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Euglycemic Dka Sglt2

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Euglycemic Diabetic Ketoacidosis: A Potential Complication Of Treatment With Sodiumglucose Cotransporter 2 Inhibition

Objective Sodiumglucose cotransporter 2 (SGLT-2) inhibitors are the most recently approved antihyperglycemic medications. We sought to describe their association with euglycemic diabetic ketoacidosis (euDKA) in hopes that it will enhance recognition of this potentially life-threatening complication. Research Design and Methods Cases identified incidentally are described. Results We identified 13 episodes of SGLT-2 inhibitorassociated euDKA or ketosis in nine individuals, seven with type 1 diabetes and two with type 2 diabetes, from various practices across the U.S. The absence of significant hyperglycemia in these patients delayed recognition of the emergent nature of the problem by patients and providers. Conclusions SGLT-2 inhibitors seem to be associated with euglycemic DKA and ketosis, perhaps as a consequence of their noninsulin-dependent glucose clearance, hyperglucagonemia, and volume depletion. Patients with type 1 or type 2 diabetes who experience nausea, vomiting, or malaise or develop a metabolic acidosis in the setting of SGLT-2 inhibitor therapy should be promptly evaluated for the presence of urine and/or serum ketones. SGLT-2 inhibitors should only be used with grea Continue reading >>

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  1. Desley

    Help! I'm frustrated, I'm into my 2nd week on Induction & I'm still not into Ketosis. I've been keeping my carbs below 20 carbs a day.
    If fact I've been averaging 18. Testing my Urine every 2sd day for the recommended 15 seconds. Anybody got any ideas?

  2. Desley

    Have been reading some old posts (2011) about bringing on Ketosis by upping your fat intake using Coconut Oil. Has anyone got any info on this. What does Atkins think about this?

  3. Helen

    The ketostix are not always accurate. You may be in ketosis when they say you aren't.
    Are you thirsty all the time? Has your hunger gone away? Those are generally the best two ways to recognise that you are in ketosis.
    Saying that, while most people can achieve ketosis in 3-6 days, for some it can take a few weeks, especially if they are insulin resistant.
    Not sure about the Coconut oil (although it is good for you). I have read that it can help in ketogenic diets, but not sure if it will help in the case of Atkins.
    Helen

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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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  1. Craig Stephenson

    So....apparently I have placed my self in a state of ketosis by loosely following the paleo diet....(very limited grains, and or processed foods) I base this on the fact that my wife finds my breath similar to sucking on a sock soaked in paint thinner....
    I have spent some time researching this topic both here on the board and elsewhere on the web....still, I am confused. Some say its bad, some say its not.....some say protein sparing, some say liver damaging.....
    Does anyone really know? Am I in a happy place?... or should I be concerned that my brain and liver are going to revolt against me? I might add that I was not necessarily trying to obtain ketosis....I am 6'3" 200# ~11% BF....so I am not really trying to loose wt...I caught the paleo bug and like how I feel following it....however....if it is causing this ketosis and it is "bad"...maybe I need to re-evaluate or at least adjust what I am doing.
    Anybody have any advice??
    Thanks
    Craig "ELI" Stephenson

  2. Sarah Clent

    How is your body feeling?
    Do you feel lethargic? Full of energy? Unusual soreness after workouts? etc?
    Do you eat alot of fruit and veg?
    I have done the atkins diet in the past and been in ketosis... I didnt harm my body but it seems its mainly for weight loss? And it seems you dont need weight loss
    I am loosley following paleo in zone and i havent tested if i am in ketosis... would be interesting to see as i have cut all wheat and grains (except corn) for the last week... As for it harming you, i guess you need to work out how your body is feeling... if you are feeling good and healthy and if you are eating alot of veggies and fruit and lean meat... i dont see how it could be damaging to you? your body might just have a higher requirement for carbs?

