Euglycemic Dka Uptodate

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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

Prevalence Of Diabetes Ketoacidosis Rises And Still No Strict Treatment Adherence

Prevalence of Diabetes Ketoacidosis Rises and Still No Strict Treatment Adherence Author(s): Alex Jervis , Susannah Champion , Gemma Figg , Jane Langley , Gary G. Adams . Insulin Diabetes Experimental Research Group, Faculty of Medicine and Health Sciences, The University of Nottingham, Nottingham, NG7 2UH, United Kingdom. Diabetes ketoacidosis (DKA) should be managed following clear written guidelines. However, evidence suggests thathealthcare professionals do not always adhere strictly to the agreed guidelines. Objective: This investigation aimed to review the management of DKA in a hospital setting, to assess what DKA treatmentwas implemented and its effectiveness on patient care. As a result of the study, it was also anticipated that the datawould highlight other matters of interest, such as whether certain categories of people are more prone to DKA. Method: A retrospective audit was carried out on patients case notes in hospitals within the East Midlands, UK. Thismethod prevents study outcomes being swayed because DKA management has already taken place. To reduce selectionbias the most recent available case notes were selected. All patients aged 39 and under who were admitted Continue reading >>

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  1. spage_rn

    I have smelled sinus infections like that, but I would definitely keep the appt with the doctor!
    Quote from spage_rn
    Nurses...I am so glad I found this web site (thanks Jeeves!). Anyway, my husband's breath smells like moth balls. Yes, it is disgusting. I am making him an appt at the internist tomorrow. This has been going on since Thursday...poor guy has brushed, flossed, scrubbed and used listerine like crazy. He feels fine.
    I guess I am asking if you all can think of some reason for this!! I have looked and looked on line and in the Merck Manual. All I find is acetone smelling breath for ketosis. And his breath smells like an old man...reminds me of my father in law (66, had prostate cancer 5 years ago). Help!! My husband has no s/sx of diabetes. I have even done finger sticks...always less than 110.
    He had this happen about a year ago but we can't remember what or when it went away.
    thanks for any help or insight.

  2. CDN_NPtobe

    Any problems with urination? Sometimes kidney failure will cause people to be malodorous because its a way for the body to try and rid itself of toxins. He also may have a pharygeal pouch or something that is filling with food that could cause the odor.
    Just ideas--I would agree that he should keep his appointment. Let us know how he makes out...

  3. LydiaGreen

    There are many possibilities so the appointment should definitely be kept. Could be a sinus infection. Does he have any trouble sleeping? Excessive snoring, periods where he stops breathing? My daughter has enlarged adenoids (possible T&A surgery this month) and it doesn't matter how often she brushes, flosses, gargles - she still has bad breath (although, she isn't aware of it - we've never told her. She's seven and the poor kid has more than enough to worry about with the lack of sleep.)

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Emergency Medicine Pharmd

Emergency medicine from the perspective of a pharmacist Trick of the Trade: Simplify Treatment of the SSTI In 2010, skin and soft tissue infections (SSTIs) accounted for approximately 4.2 million emergency department visits (1). With such a bread-and-butter emergency medicine encounter, one might not give a second thought as to whether the standard dosing is less than ideal. However, the nuance of appropriate pharmacokinetic dosing that drug references omit may be the more ideal approach. The most appropriate dosing regimen, based on pharmacokinetic parameters, may not be highlighted by tertiary drug resources (2).With a condition seen every day, we should be nailing the treatment. If we see it every day, we should be excellent at treating it, right? Lets start with the organisms likely to cause these infections. Generally, gram (+) streptococcal and staphylococcal species are our biggest offenders. For streptococcus, we can utilize first-generation cephalosporins or penicillins. Between 20-50% of SSTIs are secondary to community-acquired methicillin-resistant staphylococcus aureus (MRSA) (3). The Infectious Diseases Society of America guidelines offer insight for purulent and non Continue reading >>

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  1. foodie

    Dr won't prescribe Metformin

    I just got in from an appointment this morning with my doctor. I had asked for a prescription for Metformin, but she said she wouldn't prescribe until my A1c is 7 or above.
    I have tried my best to eat low carb but after 6 months, it is becoming more and more difficult. Still in that time, I have lost 27 pounds. Even with that weight loss and exercise, 15 grams of carbs at a meal sends my bg level to 150. She said that is normal and she considers that pre-diabetes.
    I'll have today's lab results back next week. If my A1c isn't up, I won't get the Metformin. Is she right?

  2. jwags

    Welcome to DD. Congratulations on the weight loss. You must be doing something right. Is that 150, 2 hrs after meals. I find that when I was first diagnosed I had to increase my protein. My best numbers come aftter I eat eggs and bacon or sausage or a BLT on sprouted bread. My morning numbers are still high ( 115 -150) I'm on 850 metformin 2 x day. The metformin makes the liver produce less glucose, sometimes. But I find I still get bg spikes throughout the day and when I don't eat enough. One thing I have found out about diabetes is nothing is ever the same. What works one day, does not work the next. Stress also causes bg to spike. In my case when I exercise my bg will jump 60 or 70 points. So its about balance. I don't have any problems with metformin but many people have stomach cramps .

