Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in Continue reading >>
How Does Type 2 Diabetes Affect Urine Odor?
Before digging into “How Diabetes Type 2 Affects Urine Odor?” we’d like to first cover normal urine odor. What’s considered normal urine odor? Your urine or pee is a way for your body to get rid of extra water. In addition, your body tries to flush out a lot of unnecessary materials through your urine. The urine contains a chemical called ammonia, which sometimes gives your urine a strong odor (smell). Urine is a way for the body to get rid of things that might be harmful to it or might be building up in excess within the body. Normally, your urine is yellowish in color and has no specific or somewhat strong odor. What happens to urine odor in diabetes? Something strange happens to the urine odor for type 2 diabetes. The urine starts smelling “sweet or fruity”. Why does the smell change? Your body needs sugar to accomplish all your daily activities. This sugar comes from the food you eat. To turn this sugar into energy, your body relies on a hormone called “insulin”. Think of insulin as a messenger that signals your cells to convert sugar into energy. But in diabetes type 2, your body stops responding to the insulin in your body. Your insulin is still there but it does not work the way it is supposed to. It’s the same as getting a key stuck in a door lock. The key is there but it’s not functioning the way it should. This is what happens in diabetes type 2 as well. As already mentioned, the main function of insulin is to decrease blood sugar levels by signaling body cells and turning them into energy. Once your bodies insulin fails to perform its function, your cells do not get the signal to turn blood sugar into energy and your blood levels of sugar start to rise. Once your blood sugar levels are high enough, your body cells start breaking sugar into Continue reading >>
What To Do If You Have Ketones
I woke up pretty late today, around 11am. I really didn’t feel like getting up at all because I was still really tired. I was woken up by a ringing house phone that I ignored, then a cell phone with my husband on the other end. Then my mom coming downstairs to get the laundry and reminding me that we were going out today. (I live in my parents basement apartment.) “Ok, Ok… I am getting up” I tell her. I took in a big yawn and stretch of the arms. Then I actually got up out of my bed. I felt weird but I just thought it was because I got out of the bed too quickly. I tried to lick my lips together, but I had no saliva in my mouth - it was like the Mojave desert in there. I went to the bathroom to wash up because now my mom was getting antsy and rushing me. Don’t you just love getting up like that? Anyway, I started to feel a bit nauseated after about 20 minutes. I know these symptoms all too well. Dry mouth, Nausea = High blood sugar or Ketones. So, I checked my blood sugar. 3 2 1 334. Oh boy. Ok, umm… how did this happen? I didn’t really eat anything high carb last night? I went to bed with a pretty decent number and I just changed my infusion set. I don’t feel sick. My pump site isn’t hurting. It really boggled my mind. I felt my heart race a bit and started feeling panicky, and my breathing was getting heavier. Can you say panic attack? I always get a little paranoid though, it’s just my thing. Anyway, I told myself “Ok, Gina just calm down, you know what to do.” So I did my thing. I went back into the bathroom and grabbed my Ketostix to check my urine for Ketones. This is something I do when I have an unexpected high blood sugar with nausea. My urine test came out with Large, the highest level. Ugh. Ketones on the back of the bottle start out w Continue reading >>
Diabetic Ketoacidosis
A Preventable Crisis People who have had diabetic ketoacidosis, or DKA, will tell you it’s worse than any flu they’ve ever had, describing an overwhelming feeling of lethargy, unquenchable thirst, and unrelenting vomiting. “It’s sort of like having molasses for blood,” says George. “Everything moves so slow, the mouth can feel so dry, and there is a cloud over your head. Just before diagnosis, when I was in high school, I would get out of a class and go to the bathroom to pee for about 10–12 minutes. Then I would head to the water fountain and begin drinking water for minutes at a time, usually until well after the next class had begun.” George, generally an upbeat person, said that while he has experienced varying degrees of DKA in his 40 years or so of having diabetes, “…at its worst, there is one reprieve from its ill feeling: Unfortunately, that is a coma.” But DKA can be more than a feeling of extreme discomfort, and it can