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Hhs Diabetes Guidelines

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Visit us (http://www.khanacademy.org/science/he...) for health and medicine content or (http://www.khanacademy.org/test-prep/...) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Matthew McPheeters. Watch the next lesson: https://www.khanacademy.org/test-prep... Missed the previous lesson? https://www.khanacademy.org/test-prep... NCLEX-RN on Khan Academy: A collection of questions from content covered on the NCLEX-RN. These questions are available under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States License (available at http://creativecommons.org/licenses/b...). About Khan Academy: Khan Academy offers practice exercises, instructional videos, and a personalized learning dashboard that empower learners to study at their own pace in and outside of the classroom. We tackle math, science, computer programming, history, art history, economics, and more. Our math missions guide learners from kindergarten to calculus using state-of-the-art, adaptive technology that identifies strengths and learning gaps. We've also partnered with institutions like NASA, The Museum of Modern Art, The California Academy of Sciences, and MIT to offer specialized content. For free. For everyone. Forever. #YouCanLearnAnything Subscribe to Khan Academys NCLEX-RN channel: https://www.youtube.com/channel/UCDx5... Subscribe to Khan Academy: https://www.youtube.com/subscription_...

Hyperosmolar Hyperglycemic State: A Historic Review Of The Clinical Presentation, Diagnosis, And Treatment

The hyperosmolar hyperglycemic state (HHS) is the most serious acute hyperglycemic emergency in patients with type 2 diabetes. von Frerichs and Dreschfeld described the first cases of HHS in the 1880s in patients with an “unusual diabetic coma” characterized by severe hyperglycemia and glycosuria in the absence of Kussmaul breathing, with a fruity breath odor or positive acetone test in the urine. Current diagnostic HHS criteria include a plasma glucose level >600 mg/dL and increased effective plasma osmolality >320 mOsm/kg in the absence of ketoacidosis. The incidence of HHS is estimated to be <1% of hospital admissions of patients with diabetes. The reported mortality is between 10 and 20%, which is about 10 times higher than the mortality rate in patients with diabetic ketoacidosis (DKA). Despite the severity of this condition, no prospective, randomized studies have determined best treatment strategies in patients with HHS, and its management has largely been extrapolated from studies of patients with DKA. There are many unresolved questions that need to be addressed in prospective clinical trials regarding the pathogenesis and treatment of pediatric and adult patients with Continue reading >>

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Popular Questions

  1. Margot LaNoue

    A few methods:
    - pee on a stick. There's a generic brand (I use Walgreen's) and the official brand. In general, they're called "ketone test strips" and they will change colors depending on the amount of ketone bodies in your urine. There is no "perfect level" of ketone bodies; you are either in ketosis or you are not. You will find these test strips in the same isle as the diabetic test stuff.
    - smell your breath. It will smell *awful* because a side product of ketosis is acetone in the urine and breath. While urine might always smell bad to you, your breath will smell truly, noticeably foul.
    - no bloating. Ketones do not bind with water the way glucose/glycogen does. You will not retain water when in ketosis. Nice!

  2. Cherie Nixon

    Warning: this might gross you out, but there's a simple answer to this question.
    OK, you want to know how you can tell? If you're in ketosis, you will often find oily residue floating in the toilet (assuming adequate lighting to see it). That's because while in ketosis, you excrete excess fat calories.

  3. Gary Wayne Nettoc

    The taste that people have mentioned is from the acetone in your breath, produced when you are in ketosis. There's a cool gadget that can measure that and let you know if you are in ketosis. KETONIX by Moose AB, Org.nr 556443-3794 It doesn't require strips or any replacement parts so in the long run it is the cheapest alternative.

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Management Of Hyperosmolar Hyperglycaemic State In Adults With Diabetes.

Diabet Med. 2015 Jun;32(6):714-24. doi: 10.1111/dme.12757. Management of hyperosmolar hyperglycaemic state in adults with diabetes. Sheffield Teaching Hospitals NHS Trust, Sheffield, UK. Hyperglycaemic hyperosmolar state (HHS) is a medical emergency, which differs from diabetic ketoacidosis (DKA) and requires a different approach. The present article summarizes the recent guidance on HHS that has been produced by the Joint British Diabetes Societies for Inpatient Care, available in full at HHS has a higher mortality rate than DKA and may be complicated by myocardial infarction, stroke, seizures, cerebral oedema and central pontine myelinolysis and there is some evidence that rapid changes in osmolality during treatment may be the precipitant of central pontine myelinolysis. Whilst DKA presents within hours of onset, HHS comes on over many days, and the dehydration and metabolic disturbances are more extreme. The key points in these HHS guidelines include: (1) monitoring of the response to treatment: (i) measure or calculate the serum osmolality regularly to monitor the response to treatment and (ii) aim to reduce osmolality by 3-8 mOsm/kg/h; (2) fluid and insulin administration: ( Continue reading >>

