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Does Dka Go Away

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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) happens when your blood sugar is high and your insulin level is low. This imbalance in the body causes a build-up of ketones. Ketones are toxic. If DKA isn’t treated, it can lead to diabetic coma and even death. DKA mainly affects people who have type 1 diabetes. But it can also happen with other types of diabetes, including type 2 diabetes and gestational diabetes (during pregnancy). DKA is a very serious condition. If you have diabetes and think you may have DKA, contact your doctor or get to a hospital right away. The first symptoms to appear are usually: frequent urination. The next stage of DKA symptoms include: vomiting (usually more than once) confusion or trouble concentrating a fruity odor on the breath. The main cause of DKA is not enough insulin. A lack of insulin means sugar can’t get into your cells. Your cells need sugar for energy. This causes your body’s glucose levels to rise. To get energy, the body starts to burn fat. This process causes ketones to build up. Ketones can poison the body. High blood glucose levels can also cause you to urinate often. This leads to a lack of fluids in the body (dehydration). DKA can be caused by missing an insulin dose, eating poorly, or feeling stressed. An infection or other illness (such as pneumonia or a urinary tract infection) can also lead to DKA. If you have signs of infection (fever, cough, or sore throat), contact your doctor. You will want to make sure you are getting the right treatment. For some people, DKA may be the first sign that they have diabetes. When you are sick, you need to watch your blood sugar level very closely so that it doesn’t get too high or too low. Ask your doctor what your critical blood sugar level is. Most patients should watch their glucose levels c Continue reading >>

What Is Diabetic Ketoacidosis?

What Is Diabetic Ketoacidosis?

Having diabetes means that there is too much sugar (glucose) in your blood. When you eat food, your body breaks down much of the food into glucose. Your blood carries the glucose to the cells of your body. An organ in your upper belly, called the pancreas, makes and releases a hormone called insulin when it detects glucose. Your body uses insulin to help move the glucose from the bloodstream into the cells for energy. When your body does not make insulin (type 1 diabetes), or has trouble using insulin (type 2 diabetes), glucose cannot get into your cells. The glucose level in your blood goes up. Too much glucose in your blood (also called hyperglycemia or high blood sugar) can cause many problems. People with type 1 diabetes are at risk for a problem called diabetic ketoacidosis (DKA). It is very rare in people with type 2 diabetes. DKA happens when your body does not have enough insulin to move glucose into your cells, and your body begins to burn fat for energy. The burning of fats causes a build-up of dangerous levels of ketones in the blood. At the same time, sugar also builds up in the blood. DKA is an emergency that must be treated right away. If it is not treated right away, it can cause coma or death. What can I expect in the hospital? You will need to stay in the hospital in order to bring your blood sugar level under control and treat the cause of the DKA. Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include: Monitoring You will be checked often by the hospital staff. You may have fingersticks to check your blood sugar regularly. This may be done as often as every hour. You will learn how to check your blood sugar level in order to manage your diabetes when you go home. A heart (cardiac) monitor may Continue reading >>

Diabetes And Nausea

Diabetes And Nausea

Diabetes can be associated with an increased risk of nausea. There are several reasons why a diabetic might have more nausea when compared to those without diabetes. Some things that contribute to nausea in diabetics include the following: Diabetic medications. Some of the injectable medications used in the management of diabetes will increase the risk of nausea. Common injectable diabetic medications include Symlin (pramlintide), Victoza (liraglutide), and Byetta (exenatide). There is some evidence to suggest that the nausea associated with these medications is temporary and will go away the longer you take the medications. Your physician may also try a lesser dose of the medication in the beginning to try and lessen the risk of nausea. Hypoglycemia or Hyperglycemia. Both elevated blood glucose levels (hyperglycemia) and low blood glucose levels (hypoglycemia) carry the risk of developing nausea. In order to reduce the incidence of nausea, you need to check your blood glucose levels on a regular basis and use insulin (or other diabetic medications) to keep your blood sugar within the normal range. Besides medications for blood sugar control, you can avoid the nausea of blood glucose abnormalities, you need to eat a healthy diet and exercise—both surefire ways of controlling the blood sugar levels. One other thing you can do is avoid doing any type of exercise when the environment is too hot or too cold. Drink cold water or electrolyte solution while exercising outdoors in order to maintain adequate hydration and to keep your blood sugars in good control. Diabetic ketoacidosis. One of the signs that you might have diabetic ketoacidosis is the presence of nausea. Diabetic ketoacidosis happens when the blood sugar cannot enter the cells so that the cells of the body mus Continue reading >>