  3. foodie

    The 150 is 2 hours after a meal. I just need to add that I am definitely diabetic, not pre-diabetic as my doctor said this morning. I want the Metformin because I want a dang bowl of pinto beans sometimes. Is that too much to ask?

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This video Abdominal Aortic Aneurysm: A Case Study is part of the Lecturio course Emergency Medicine WATCH the complete course on http://lectur.io/aaaneurysm LEARN ABOUT: - Case study - Risk factors THE PROF: As an assistant professor in the Department of Emergency Medicine at the Johns Hopkins University School of Medicine, Sharon Bord, M.D. knows how to teach important skills to students. She is a member of the Committee of Emergency Medicine Residency Directors and Clerkship Directors in Emergency Medicine and on the editorial board for a board review question book. LECTURIO is your single-point resource for medical school: Study for your classes, USMLE Step 1, USMLE Step 2, MCAT or MBBS with video lectures by world-class professors, recall & USMLE-style questions and textbook articles. Create your free account now: http://lectur.io/aaaneurysm INSTALL our free Lecturio app iTunes Store: https://app.adjust.com/z21zrf Play Store: https://app.adjust.com/b01fak READ TEXTBOOK ARTICLES related to this video: Aortic Aneurysm http://lectur.io/aorticaneurysmarticle SUBSCRIBE to our YouTube channel: http://lectur.io/subscribe WATCH MORE ON YOUTUBE: http://lectur.io/playlists LETS

Best Case Ever 58 Euglycemic Dka - Emergency Medicine Cases (podcast)

MP3 • Episode home • Series home • Public Feed Discovered by Player FM and our community copyright is owned by the publisher, not Player FM, and audio streamed directly from their servers. It's not only run of the mill DKA, starvation and alcoholic ketoacidosis that can cause a metabolic acidosis with elevated ketones. Euglycemic DKA can be caused by the newer diabetes medications sodium-glucose co-transporter 2 inhibitors like Canagliflozin; and it's important to recognize this tricky diagnosis early and initiate treatment for DKA despite a normal serum glucose level... 203 episodes available.A new episode about every11 days. How do you distinguish cellulitis from the myriad of cellulitis mimics? At what point do we consider treatment failure for cellulitis? What is the best antibiotic choice for patients who are allergic to cephalosporins? Which patients with cellulitis or skin abscess require IV antibiotics? Coverage for MRSA? What is the best and most resource wi ... In anticipation of EM Cases Episode 109 Recognition and Management of Skin and Soft Tissue Infections with Melanie Baimel and Andrew Morris we have Dr. Morris telling us his Best Case Ever of Continue reading >>

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  1. Christian

    I read conflicting views about whether or not the human body can create glucose out of fat. Can it?

  2. David

    Only about 5–6% of triglyceride (fat) can be converted to glucose in humans.
    This is because triglyceride is made up of one 3-carbon glycerol molecule and three 16- or 18-carbon fatty acids. The glycerol (3/51-to-57 = 5.2–5.9%) can be converted to glucose in the liver by gluconeogenesis (after conversion to dihydroxyacetone phosphate).
    The fatty acid chains, however, are oxidized to acetyl-CoA, which cannot be converted to glucose in humans. Acetyl-CoA is a source of ATP when oxidized in the tricarboxylic acid cycle, but the carbon goes to carbon dioxide. (The molecule of oxaloacetate produced in the cycle only balances the one acetyl-CoA condenses with to enter the cycle, and so cannot be tapped off to gluconeogenesis.)
    So triglyceride is a poor source of glucose in starvation, and that is not its primary function. Some Acetyl-CoA is converted to ketone bodies (acetoacetate and β-hydroxybutyrate) in starvation, which can replace part — but not all — of the brain’s requirement for glucose.
    Plants and some bacteria can convert fatty acids to glucose because they possess the glyoxylate shunt enzymes that allow two molecules of Acetyl-CoA to be converted into malate and then oxaloacetate. This is generally lacking in mammals, although it has been reported in hibernating animals (thanks to @Roland for the last piece of info).

  3. blu potatos

    To be more detailed it is the irreversibly of the reaction carried by Pyruvate dehydrogenase that makes the conversion of the fatty acid chains to glucose impossible. The fatty acids chains are converted to acetyl-CoA.
    Acetyl-CoA to be converted into pyruvate need an enzyme that can do the Pyruvate Dehydrogenase's inverse reaction (in humans there is no such enzyme). Than the pyruvete inside the mitochondria is converted into glucose(gluconeogenesis).

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    Background: Diabetic ketoacidosis (DKA) is traditionally defined as a triad of hyperglycemia (>250mg/dL), anion gap acidosis, and increased plasma ketones. There is another entity that providers must be aware of known as euglycemic DKA (euDKA), which is essentially DKA without the hyperglycemia (Serum glucose <200 mg/dL). Euglycemic DKA is a rare entity that mostly occurs in patients with type 1 diabetes, but can possibly occur in type 2 diabetes ...

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    Diabetic ketoacidosis in patients with presenting serum blood glucose less than 200 is not common. Particularly when practicing in the Bible/Diabetes belt of the United States. This euglycemic DKA (euDKA) is more often associated in patients with type 1 diabetes in conjunction with starvation and acute illness.[1] It's difficult to determine an incidence of euglycemic serum glucose among all DKA cases in the literature given the migration of the ...

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