Understanding And Treating Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a serious metabolic disorder that can occur in animals with diabetes mellitus (DM).1,2 Veterinary technicians play an integral role in managing and treating patients with this life-threatening condition. In addition to recognizing the clinical signs of this disorder and evaluating the patient's response to therapy, technicians should understand how this disorder occurs. DM is caused by a relative or absolute lack of insulin production by the pancreatic b-cells or by inactivity or loss of insulin receptors, which are usually found on membranes of skeletal muscle, fat, and liver cells.1,3 In dogs and cats, DM is classified as either insulin-dependent (the body is unable to produce sufficient insulin) or non-insulin-dependent (the body produces insulin, but the tissues in the body are resistant to the insulin).4 Most dogs and cats that develop DKA have an insulin deficiency. Insulin has many functions, including the enhancement of glucose uptake by the cells for energy.1 Without insulin, the cells cannot access glucose, thereby causing them to undergo starvation.2 The unused glucose remains in the circulation, resulting in hyperglycemia. To provide cells with an alternative energy source, the body breaks down adipocytes, releasing free fatty acids (FFAs) into the bloodstream. The liver subsequently converts FFAs to triglycerides and ketone bodies. These ketone bodies (i.e., acetone, acetoacetic acid, b-hydroxybutyric acid) can be used as energy by the tissues when there is a lack of glucose or nutritional intake.1,2 The breakdown of fat, combined with the body's inability to use glucose, causes many pets with diabetes to present with weight loss, despite having a ravenous appetite. If diabetes is undiagnosed or uncontrolled, a series of metab Continue reading >>
Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?
In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>
Protein In Urine
Your kidneys filter waste products from your blood while retaining what your body needs — including proteins. However, some diseases and conditions allow proteins to pass through the filters of your kidneys, causing protein in urine. Conditions that can cause a temporary rise in the levels of protein in urine, but don't necessarily indicate kidney damage, include: Diseases and conditions that can cause persistently elevated levels of protein in urine, which might indicate kidney disease, include: Amyloidosis (buildup of abnormal proteins in your organs) Certain drugs, such as nonsteroidal anti-inflammatory drugs Endocarditis (an infection of the inner lining of the heart) Focal segmental glomerulosclerosis (FSGS) Glomerulonephritis (inflammation in the kidney cells that filter waste from the blood) Hodgkin's lymphoma (Hodgkin's disease) (Hodgkin's disease) IgA nephropathy (Berger's disease) (kidney inflammation resulting from a buildup of the antibody immunoglobulin A) Orthostatic proteinuria (urine protein level rises when in an upright position) Pregnancy Sarcoidosis (development and growth of clumps of inflammatory cells in your organs) Continue reading >>
High Fat Diet May Be Able To Reverse Kidney Failure
Scientists, in experiments with mice, have demonstrated for the first time that a special high-fat, low-carbohydrate diet called the ketogenic diet can reverse kidney failure caused by type 1 or type 2 diabetes. See also: A new exercise prescription for diabetes. If the findings can be replicated in humans, the diet would have profound implications for personal health and for the nation's health care, says neuroscientist Charles Mobbs of Mount Sinai School of Medicine in New York. "This is the first study to show that a dietary intervention alone is enough to reverse this serious complication of diabetes," says Mobbs, senior author of a paper published online in PLoS One on April 20. The mice, bred to develop type 1 or type 2 diabetes, were allowed to develop kidney failure, known as diabetic nephropathy. Then half were fed a standard high-carbohydrate diet while the other half ate a high-fat ketogenic diet, typically used to control epilepsy in children. After eight weeks, kidney failure was reversed in the mice on the ketogenic diet. Their blood glucose returned to normal and the presence of the protein albumin in urine, a strong predictor of the progression of kidney disease, also was corrected. Controlling blood glucose and blood pressure slows the progression of diabetic kidney disease, but once the kidneys are damaged there currently is no way to repair them. If they fail, dialysis or a kidney transplant is the only option, experts say, which means that reversing the disease would be far more valuable than simply delaying it. "I believe that glucose metabolism in the cells drives diabetic complications," says Mobbs. "But controlling blood glucose levels alone doesn't correct the complications. We had to go beyond simply correcting blood glucose." In monitoring the Continue reading >>
Could A High-fat, Low-carb Diet Someday Replace Dialysis?