Diabetic Ketoacidosis - Symptoms

Diabetic Ketoacidosis - Symptoms

A A A Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel. In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common. The most common Continue reading >>

How Long Does Diabetes Ketoacidosis Last?

How Long Does Diabetes Ketoacidosis Last?

Diabetic ketoacidosis (DKA) is a common complication of diabetes in children, which needs hospitalisation and can be fatal. In most cases of diabetic ketoacidosis, death is caused due to cerebral edema or complication of DKA. Diabetic ketoacidosis (DKA) can be the first sign or presenting symptom in some cases of type 1 diabetes (before diabetes is diagnosed or they have any other symptoms). According to studies, about 20 to 40% of newly diagnosed patients of type 1 diabetes are admitted in DKA. Duration of Diabetic ketoacidosis: with appropriate treatment (fluid replacement and insulin therapy), DKA can be corrected in about 24-48 hours (depending on the severity of DKA at presentation). In most cases, the duration of therapy is about 48 hours. Treatment for DKA aims to correct the metabolic abnormalities of DKA such as high blood sugar level, high ketone levels and serum osmolality with insulin and fluids. Treatment of DKA includes: Insulin replacement to correct blood glucose levels. Fluid and electrolyte replacement to correct dehydration and imbalance of electrolytes in the body. Treating the cause of DKA (such as infection, injury etc). Duration of fluid replacement: fluid is replaced slowly; if it is given at an excessive rate or more than required, it can cause brain swelling (cerebral edema). Most cases have a fluid deficit of about 10% or 100 ml/kg. Fluid is given intravenously (into a vein) slowly with the aim of replacing 50% of the fluid deficit during the first 12 hours of presentation and the remainder within the next 12-16 hours. As high blood sugar is corrected more rapidly than ketoacidosis (high blood ketone levels), glucose-containing fluids is given once the glucose falls to < 14 mmol/l to prevent the fall in blood glucose levels hypoglycaemia). Dur 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 >>

I Nearly Died From Dka

I Nearly Died From Dka

“Geez kid, when’d you get so skinny?” My dad was getting me ready for school one February morning. As he began to help me into my school clothes, he’d lifted my pajama shirt up and was shocked at the sight of my protruding ribs. “You’d better start eating more,” he said to me. And so I did. My appetite increased immensely. For breakfast, I’d finish two, sometimes three large bowls of cereal, which wasn’t adding up considering the noticeable weight I was losing. My thirst intensified. Late one night, my mom awoke to a commotion coming from the kitchen. To her dismay, there was her 6-year-old daughter on the countertop in her nightgown, pouring six glasses of apple juice. “Carlie, what’re you doing? Are you alright?” “Go away! Leave me alone!” I snapped, proceeding to guzzle down all six glasses. I felt so sick, like I was wasting away. But I kept it to myself and I didn’t tell my parents how I was feeling in fear of being taken to a doctor. February 22, 2003 as I sat in the basement, staring lifelessly at the television in front of me, I tried my best to listen to the conversation that was taking place between my parents in the kitchen. “Dave, she’s sick. We need to do something.” I could tell my mom was in tears just by her voice. “We’ll call the nurse hotline today and see what they tell us to do.” The woman whom my dad spoke with told him that she believed it may be diabetes, but said that he should wait until Monday to take me to a doctor because of the snowstorm my city was currently in the middle of. However, later that day, my mom had enough. While my dad was shoveling my grandma’s driveway, back at home, my mom had lifted me over a baby gate in the kitchen and watched my eyes roll back into my head. She called my dad an 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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Print Overview Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care. Symptoms Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: Excessive thirst Frequent urination Nausea and vomiting Abdominal pain Weakness or fatigue Shortness of breath Fruity-scented breath Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: High blood sugar level (hyperglycemia) High ketone levels in your urine When to see a doctor If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit. Contact your doctor immediately if: You're vomiting and unable to tolerate food or liquid Your blood sugar level is higher than your target range and doesn't respond to home treatment Your urine ketone level is moderate or high Seek emergency care if: Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 mill Continue reading >>

