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Euglycemic Dka Mechanism

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  1. xSinead

    Silly question since i've been on cambridge almost 6 weeks now.. but i've been doing SS+ for about 10 days, and the past 4 days i've done SS, ive got the metal taste in my mouth and no longer feeling hungry.. so i think i'm probably in ketosis now?
    I get weighed at 5pm tonight, lord help me pleaaaaaaaase.

  2. Charlie Woo Woo

    xSinead said:
    Silly question since i've been on cambridge almost 6 weeks now.. but i've been doing SS+ for about 10 days, and the past 4 days i've done SS, ive got the metal taste in my mouth and no longer feeling hungry.. so i think i'm probably in ketosis now?
    I get weighed at 5pm tonight, lord help me pleaaaaaaaase. Im not too sure but it sounds like you are in ketosis. Does ss+ knock people out of ketosis or is it a milder ketosis?
    Sorry pretty new to this so am unsure
    Good luck for 5pm x

  3. AnnieAnnie

    You stay in ketosis at ss+ & 810 generally too. Although I find as soon as I eat I lose the taste of metal (but stay in ketosis). Hope this makes sense.

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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.....

Euglycemic Diabetic Ketoacidosis Due To Canagliflozin In A Patient With An Uncertain Diagnosis Of Type 2 Diabetes: A Case Report

University of Pittsburgh Medical Center, Pittsburgh, PA, USA *Corresponding Author: Bonnie B. Lu University of Pittsburgh Medical Center Pittsburgh, PA, USA Tel: +1 412-647-2345 E-mail: [email protected] Citation: Lu BB, Rivera-Lebron B, Ng J (2017) Euglycemic Diabetic Ketoacidosis Due to Canagliflozin in A Patient with an Uncertain Diagnosis of Type 2 Diabetes: A Case Report. Diabetes Case Rep 2:127. doi: 10.4172/2572-5629.1000127 Copyright: © 2017 Lu BB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Diabetes Case Reports Abstract Sodium-glucose cotransport 2 (SGLT2) inhibitors are approved for use only in patients with type 2 diabetes and work by blocking glucose reabsorption in the proximal renal tubule. There is also evidence that SGLT2 inhibitors directly act on pancreatic α-cells to stimulate glucagon secretion, leading to additional ketone body production, and that SGLT2 inhibitors decrease renal clearance of ketone bodies. While the risk of eu Continue reading >>

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  1. friedrice683

    How many carbs knocks you outa ketosis?

    On the average - how many carbs will knock an average individual out of ketosis. Just want to know.
    Just for knowing - like if one day I accidentally get hidden carbs in via something. Like are you out keto if you go above 30g a day - or is that just a daily guideline to keep you safely in keto?
    Thanks guys

  2. tinyman5000

    Originally Posted by friedrice683
    On the average - how many carbs will knock an average individual out of ketosis. Just want to know.
    Just for knowing - like if one day I accidentally get hidden carbs in via something. Like are you out keto if you go above 30g a day - or is that just a daily guideline to keep you safely in keto?
    Thanks guys

    depends how how much anaerobic activity you do on the day you go over

  3. unkept_

    Test waters, that's pretty much it.
    I used to freak out if I had more than 25g a day, but I found after testing waters, around 50g is my maximum threshold, spread out carbs of course .
    Also depends on bodyweight, muscle, metabolism, exercise, activity, and several other factors, so one size does not fit all.

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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.

Euglycemic Diabetic Ketoacidosis: The Clinical Concern Of Sglt2 Inhibitors

Euglycemic diabetic ketoacidosis is a post market warning in patients with type 1 diabetes and type 2 diabetes treated with SGLT-2 inhibitors. We report a case of a 39-year-old obese female with presumed type 2 diabetes for seven years who presented to the emergency department with three days of nausea, vomiting, and abdominal pain. Due to previous total non-adherence with a prescribed insulin regimen, she was recently started on canagliflozin and liraglutide. The diagnosis of euDKA was missed in the initial evaluation as the blood glucose level was only 167 mg/dL. Further work up showed severe metabolic acidosis with an anion gap of 25 and positive ketones in the urine. She was treated successfully with dextrose water 5%/half normal saline and an insulin drip. As part of the work up, she tested positive for glutamic acid decarboxylase autoantibodies. Given the increasing utilization of SGLT-2 inhibitors and the fact that patients can present with near-normal glycemia, the diagnosis can be missed. Vigilance with the use of SGLT-2 inhibitors is necessary to decrease morbidity and potentially mortality particularly in patients with long-standing type 2 diabetes associated with marked Continue reading >>

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  1. walkerwally1

    Interpreting the ReliOn Ketone Test Strips

    I have been low carb, less than 25g/day, for the last week and was sure I was in ketosis but thought I would check with the ReliOn test strips from Walmart. My result was 40mg/dl on their chart which they call moderate. Everything I have read lists ketones as mmol and it is said ketosis is from 0.5 to 5.0 mmol. I thing 40mg/dl converts to about 2.2 mmol but I am not sure. If someone understands this better than me I would like to know if I am doing the conversion right.
    I am currently reading a book about Low Carb Living:
    The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable: Stephen D. Phinney, Jeff S. Volek: 9780983490708: Amazon.com: Books
    I think this is one of the best books I have found so far, not better than Dr. Bernstein's or Jenny Ruhl's, but a great compliment to the lchf WOE. It goes into great detail about the science of low carb and why it works and is more natural than our high carb diets. It is written to inform professionals and they invite you to give a copy to your Doctor. The link is to Amazon so you can get more info and see some of the reviews it has received. I have no connection to this book or authors other than being impressed.

  2. Steve3129

    Quote:

    Originally Posted by walkerwally1
    I have been low carb, less than 25g/day, for the last week and was sure I was in ketosis but thought I would check with the ReliOn test strips from Walmart. My result was 40mg/dl on their chart which they call moderate. Everything I have read lists ketones as mmol and it is said ketosis is from 0.5 to 5.0 mmol. I thing 40mg/dl converts to about 2.2 mmol but I am not sure. I use these strips as well, but the only thing they tell you is if you are spilling Ketones in the urine, excess Ketones at that. The color code really doesn't tell you more other than the darker the color, the more your kidneys are taking out of the blood.
    You have to get a special meter and strips to accurately measure blood Ketones, which is rather expensive and I'm not willing to buy. I'm satisfied to know that I'm producing Ketones by the excess production as indicated by the strip.

  3. MCS

    If your showing any color on the urine test strip your in ketosis.

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