MORE A type of low-carb, high-fat diet that's typically used to manage seizures for children with epilepsy could reverse kidney disease in Type 1 and Type 2 diabetics, a new animal study suggests. If successful in humans, the so-called ketogenic diet could have the potential to replace dialysis, which is a procedure that artificially filters blood in place of a damaged or failed kidney, said study researcher Charles Mobbs, professor of neuroscience and geriatrics and palliative care medicine at Mount Sinai School of Medicine in New York City. "I speculate that this may be useful to completely cure diabetic kidney failure , and I hope that it's possible," Mobbs told MyHealthNewsDaily. "If it's possible, we can potentially not require dialysis. That's a big deal." However, a lot more research in mice is needed before any studies can be done in humans, Mobbs said, let alone determine if the diet can reverse advanced kidney disease in humans, he said. "That's the first thing we want to establish in mice: Can we truly reset the clock? Can we completely correct the [kidney] impairments?" Mobbs said. Other experts say the finding is promising for Type 1 and Type 2 diabetics with earlier-stage kidney disease, but more research must be done to provide evidence that the diet can make an impact on end-stage kidney disease , or kidney failure. Type 1 diabetes is a chronic disease that occurs when the pancreas cannot produce enough insulin (needed to move blood sugar into cells for energy) to control blood sugar levels, according to the National Institutes of Health. Type 2 diabetes occurs when the body becomes resistant to insulin, leading to high blood sugar levels. Overweight and obesity, a sedentary lifestyle and poor diet are risk factors for Type 2 diabetes, according to the N Continue reading >>
Does A Ketogenic Diet Cause Kidney Stones?
I remember the first time I learned about the connection between a diet high in sugar and gout, kidney stones and heart disease. I was reading a book (I don’t remember which one) that was laying out the evidence that showed a clear link between sugar consumption and those diseases and it immediately peaked my interest because I didn’t know that gout was still a thing. I had only heard of old French monarchs having it and honestly didn’t know it was still around until just a few weeks before reading that book. Just a few weeks prior to reading that, I learned that my son’s Father in Law had gout and occasional kidney stones and as I read that passage in the book, I thought about calling him and telling him what I read. I decided against it and figured I would bring it up the next time I saw him at church. Unfortunately, before I ever got a chance to say anything to him, he had a heart attack. He’s fine now but I have always felt bad I didn’t immediately make a call. I realize it wouldn’t have done much given how quickly it all happened but still, I should have said something. Since then, probably the most common question I get about the ketogenic diet is whether or not it will cause kidney stones and there is definitely a connection but possibly not how you think. First let’s go over how kidney stones are formed. How Kidney Stones are Formed At one point in time it was thought that uric acid was produced solely from the breakdown of purines found in foods like liver, pork, mushrooms, anchovies, mackerel and dried beans which is why most patients that were susceptible to kidney stones or gout were put on a low purine diet. Unfortunately those diets didn’t work too well and almost always had to be supplemented with additional medications that controlled t Continue reading >>
Invokana Kidney Failure Lawsuit
**Blog shared with us by attorney Stuart Scott at Spangenberg Law Firm** Invokana Lawsuit: Investigation of Kidney Failure, Ketoacidosis and Other Injuries Linked to Type 2 Diabetes Medicines Invokana and Invokamet The attorneys at the Spangenberg Law Firm are investigating the link between several type 2 diabetes medicines and serious injuries – including kidney failure and ketoacidosis – suffered by patients after taking them, including: Invokana (canagliflozin) Invokamet (canagliflozin/metformin) Jardiance (empagliflozin) Xigduo XR (dapagliflozin/metformin) Farxiga (dapagliflozin) Glyxambi (empagliflozin/linagliptin) The FDA has warned in a drug safety announcement that these drugs may cause a serious health condition known as ketoacidosis. Ketoacidosis (also known as acidosis or diabetic ketoacidosis (DKA) – causes the body to produce excessive levels of blood acids and may cause diabetic comas or death. In addition to causing an increased risk of ketoacidosis, Invokana, Invokamet, and SGLT2 inhibitors have been linked to incidents of other side effects including kidney damage and ketoacidosis. The FDA, in its announcement, warned patients that they should seek immediate medical attention if they experience any symptoms of kidney failure, or ketoacidosis, including: Difficulty breathing Nausea Vomiting Abdominal pain Confusion Unusual fatigue or sleepiness These drugs belong to a class of medications known as sodium-glucose cotransporter-2 (SGLT2) inhibitors, which have been FDA approved to lower blood sugar in adults with type 2 diabetes. The problem with Invokana, Invokamet, and other SGLT2 Inhibitors Most type 2 diabetes drugs either battle insulin resistance or inhibit the production of glucagon. They metabolize or keep blood sugars low so that your body c Continue reading >>
What You Should Know About The Low-carb Ketogenic Diet