result in more than a coma. “It has the potential to kill,” says Richard Hellman, MD, past president of the American Association of Clinical Endocrinologists. “DKA is a medical emergency. It’s the biggest medical emergency related to diabetes. It’s also the most likely time for a child with diabetes to die.” DKA occurs when there is not enough insulin in the body, resulting in high blood glucose; the person is dehydrated; and too many ketones are present in the bloodstream, making it acidic. The initial insulin deficit is most often caused by the onset of diabetes, by an illness or infection, or by not taking insulin when it is needed. Ketones are your brain’s “second-best fuel,” Hellman says, with glucose being number one. If you don’t have enough glucose in your cells to supply energy to your brain, yo Continue reading >>
Urine Tests For Diabetes: Glucose Levels And Ketones
The human body primarily runs on glucose. When your body is low on glucose, or if you have diabetes and don’t have enough insulin to help your cells absorb the glucose, your body starts breaking down fats for energy. Ketones (chemically known as ketone bodies) are byproducts of the breakdown of fatty acids. The breakdown of fat for fuel and the creation of ketones is a normal process for everyone. In a person without diabetes, insulin, glucagon, and other hormones prevent ketone levels in the blood from getting too high. However, people with diabetes are at risk for ketone buildup in their blood. If left untreated, people with type 1 diabetes are at risk for developing a condition called diabetic ketoacidosis (DKA). While rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well. If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. These include: If you don’t get treatment, the symptoms can progress to: a fruity breath odor stomach pain trouble breathing You should always seek immediate medical attention if your ketone levels are high. Testing your blood or urine to measure your ketone levels can all be done at home. At-home testing kits are available for both types of tests, although urine testing continues to be more common. Urine tests are available without a prescription at most drugstores, or you can buy them online. You should test your urine or blood for ketones when any of the following occurs: Your blood sugar is higher than 240 mg/dL. You feel sick or nauseated, regardless of your blood sugar reading. To perform a urine test, you urinate into a clean container and dip the test strip into the urine. For a child who isn’t potty-trained, a pa Continue reading >>
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Blood And Urine Ketones
WHAT YOU NEED TO KNOW: Ketones are made when your body turns fat into energy. This happens when your body does not have enough insulin to turn sugar into energy. Ketones are released into your blood. Your kidneys get rid of ketones in your urine. You may need to test your urine or blood for ketones when your blood sugar levels are high. Early treatment for high levels of urine or blood ketones may prevent diabetic ketoacidosis. Diabetic ketoacidosis is a life-threatening condition that can lead to coma or death. DISCHARGE INSTRUCTIONS: Call 911 for any of the following: You have a seizure. You begin to breathe fast, or are short of breath. Return to the emergency department immediately if: You become weak and confused. You have fruity, sweet breath. You have severe, new stomach pain and are vomiting. You are more drowsy than usual. Contact your healthcare provider if: Your ketone level is higher than your healthcare provider said it should be. Your blood sugar level is lower or higher than your healthcare provider says it should be. You have moderate or large amounts of ketones in your urine or blood. You have a fever or chills. You are more thirsty than usual. You are urinating more often than usual. You have questions or concerns about your condition or care. When to test your urine or blood for ketones: Your healthcare provider will tell you if you need to test your urine or blood. Test for ketones when you have any of the following: Your blood sugar level is higher than 300 mg/dl. You have nausea, abdominal pain, or are vomiting. You have an illness such as a cold or the flu. You feel more tired than usual. You are more thirsty than normal or have a dry mouth. Your skin is flushed. You urinate more than usual. How to test for urine ketones: Ask your healthcare provi Continue reading >>
High Blood Glucose (hyper) & Type 1 Diabetes