Ketones.

Ketones.

Headache. Check. Eyes that weighed at least a pound apiece. Check. Mouth full of sweaters. Check. Looks like they're all here - the symptoms of a high blood sugar. Sitting down to catch up on some emails, I absently fish my meter out of my gym back and lance my fingertip. I hit send, graze against the new infusion set on my left thigh, and see a meter result of 420 mg/dl. "Oh, that is just fantastic." Taking out my pump, I calculated the massive correction bolus and felt the quiet sting of the insulin as it coursed through the infusion set I had placed an hour earlier. Normally when I'm at an elevated blood sugar, I feel lethargic and generally Crumbs Morrone, but this one had a different feel to it entirely. My stomach felt like it was playing host to a hamster wheel, and my headache was blinding. I brought the ketone strips into the bathroom and watched uneasily as the pad on the ketone strip turned a deep purple. Large ketones. I hadn't seen those suckers since my days at Clara Barton Camp. I never, ever have ketones, and I test regularly for them. So where did this come from? My stomach in knots, I wandered back into the living room and filled Chris in on the situation. "I'm high. Like crazy high - 420 mg/dl. And I just tested for ketones. I have large ketones. I feel like complete shit, and my stomach is really nauseous." He rubbed my back. "So what do we do?" "Drink a ton of water and try to flush out the ketones, I guess. If I can't keep the water down, we're off to the emergency room." It dawned on me that I had the process of treating a low blood sugar down to a science, but navigating a serious high was unfamiliar territory. Normally, I just bolus and wait for the numbers to fall, but this high came with an added bonus of ketones. The word "ketones" was enough Continue reading >>

Why Does Diabetes Cause Excessive Thirst?

Why Does Diabetes Cause Excessive Thirst?

7 0 We’ve written before about the signs and symptoms of diabetes. While there are a lot of sources about what symptoms diabetes causes, and even some good information about why they’re bad for you, what you don’t often get are the “whys”. And while the “whys” aren’t necessarily critical for your long-term health, they can help you to understand what’s going on with your body and why it acts the way it does. That, in turn, can help with acceptance and understanding of how to better treat the symptoms, which in turn can help you stay on a good diabetes management regimen. In short, you don’t NEED to know why diabetes causes excessive thirst, but knowing the mechanism behind it can make your blood glucose control regimen make more sense and help you stick to it. So why DOES diabetes cause thirst? First, we’d like to start by saying that excessive thirst is not a good indicator of diabetes. For many people, the symptom creeps up so slowly that it’s almost impossible to determine if your thirst has noticeably increased (unless you keep a spreadsheet of how much water you drink, in which case you also probably get tested pretty regularly anyway). It’s also a common enough symptom that a sudden increase in thirst can mean almost anything. Some conditions that cause thirst increases include allergies, the flu, the common cold, almost anything that causes a fever, and dehydration caused by vomiting or diarrhea. So while excessive thirst is one of those diabetes symptoms that happens, and needs to be addressed, it’s not always a great sign that you should immediately go out and get an A1C test. Why does diabetes cause thirst? Excessive thirst, when linked to another condition as a symptom or comorbidity, is called polydipsia. It’s usually one of the Continue reading >>