Though it was originally developed to treat patients with epilepsy, interest in the ketogenic diet has taken off in recent years as we've learned more about its therapeutic and health benefits. Here’s what you need to know about ‘keto’ and why some health experts believe it's good for your body — especially your brain. Fasting and other ketogenic-like diets have been used to treat conditions like epilepsy for thousands of years. And in fact, a version of the keto diet has been traced back to 500 BC. Fast forwarding a bit, Dr. Rawle Geyelin gave a 1921 presentation to the American Medical Association in which he reported on the remarkable outcomes of several children who had benefited from fasting; his patients were having fewer seizures — and the effect appeared to be long-lasting. Geyelin continued this work, and he developed a tolerable and reproducible high-fat and low carbohydrate diet now formally known as the ketogenic diet. For the next two decades, it was used by physicians to minimize seizures in their patients. Once modern antiepileptic drugs were introduced, however, the practice declined dramatically. But interest in keto was renewed about 20 years ago as a number of scientists began to study it more closely — and not just for its ability to treat epilepsy. As we’re now learning, and despite its reputation as a “starvation” diet, a keto regimen has been shown to confer a variety of benefits. The state of ketosis The ketogenic diet is essentially a way to get our bodies to enter into a condition known as ketosis. Normally, our bodies rely on glucose for fuel — the result of our moderate to high-carb diets. Carbohydrates are broken down to glucose, which gets converted into energy and transported to our muscles and organs. But when carbs ar Continue reading >>
Diabetes Dictionary: K
Ketoacidosis Ketones (Ketone Bodies) Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. See also Diabetic ketoacidosis and Ketones in Wikipedia. Ketonuria Having ketone bodies in the urine; a warning sign of diabetic ketoacidosis (DKA). Ketosis A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis. Ketotic Hypoglycemia A poorly-understood disorder of childhood, marked by hypoglycemia and ketosis. There is carbohydrate deprivation, with consequent dependence on fat stores for energy. Ketotic hypoglycemia can often be effectively treated by simple dietary changes involving frequent feedings of carbohydrate and protein. Kidney Disease Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. Kidneys Two organs in the lower back that clean waste and poisons from the blood. The kidneys are shaped like two large beans, and they act as the body's filter. They also control the level of some chemicals in the blood such as hydrogen, sodium, potassium, and phosphate. Kidney Threshold The point at which the blood is holding too much of a substance such as glucose (sugar Continue reading >>
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Ketosis & Kidney Failure
Ketosis happens when your body resorts to fat for energy after your stored carbohydrates have been burned out. It often occurs when people fast and exercise. But most commonly, ketosis occurs in people who eat low-carb, high-protein diets, which are also called ketogenic diets. There’s some evidence that ketosis can tax your kidneys, leading to kidney stones and low blood pressure. In diabetics, a variant of ketosis can be fatal. However, a small but growing group of health professionals say ketosis is not the poison you’ve been lead to think it was, and it may be better for you than high-carbohydrate eating. Your specific dietary habits are best advised by your healthcare provider or nutritionist. Video of the Day Ketosis happens when you get a buildup of a substance known as ketones, or ketone bodies in your blood. They are released when your body’s carbohydrate stores run out and you have to break down fat stores for energy. Dieters tend to deliberately cause ketosis because it makes you feel less hungry. However, ketosis also makes you feel tired and sluggish, because as "Medical News Today" reports, ketones aren’t the most efficient source of energy, especially for your brain. Ketosis can also harm your kidneys. Annually, more than 100,000 people are diagnosed with kidney failure in the United States, reports the National Institute of Diabetes and Digestive and Kidney Diseases, or NIDDK. The condition is marked by the inability of your kidneys to do their job of eliminating wastes. One treatment for kidney failure is dialysis, a draining and lengthy artificial blood cleansing process. Another option is a kidney transplant. The NIDDK states that the cost of care for patients with kidney failure reached close to $32 billion in 2005. The federal government sub Continue reading >>