Key points Hyperglycaemia happens from time to time to all people who have diabetes. Hyperglycaemia is a major cause of many of the complications that happen to people who have diabetes. For this reason, it’s important to know what hyperglycaemia is, what its symptoms are, and how to treat it. Untreated hyperglycaemia diabetes can lead to a life threatening condition called diabetic ketoacidosis (DKA). If you have Type 1 diabetes, you will often develop high blood glucose levels. Managing your Type 1 diabetes is a lot to do with developing problem solving skills and learning to use them. Remember that if your body is producing its own insulin, it alters the amount all the time (minute by minute). When you have Type 1 diabetes you have to do this consciously by using your knowledge and making sensible choices. Your diabetes nurse educator can help you learn the skills you need to do this. Some people prefer to get guidance on any of the choices they make. Everyone is different. If you are making choices you haven’t previously put into practice, get advice and support from your diabetes team before and while you make the changes. The effects of high blood glucose levels are probably what first led you to visit the doctor when your diabetes was diagnosed. Normally the human body keeps its blood glucose level very stable (between 4mmol/L – 7.5mmol/L). The body has various systems (regulated by hormones such as insulin and glucagon) for keeping the blood glucose level in this range. This doesn’t happen if you have Type 1 diabetes. Symptoms of high blood glucose levels Feeling thirsty Passing a lot of urine (you may need to get up often during the night) Feeling very tired Treatment for high blood glucose levels Try to work out why your glucose level is high. If it is Continue reading >>
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Diabetic Ketoacidosis
The Facts Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, most often in those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a fatal coma. DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. It can also occur in people already diagnosed with type 1 diabetes that have missed an insulin dose, have an infection, or have suffered a traumatic event or injury. Although much less common, DKA can occasionally occur in people with type 2 diabetes under extreme physiologic stress. Causes With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take in glucose from the blood. In the case of type 2 diabetes, the pancreas is unable to make sufficient amounts of insulin in order to take in glucose from the blood. Glucose, a simple sugar we get from the foods we eat, is necessary for making the energy our cells need to function. People with diabetes can't get glucose into their cells, so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL) while insulin levels are very low. Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood, causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able Continue reading >>
How To Get Rid Of Ketones
If you’re a diabetic, you’re probably familiar with ketones, which are byproducts of burned fat in the body. Even people without diabetes, however, should be concerned about their ketone levels in certain situations. If your ketone test reveals that you have too many ketones in your body, you’re probably starving or in danger of developing ketoacidosis, a condition that can lead to diabetic coma or even death if not treated immediately. The key to getting rid of ketones is to eat a healthy diet and live a healthy lifestyle. How Does the Body Produce Ketones? The food you eat is digested inside the body in the form of glucose, a type of sugar. Glucose travels in the blood and is absorbed by your cells. Insulin is a hormone that acts like a key that unlocks the doors of your cells to glucose. Your body constantly needs glucose to function properly. At night, when you’re asleep, your liver releases stored glucose to maintain your energy. If you don’t eat for a long time, however, the glucose stores of the liver get depleted, and your body adapts by breaking down stored fat for energy. Ketones result from this burning process, and they show up in your urine, as a ketone test would reveal. A diabetic usually has problems with his glucose and ketone levels because his body can’t use insulin to unlock the doors of his cells for the glucose. When this happens, fat is burned up, producing lots of ketones. Glucose may also accumulate in his blood, resulting in ketoacidosis. Whether you’re a diabetic or not, it is important to keep your ketones in a normal level to avoid ketoacidosis and other illnesses. Getting Rid of Ketones for Non-diabetics Not a diabetic, but getting high ketone levels from ketone tests? Follow these tips to get rid of your ketones as quickly as Continue reading >>
What Causes High Ketones In A Canine?