Take Care Of Yourself When Sick Or Under Stress

Take Care Of Yourself When Sick Or Under Stress

When we're stressed, our bodies need extra energy to help us cope and recover. This is true whether bodies are under stress from illness or injury or are dealing with the effects of emotional stress, both good and bad. To meet the demand for more energy, the body responds by releasing into the bloodstream sugar that's been stored in the liver, causing blood sugar levels to rise. In someone without diabetes, the pancreas responds to the rise in blood sugar by releasing enough insulin into the bloodstream to help convert the sugar into energy. This brings blood sugar levels back down to normal. In someone with diabetes, the extra demand usually means needing to take more diabetes medicine (insulin or pills.) To make sure your body is getting enough medicine to help keep your blood sugar levels close to normal, you'll need to test more often when you are: Sick Recovering from surgery Fighting an infection Feeling upset Under more stress than usual Traveling Type 1 Diabetes In people with type 1 diabetes, blood sugar levels rise in response to stress, but the body doesn't have enough insulin to turn the sugar into energy. Instead, the body burns stored fat to meet energy needs. When fat is burned for energy, it creates waste products called ketones. As fat is broken down, ketones start to build up in the bloodstream. High levels of ketones in the blood can lead to a serious condition known as diabetic ketoacidosis (DKA), which can cause a person to lose consciousness and go into a diabetic coma. Type 2 Diabetes In people with type 2 diabetes, the body usually has enough insulin available to turn sugar into energy, so it doesn't need to burn fat. However, stress hormones can cause blood sugar levels to rise to very high and even dangerous levels. People with type 2 diabetes Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

What Is It? Diabetic ketoacidosis is a potentially fatal complication of diabetes that occurs when you have much less insulin than your body needs. This problem causes the blood to become acidic and the body to become dangerously dehydrated. Diabetic ketoacidosis can occur when diabetes is not treated adequately, or it can occur during times of serious sickness. To understand this illness, you need to understand the way your body powers itself with sugar and other fuels. Foods we eat are broken down by the body, and much of what we eat becomes glucose (a type of sugar), which enters the bloodstream. Insulin helps glucose to pass from the bloodstream into body cells, where it is used for energy. Insulin normally is made by the pancreas, but people with type 1 diabetes (insulin-dependent diabetes) don't produce enough insulin and must inject it daily. Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School. Continue reading >>

Five Things To Know About Ketones

Five Things To Know About Ketones

If you live with diabetes, you have probably heard that ketones are something to watch out for. That they have something to do with the dreaded diabetic ketoacidosis (DKA). But do you really understand what ketones are and why they happen? It’s scary to think about, sure. But it’s also very important to be in the know about ketones and to be prepared. 1) What are ketones? If there isn’t enough insulin in your system, you can’t turn glucose into energy. So your body starts breaking down body fat. Ketones are a chemical by-product of this process. This can occur when people with type 1 diabetes don’t take insulin for long periods of time, when insulin pumps fail to deliver insulin and the wearer does not monitor blood glucose, or during serious illness (in type 1 or type 2) when insulin doses are missed or not increased appropriately for the stress of illness. Ketones can happen to anyone with diabetes, but the condition is more common in people with type 1. 2) Why are ketones dangerous? Ketones upset the chemical balance of your blood and, if left untreated, can poison the body. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Eventually they build up in the blood. The presence of ketones could be a sign that you are experiencing, or will soon develop, diabetic ketoacidosis (DKA)—a life-threatening medical emergency. 3) When should I test for ketones, and how? There are several situations in which it is a good idea to check for ketones, usually every four to six hours. Talk to your doctor to know what makes the most sense for you and your diabetes management plan. Your blood glucose is more than 300 mg/dl (or a level recommended by your doctor) You feel nauseated, are vomiting or have abdominal pain You are Continue reading >>

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