Diabetic Kidney Failure May Be Reversed With Low-carbohydrate Diet
Researchers have found that by administering a low-carb, high-fat diet in mice, that diabetic kidney damage was reversed, and also uncovered an array of genes associated with kidney failure. Researchers from Mount Sinai School of Medicine have for the first time determined that the ketogenic diet, a specialized high-fat, low carbohydrate diet, may reverse impaired kidney function in Type 1 and Type 2 diabetes. They also identified a previously unreported panel of genes associated with diabetes-related kidney damage, whose changes in expression were reversed by the diet. The findings were published online in the peer-reviewed journal PLoS ONE. Charles Mobbs, PhD, Professor of Neuroscience and Geriatrics and Palliative Care Medicine at Mount Sinai School of Medicine, and his research team evaluated mice that were genetically predisposed to have Type 1 or 2 diabetes. The mice were allowed to develop diabetic nephropathy, or kidney damage. Half of the mice were put on the ketogenic diet, while the control group maintained a standard high carbohydrate diet. The researchers found that after eight weeks, molecular and functional indicators of kidney damage were reversed in the mice on the ketogenic diet. Microscopic analysis showed that kidney pathology in the model of Type 2 diabetes was partially reversed. "Our study is the first to show that a dietary intervention alone is enough to reverse this serious complication of diabetes," said Dr. Mobbs. "This finding has significant implications for the tens of thousands of Americans diagnosed with diabetic kidney failure, and possibly other complications, each year." The ketogenic diet is a low-carbohydrate, moderate protein, and high-fat diet typically used to control seizures in children with epilepsy. Many cells can get their e Continue reading >>
Are Ketogenic Diets Bad For People With Kidney And Liver Issues?
There is an international organization of doctors and other professionals who have clinical experience with ketogenic diets. It's called the International Ketogenic Diet Study Group. They publish guidelines for safe use of ketogenic diets. The guidelines include a list of medical conditions (contraindications) which would make a ketogenic diet unsafe. At least one of the conditions on the list (carnitine deficiency) can cause liver dysfunction. You don't say exactly what sort of liver problem you have in mind. If you personally have a disease that affects the liver, maybe you should look at the list of contraindications carefully. Another condition on the list, beta-oxidation defects, can cause the liver to lack the ability to oxidize fatty acids. Regarding this condition the guidelines say, "An inborn metabolic error at any point along this pathway can lead to a devastating catabolic crisis (i.e., coma, death) in a patient fasted or placed on a [ketogenic diet]." Ketogenic diets increase the risk of kidney stones. Doctors often prescribe potassium citrate to people on medical ketogenic diets as a prophylactic measure against kidney stones. Here is a link to the full text of the guidelines. Contradindications are in Table 2. The title says "children" because virtually all clinical experience with ketogenic diets has been with kids. If you want to read more about the risks of ketogenic diets, click here to see a bibliography on my website (with many links to full text) of articles about risks and prevention. Some people seem to believe that ketogenic diets are harmless, risk-free, totally wonderful things. This isn't true. Ketogenic diets are like medications. They bring benefits but they also bring risks and harmful side effects. They involve tradeoffs. I'm not against Continue reading >>
Reversal Of Diabetic Nephropathy By A Ketogenic Diet