  3. Frank E Morel

    Quote:

    Originally Posted by Craig Stephenson
    So....apparently I have placed my self in a state of ketosis by loosely following the paleo diet....(very limited grains, and or processed foods) I base this on the fact that my wife finds my breath similar to sucking on a sock soaked in paint thinner....
    I have spent some time researching this topic both here on the board and elsewhere on the web....still, I am confused. Some say its bad, some say its not.....some say protein sparing, some say liver damaging.....
    Does anyone really know? Am I in a happy place?... or should I be concerned that my brain and liver are going to revolt against me? I might add that I was not necessarily trying to obtain ketosis....I am 6'3" 200# ~11% BF....so I am not really trying to loose wt...I caught the paleo bug and like how I feel following it....however....if it is causing this ketosis and it is "bad"...maybe I need to re-evaluate or at least adjust what I am doing.
    Anybody have any advice??
    Thanks
    Craig "ELI" Stephenson well you must be cycling in and out of ketosis as if your inconstant state of ketosis.. you get a really bad case of brain fog. Out of ketsis, your giving your brain enough glucose/carbs for it to function.
    cardiac arrthymias from electrolyte imbalances, increased risk of osteoporosis from urinary calcium losses, gout, kidney stones and nausea, lethargy and general weakness associated with prolonged ketosis. not many studies address this but there is enough anecdotal events ( mass famines ) that its not a wise thing to in for a prolonged period.
    http://www.ajur.uni.edu/v4n1/Harris%...0pp%201-18.pdf wfs warning ..boring

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Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor Inhibitors of sodiumglucose cotransporter 2 (SGLT2) decrease plasma glucose by blocking the reabsorption of glucose at the proximal tubule.1,2 Case reports have suggested that SGLT2 inhibitors may be associated with an increased risk of diabetic ketoacidosis, which led to a warning from the Food and Drug Administration (FDA) in May 2015.3,4 The objective of our study was to assess the risk of diabetic ketoacidosis after the initiation of an SGLT2 inhibitor. https://www.youtube.com/channel/UCsqm...

Sglt2 Inhibitor-linked Diabetic Ketoacidosis Is Rare, But Severe

SGLT2 Inhibitor-Linked Diabetic Ketoacidosis Is Rare, but Severe Many cases of sodium-glucose cotransporter-2 (SGLT2) inhibitor-associated diabetic ketoacidosis (DKA) are preventable, new research suggests. But physicians and patients are missing the signs and symptoms of this rare side effect or not even aware of the link and as a result, any cases are severe and one was fatal, according to this latest audit of Australian databases, published online February 13 in Diabetes Care by Emily J Meyer, MBBS, of the Royal Adelaide Hospital and University of Adelaide, Australia, and colleagues. As DKA was initially missed by both patients and physicians, likely due in part to relative euglycemia, this led to delayed treatment, say the researchers. However, "identifiable precipitants were often present, suggesting the potential for risk mitigation," Meyer and colleagues write. Stop SGLT2 Inhibitors for Acute Illness, Surgery The US Food and Drug Administration (FDA) first warned about the risk for DKA with SGLT2 inhibitors, a relatively new class of oral agents for type 2 diabetes, in 2015, and the European Medicines Agency followed suit in 2016. The phenomenon has also been reported sever Continue reading >>

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  1. jubatum

    I just reached my full dose of topamax and I have the tingling too. each time I increase the drugs I get tingling for a lil while. Make sure you stay hydrated! drink lots of water. It is puzzling for sure and a bit annoying. I get it in my hands too but i'm told it goes away after a bit. Im telling you to stay hydrated because personally I find that if I drink more water it seems to help....at least it does for me...
    good luck! I hope the switch over helps .. i just had a simple partial the other day so i'm a lil worried this drug won't work for me at the neuros recommended dose but I guess we will see.
    let me know if your tingling goes away. but patience is key.

  2. lyneeeh

    I've been on Topamax 8 months and am up to 400mg a day.
    The tingling eventually went away other than when I play sport.
    I was managing on it.
    But now all my hair is falling out.
    One to watch out for as you get up to the higher doeses!
    Lyn

  3. reneemodonnell

    I have been on topamx for about 5 years and have tried the other meds you have been on. All the other ones gave me bad side affects. With the topamx i always have the numbness in my hands and feet i hate it but its better then the other stuff i have been on. Also i have heard it called Dopamax because it can make you seen forgetful and not all there.

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