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  1. needtolose4me2

    since last week when I messed up and had some ad carbs one day, I basically started over Tuesday. I was really good all day Tuesday and Wednesday. Wednesday night I used a ketosis stick and it came up "trace". is that normal?should it take longer to get into ketosis? I was doing good the first 3 weeks (however not measuring my ketone levels) then all of a sudden I gained 2 pounds at which point I got aggrivated and screwed up for one day. the next day I got right back in the groove. I know my carbs are low, Ihaven't gotten on a scale,but this trace amount of keytones is concerning me. DO you think I should do some kind of fast (could onl really stomach the macadamia nut one) or wait it out a bit longer?
    thanks
    maggie

  2. JerseyGyrl

    I would not be too concerned about the Ketosis Stix....they have been known to not be accurate. If you are drinking a lot of water (as you should be) or eating a lot of fat & protein, they can give you false readings.
    Eating something you shouldn't, can definately knock you out of ketosis. Getting back into ketosis can vary depending on the person.
    As far as "fasts" are concerned, personally, I woudn't consider a fast unless I was in a very serious stall (not losing lbs OR inches). My best advice to you is to do a clean induction (only real foods..meat,eggs,cheese, veggies, etc) and be patient. Sometimes we get so anxious to lose the unwanted pounds we forget that we didn't gain them overnite & we aren't going to lose them overnite.
    All the best to you,
    Kim

  3. Tiffany_Bracelet

    For me, it depends on the amount of water and foods that I consume. Ketosis makes my mouth really dry....so I don't go into a deep ketosis like I have before with the meat/egg fast.

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A lecture on the recognition, pathogenesis, and management of diabetic ketoacidosis and the hyperosmolar hyperglycemic state. Use of the VA and Stanford name/logos is only to indicate my academic affiliation, and neither implies endorsement nor ownership of the included material.

Hyperglycemic Crises In Adult Patients With Diabetes

Diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS) are the two most serious acute metabolic complications of diabetes. DKA is responsible for more than 500,000 hospital days per year (1,2) at an estimated annual direct medical expense and indirect cost of 2.4 billion USD (2,3). Table 1 outlines the diagnostic criteria for DKA and HHS. The triad of uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketone concentration characterizes DKA. HHS is characterized by severe hyperglycemia, hyperosmolality, and dehydration in the absence of significant ketoacidosis. These metabolic derangements result from the combination of absolute or relative insulin deficiency and an increase in counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone). Most patients with DKA have autoimmune type 1 diabetes; however, patients with type 2 diabetes are also at risk during the catabolic stress of acute illness such as trauma, surgery, or infections. This consensus statement will outline precipitating factors and recommendations for the diagnosis, treatment, and prevention of DKA and HHS in adult subjects. It is based on a previous tech Continue reading >>

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  1. hide

    Has anyone had any luck finding them at a pharmacy? I went into a big Boots and the guy was trying to be helpful, but he found out that Boots don't carry them because it's their policy not to carry these types of medical accessories that you don't need a prescription for (meanwhile, loads of herbal "remedies" line the shelves). Anyway he suggested I try a small independent pharmacy, and I know you can get them from amazon, but I was wondering if anyone had any luck getting them from a pharmacy?
    Update I asked a little pharmacy tucked away next to my work, nice Irish bloke, after discussing it he said he could order some in, "about six quid", so even if it's 7 quid, it's still convenient.
    Update 2 Yep he sold them to me for six quid. I'm finding them interesting to tweak my diet, but even after eating at a nice restaurant for Valentine's day, which involved some bread, polenta, potato, and sugary pudding, I still registered ketones the next day, so I think the "if in doubt eat more butter" approach, while using MFP, is probably just fine. Still, I'll probably use them for another week or so out of curiosity.

  2. JenCarpeDiem

    I don't think you're going to find them -- I never have -- and if you do, they likely won't be any cheaper than they are on Amazon (£6.54). If anyone can prove me wrong though, I'd love to know! My 'stix are about to expire and I need to get some more soon. :)

  3. kersh2099

    I know its not much, but I found these on ebay for £6.30 inc postage. Arrived in 2 days with no problems for me.
    I too have found none in the shops though.

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