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Euglycemic Dka Mechanism

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A Can't Miss Ed Diagnosis: Euglycemic Dka

The FDA has approved these three SGLT2 inhibitors for Type 2 diabetics, and at times, they are prescribed off-label for Type 1. The mechanism involves decreasingglucose reabsorption in the nephrons proximal tubule (via inhibition of the sodium-glucose linked cotransporter-2 protein). This results in increased urinary excretion of glucose that is independent of the bodys insulin secretion.1 Other potential benefits of this class of medications include:13 In 2015 the FDA issued a warning, however, that SGLT2 inhibitors may cause ketoacidosis, urinary tract infections, and urosepsis.4 Since then, multiple case reports have been published showing an association between SGLT2 inhibitors and the development of euglycemic DKA. Euglycemic DKA is an uncommon and likely under-diagnosed phenomenon, best defined as DKA with alower than expected blood glucose (less than 250 mg/dL according to the American Diabetes Association).46 Potential precipitants, in addition to SGLT2 inhibitors, include:7 EPs may delay diagnosis, given the modest glucose levels at the time of presentation. This, however, is false reassurance because DKA is not defined by an absolute blood glucose. Interestingly, patient Continue reading >>

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Popular Questions

  1. timothyw

    Ketosis & BG

    Has anyone ever made a correlation between their blood sugar numbers and Ketosis? I imagine it would be different for everyone. seems to me that if the BG went down to x then you would switch into ketosis for fuel needs. Too high a BG and you wouldn't be in ketosis. Or am I off track here and it is purely the carb count that matters? I have read how atkins suggested increasing carbs each week to find the right level of carbs to maintain weight on his diet.
    Any ideas or thoughts?

  2. MarkM

    You can be in ketosis and have high blood sugar levels but low insulin levels. This what happens to T1s at onset, but it gets worse and there can be ketoacidosis. T2s, if they are insulin resistant and/or insulin deficient, can also be in ketosis and have above normal blood glucose levels.
    Normal people go in and out of ketosis every day. But for someone who has normal insulin production and insulin sensitivity, sustained ketosis would only occur if carb consumption dropped below what is needed to satisfy the normal daily glucose requirement. Some say this is 130 grams of carb a day. Low carbers will tell you it is a lot lower, based on their observations of ketone test results and eating patterns.
    That is my take on it anyway. And in answer to your question, no, I don't think there is a clear correlation there.

  3. Nicoletti

    I never gave it a thought. My concern is keeping blood sugar down.

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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 b

Euglycemic Diabetic Ketoacidosis: A Diagnostic And Therapeutic Dilemma

Euglycemic diabetic ketoacidosis: a diagnostic and therapeutic dilemma 1Department of Internal Medicine, Memorial Hospital of Martinsville and Henry County, Martinsville, Virginia, USA, 2Texas Tech University Health Sciences Center, El Paso, Texas, USA, 3Senior Research Associate, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA, 4Department of Pharmacology, St Johns Medical College, Bangalore, India, Received 2017 Jul 18; Accepted 2017 Aug 4. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License . Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation. Both Continue reading >>

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Popular Questions

  1. Sez

    I have bought them in the past from Boots etc, but got so sick of the questioning decided to try to find them elsewhere on the WWW! (I felt a second class citizen using them just to check weight loss.....)
    I just bought 2 packs of 50 genuine Ketositx, long date, on Ebay for just over a tenner. I know its a gamble that they are in fact ok, but the seller had 99.3% positive (or thereabouts) so I thought it worth the risk!
    Any thoughts? Good price or dodgy deal?

  2. LizDesigns

    I've bought them from e-Bay before and Superdrug. Both cost around about £5 each so it sounds like you paid about the right price.
    As long as they haven't been tampered with I can't see you having any problems with them.

  3. shinyhappyperson

    Sainsburys pharmacy bit - £5.15.

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Susan Cornell, PharmD, CDE, FAPhA, FAADE, describes the risks for ketoacidosis and serious urinary tract infection associated with use of SGLT2 inhibitors. This video was recorded at APhA's 2016 Annual Meeting and Exposition in Baltimore, Maryland.

Diabetic Ketoacidosis With Sglt2 Inhibitors Is Manageable

Diabetic Ketoacidosis With SGLT2 Inhibitors Is Manageable The euglycemic diabetic ketoacidosis (DKA) that has recently been associated with the use of sodiumglucose cotransporter 2 (SGLT2) inhibitors will probably turn out to be very infrequent in patients with type 2 diabetes and "predictable, detectable, and preventable" in those with type 1 diabetes, two leading clinical trialists assert in a new editorial published in the September issue of Diabetes Care. The piece by Julio Rosenstock, MD, of the Dallas Diabetes and Endocrine Center at Medical City, Texas, and Ele Ferrannini, MD, of the Institute of Clinical Physiology, Consiglio Nazionale delle Ricerche, Pisa, Italy accompanies the published versions of two related articles that had previously appeared online: a Janssen article demonstrating a low (but not zero) risk for DKA in a clinical-trial program of canagliflozin (Invokana, Janssen Pharmaceuticals, Inc), and a case series report of 13 episodes of euglycemic DKA in nine patients, seven with type 1 diabetes and two with type 2 diabetes, who developed the condition postoperatively. The issue initially came to light in May 2015, when the US Food and Drug Administration issu Continue reading >>

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Popular Questions

  1. jjcj

    I keep reading about these strips but not sure where to get them or what to ask for. I am in Canada if that makes a difference.
    Thanks in advance for any and all help.

  2. Lekker

    Hi jjcj,
    I'm in Canada too, but I haven't found the strips...although I haven't looked very hard, I just browsed a couple drug stores, then gave up. I'm sure they're out there though - I heard that diabetics used to use them(?). So maybe if you explain at the drugstore to the pharmecist, they might know what you're talking about. Maybe they keep them behind the coutner. Froufy might be your best bet, though, for knowing what they might be called up here.
    To be honest, I can find nothing in Canada except for Splenda, so I've pretty much given up many of those things. Although maybe because I'm in Quebec it's a bit tougher to find some of these things??

  3. StarPrincess

    I'm assuming you're talking about the ketone testing strips? They come under lots of names and I've seen them range from $11 - $17 here in the states. There's frequently auctions on ebay for them.
    I personally don't use them anymore. They were fun for just "checking in" to see how I was doing, but I've since learned that I'm doing just fine and don't need to risk peeing on my hand to find out

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