilet! If your levels were particularly high before, then a lot of the calories you were taking in weren't actually being used by your body, but once your insulin levels are right(ish ) and your blood sugars start to come down, then your body can actually process these calories properly again.

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Clinical Management Of Diabetic Ketoacidosis

Abstract: Background: Diabetic ketoacidosis (DKA) is a medical emergency where rapid and effective management is necessary to aid prompt recovery and to prevent life threatening complications such as: cerebral oedema, hypokalaemia, hypo/hyper-glycaemia and hypovolaemia. It requires effective co-operation between the emergency department (ED), general medical team and endocrinology team members. Within the past 4 years, a new national guideline regarding the management of DKA has been used by the majority of hospitals in the United Kingdom (1). One of many points in these guidelines is that a fixed rate of iv insulin infusion with appropriate rate of iv fluids (normal saline and 10% of glucose) is preferable to variable insulin infusion. The new guidelines describe clearly each step of DKA management. This audit investigated the management of DKA at Medway Hospital to see if national and local hospital guidelines were being adhered to. Aims and Objectives: Multiple steps of clinical management of DKA were examined, including: recognition of DKA, initiation of treatment, the occurrence of hypoglycaemia and hypokalaemia, blood glucose and ketones monitoring, venous blood gases monitor Continue reading >>

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  1. SnowPetal

    Per week weightloss that is.

  2. thepapillon

    I've done this a few times while trying to lose weight... and am doing it now. I would say the first week you lose a lot. (5-7 pounds or so) After the first week I found it reduces to more like 3-4 pounds. I think it also depends on your weight. If you have extra weight, it'll come off easier than someone trying to get those last few pounds off. Good luck!

  3. SnowPetal

    That's good to know, thanks.
    I am also doing a lower calorie ketogenic diet as well. I'm hoping I can lose a pound a day like the hcg diet. But I will see.

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