Go to: Introduction While intensive insulin therapy and other interventions slow the development of diabetic complications , there is far less evidence that these interventions reverse diabetic complications. For example, tight glucose control prevented the development of nephropathy (as indicated by proteinuria) in a rat model of Type 1 diabetes, but did not reverse nephropathy once proteinuria had developed . Thus there is a general consensus that diabetes is associated with progressive and cumulative processes that are much more amenable to retardation than to reversal. Nevertheless, from a clinical perspective, reversing pathologies associated with diabetes would be far more valuable than simply delaying their onset. We have proposed that both diabetic complications and age-related pathologies develop due to a progressive and cumulative effect of glucose metabolism that produces a bistable hysteretic effect on gene expression . In addition to glycolytic enzymes that would be expected to produce oxidative stress , glucose metabolism also induces a variety of molecular responses such as thioredoxin-interaction protein  and p65  that could plausibly contribute to nephropathy. Indeed, the latter induction is persistent, even after normalization of glucose, thus exemplifying glucose-induced hysteresis and its clinical correlate, metabolic memory, including in nephropathy . Furthermore, based particularly on detailed analysis of the hysteretic behavior of the lac operon , , we have hypothesized that sufficiently prolonged and robust reduction in glucose metabolism or molecular responses to glucose metabolism may reverse this bistable molecular state, leading to reversal of pathology . While examining basic mechanisms mediating molecular respo Continue reading >>
All About Kidney Stones
There are three things related to nutrition and lifestyle that I never want to experience: A cardiac catheterization A Cinnamon Toast Crunch-induced coma A kidney stone Needless to say, I was excited to write this article. What are kidney stones? Kidneys make clean blood by eliminating wastes. For instance, if you eat a can of soup with lots of salt, the kidney will excrete more salt to balance out levels in the body. If you eat a big steak, more urea will be excreted in the urine. If the body is unable to eliminate these wastes, you get sick. (Here’s a primer on the urinary system.) Our kidneys eliminate waste products through urine, and when there is excessive waste or not enough fluid volume, urine becomes supersaturated and a stone can form. Stones can be tiny like a grain of sand or big like a golf ball. Stones can hang out in the kidneys for years without obstructing any tubing. But when a stone obstructs the ureter, serious pain follows (it’s been said that kidney stones are the worst pain imaginable). The pain can stop/start as the stone heads to the bladder. The bladder tunnel is where most stones get hung up. Since stones may have sharp edges, they can draw blood into the urine. Kidney stone types There are four main types of kidney stones: Calcium-containing stones – these make up a majority, nearly 75% of stones Uric acid stones – these make up about 10% of stones Struvite (infected) stones – these make up about 10% of stones and form after an infection in the urinary tract Cystine stones – these are stones that form from the amino acid cystine, the most uncommon The table below shows the composition, frequency, and causes of kidney stones, aka nephrolithiasis (nephro = kidney; lith = stone). Why are kidney stones important? Kidney stones are inc Continue reading >>
Ketone Supplements: More Harm Than Good?
Enjoy this article co-authored with my dear friend, Tatiana Schallert, who is co-serving with me, my ministry, and my family. I AM Love, Dr. Sharnael Have you noticed that Ketone supplements are so popular recently? I know my Facebook newsfeed is buzzing with different articles and brands promoting ketones. I honestly had no clue what the deal was so I decided to do some research, which is exactly what I encourage you to do before jumping on the bandwagon. There is a lot of information out there on this topic right now and from what I found – taking Exogenous Ketones may be more harmful than good. What are Ketones? Ketones are produced in the liver from fatty acids. Then they are consumed as alternative fuel by the body, particularly the brain, when blood sugar (glucose) is in short supply. The brain consumes lots of energy every day and it can’t run on fat directly – only in the form of glucose or ketones. Ketones are popularly known as “brain fuel.” Eating a no-carb, moderate-protein, and high-fat diet encourages the body to organically reach a state of Ketosis. It takes about 72 hours for the liver to be in full ketosis so the kidney can assimilate the changes as the ketones gradually increase. Then it takes about two weeks for your body to adjust to the new pathway. What Is Ketosis? When the body produces ketones it’s said to be in ketosis (you can test ketone levels through urine tests). The fastest way to get there is by fasting. However, fasting is not something we do forever. On the other hand, a low-carb or “keto” diet also leads to ketosis and is a more sustainable option. The idea of a ketogenic diet is to get the body to switch its fuel supply to run almost entirely on fat. As insulin levels become very low, fat burning increases dramatically Continue reading >>