Dka Treatment Guidelines 2015

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My Site - Chapter 15: Hyperglycemic Emergencies In Adults

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) should be suspected in ill patients with diabetes. If either DKA or HHS is diagnosed, precipitating factors must be sought and treated. DKA and HHS are medical emergencies that require treatment and monitoring for multiple metabolic abnormalities and vigilance for complications. A normal blood glucose does not rule out DKA in pregnancy. Ketoacidosis requires insulin administration (0.1 U/kg/h) for resolution; bicarbonate therapy should be considered only for extreme acidosis (pH7.0). Note to readers: Although the diagnosis and treatment of diabetic ketoacidosis (DKA) in adults and in children share general principles, there are significant differences in their application, largely related to the increased risk of life-threatening cerebral edema with DKA in children and adolescents. The specific issues related to treatment of DKA in children and adolescents are addressed in the Type 1 Diabetes in Children and Adolescents chapter, p. S153. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are diabetes emergencies with overlapping features. With insulin deficiency, hyperglycemia causes urinary Continue reading >>

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  1. MKChitown

    Hello - Not sure where to categorize this, so thought I'd try here. I have read a tiny bit on here about improvement in skin on thighs/butt. I am wondering if anyone has seem improvement in these typical dimply areas? I don't have much cellulite, and I know cellulite is more about the skin than actual fat cells. What I want is improvement in my skin all over, including these areas, which would show less of a dimply appearance.


  2. Fiorella

    Fasting (through autophagy) reduces cellulite.

  3. Karen Fricke

    As you lose fat the dimply appearance will change. The layers of your skin, fat and other subcutaneous tissue are fastened together like a comforter that has been tied, not quilted, or like tufted upholstery. If you have to much stuffing (fat) the ties get pulled tight and give it a dimply look. If you take some of the stuffing out (lose weight) the ties aren't pulled as tight and the dimples get better. I think there is a difference between people as to how long the ties are.

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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.....

Management Of Adult Diabetic Ketoacidosis

Go to: Abstract Diabetic ketoacidosis (DKA) is a rare yet potentially fatal hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. Due to its increasing incidence and economic impact related to the treatment and associated morbidity, effective management and prevention is key. Elements of management include making the appropriate diagnosis using current laboratory tools and clinical criteria and coordinating fluid resuscitation, insulin therapy, and electrolyte replacement through feedback obtained from timely patient monitoring and knowledge of resolution criteria. In addition, awareness of special populations such as patients with renal disease presenting with DKA is important. During the DKA therapy, complications may arise and appropriate strategies to prevent these complications are required. DKA prevention strategies including patient and provider education are important. This review aims to provide a brief overview of DKA from its pathophysiology to clinical presentation with in depth focus on up-to-date therapeutic management. Keywords: DKA treatment, insulin, prevention, ESKD Go to: Introduction In 2009, there were 140,000 hospitalization Continue reading >>

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  1. iwiggy58

    How quickly can you kick yourself OUT of ketosis?

    I am just starting week 3 . I have been OP totally. One thing that keeps me from cheating is the fear that I will kick myself out of ketosis. What amount of non program food would it take to throw you out of ketosis? And does a person start all over and have to go thru the headaches and trauma that happen that first week? I have heard several people go off program while on vacation and start back up again later. Is it like having to start all over again???

  2. mompattie

    It would take prob more than 40-50 carbs to kick you out of ketosis. Some can handle more carbs. But it's a slippery slope. Yes, you have to go through all the symptoms to get back in. And 3-5 days worth of food and time and money. It's like a weeks worth of money and time gone. Not worth it.

  3. IP43


    Originally Posted by mompattie
    It would take prob more than 40-50 carbs to kick you out of ketosis. Some can handle more carbs. But it's a slippery slope. Yes, you have to go through all the symptoms to get back in. And 3-5 days worth of food and time and money. It's like a weeks worth of money and time gone. Not worth it. I know a few times that I've had things I shouldn't, the next day or two I was starving, had cravings etc. so I think I kicked myself out of ketosis. They weren't big cheats but I think we're so close to the limit if you have a restricted item a day. I was "perusing" the Atkins site for some of their carb counts etc. and they start with 12-15g net carbs (carb-fibre) on their phase one and then add 5g netcarbs per week or something.

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National Paediatric Diabetes Audit National Conference 2017 (13th January 2017)

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. pixiejenna

    Unique Bridal

    Order Unique Neckalces For
    You & Your Braidemaids.
    Custom Made.


    Mediana said: ↑
    Looks Yummy, I'm gonna try the cheese crust What didn't you like about the seasoning? I can't really pin point it to be honest they were all the right spices but it didn't taste Mexican too me it was a little bland not enough flavor for me. I really like Trader Joe's taco seasoning but it's spicy as heck I usually only use 1/3 -1/2 of a packet.
    dollfeet said: ↑
    Oooh I think I'm going to make that chili this weekend. Question - with the jalapeños how spicy is it? (I want to make sure the child will eat it too). I don't think it's spicy but you can always omit the jalapeños it won't change the flavor much imo. If spicy is a issue I'd also recommend using one less table spoon of chili powder. I usually use about 3.5 using 4 is a but much for me and I thought 3 wasn't enough. So maybe start with 3 and adjust as needed. Also remember if it's too spicy for your kid add extra sour cream and cheese to their serving to help tone it down. I make this chili a few times a month and everyone whose tried it loves it. I am not exaggerating at all I actually have coworkers who ask me to bring them some every time I make it. The only other thing I do different is most people drain the fat from the ground beef when they put it in the crock pot I dump everything into the crock pot. I also buy minced garlic to make life easier lol.

  2. pixiejenna

    Keto bars update I ordered them Sunday evening and I got them Wednesday which is pretty darn quick! I took pictures of them to share. My initial thought when I got them when I saw the box is they are going to be small and they are. As far as taste goes they are okay. I'm a little disappointed because a lot of the reviews said that they taste like brownies and imo they did not. They really reminded me of a mounds bar but with less coconut and more chocolate flavor. They do have a very distinct coconut flavor so if that's a flavor that you don't like I'd recommend skipping them. I am also feeling a bit under the weather so, I'll post another update after I finish them on my thoughts on them. My opinion on the flavor may change since I'm not 100% at the moment.

  3. Mediana

    I would love to be able to order something like that here in Sweden!

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