A dog with a high level of ketones in his urine suffers from a condition known as ketonuria, usually resulting from a buildup of these substances in the dog's blood. A ketone is a type of acid, which, if allowed to accumulate in the blood, can lead to ketoacidosis, a potentially fatal condition. The main health conditions that can cause high ketone levels in a canine are starvation and diabetes. A dog's body breaks down the food that he eats into sugars, also called glucose, that the cells of the body use for energy. The dog's pancreas then produces the hormone insulin to regulate the amount of glucose that the body will absorb. If the insulin to regulate the glucose is insufficient, typically due to chronic diabetes mellitus, the body breaks down alternate sources of fuel for its cells; a dog's body that is starved of nutrition will do the same. One of these sources is the fat stored in the dog's body. When the body breaks down this fat, it produces as a by-product toxic acids known as a ketones. These ketones then build up in the dog's blood and also his urine, leading to ketoacidosis. Always consult an experienced veterinarian regarding the health and treatment of your pet. A dog suffering from high ketone levels in his blood and urine exhibits symptoms of weight loss, vomiting, increased thirst, decreased appetite, increased urination, lethargy, low body temperature and yellowing of the skin and gums, according to PetMD. The dog's breath may also have a sweet, fruity smell due to the presence of acetone caused by ketoacidosis, says VetInfo. To properly diagnose high ketone levels and ketoacidosis in your dog, a veterinarian will take blood tests and a urinalysis, which will also check your dog's blood glucose levels. Depending on the dog's physical condition, hospit Continue reading >>
Ketones — Urine
Definition Ketones build up when the body needs to break down fats and fatty acids to use as fuel. This is most likely to occur when the body does not get enough sugar or carbohydrates. A urine test can be done to check the level of ketones in your body. Alternative Names Ketone bodies - urine; Urine ketones How the test is performed The test requires a clean catch urine sample. To obtain a clean catch sample, men or boys should clean the head of the penis. Women or girls need to wash the area between the lips of the vagina with soapy water and rinse well. As you start to urinate, allow a small amount to fall into the toilet bowl to clear the urethra of contaminants. Then, put a clean container under your urine stream and catch 1 to 2 ounces of urine. Remove the container from the urine stream. Cap and mark the container and give it to the health care provider or assistant. For infants, thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on the infant. For boys, the entire penis can be placed in the bag and the adhesive attached to the skin. For girls, the bag is placed over the labia. Diaper as usual over the secured bag. This procedure may take a couple of attempts -- lively infants can displace the bag. The infant should be checked frequently and the bag changed after the infant has urinated into the bag. The urine is drained into the container for transport to the laboratory. Urine ketones are usually measured as a "spot test" using a dipstick coated with chemicals that react with ketone bodies. The dipstick is dipped in the urine sample, and a color change indicates the presence of ketones. How to prepare for the test You may have to eat a special diet, and you should stop taking a Continue reading >>
February /march 2002
About Diabetes Food & Diabetes Medications & Diabetes Current Issue Archive En Español Recommended Websites Your Guide to Diet and Diabetes Recipes for Diabetes Fiesta of Flavors: Traditional Hispanic Recipes for People with Diabetes In This Issue Diabetes - The Medical Perspective Diabetes and Food Recipes to Try Exercise as a Part of Living Medication Update New Resources Diabetes -The Medical Perspective Ketosis is the condition of having too many ketones in the blood. Ketones are waste products made when your body is forced to burn body fat, instead of glucose, for energy. Your body gets rid of ketones by emptying them into your urine. Your body will use body fat instead of glucose when any of the following situations occur: You have a high blood glucose (hyperglycemia) caused by too much food and/or too little insulin. Without the right amount of insulin, your body burns fat for energy. You have a low blood glucose (hypoglycemia) caused by too much insulin and/or too little food. When your body does not have enough glucose to be used for energy, it uses fat instead. Using a lot of energy as in exercise, stress, or illness. How do I know if I have ketones in my urine? If you have high blood glucose and/or have some symptoms from the list below you may have a high level of ketones. If you have high blood glucose levels, and your ketones are high for long periods of time, you could develop ketoacidosis. Signs of ketoacidosis or ketones in your urine, include... dry mouth/great thirst fruity breath loss of appetite nausea/vomiting dry, flushed skin/fever fatigue/drowsiness frequent urination labored breathing. If you have these symptoms, or have a blood glucose level over 240 mg/dL, you should test your urine using a ketone test kit. If you have large amounts of keton Continue reading >>
When To Worry About Ketones
“Your blood sugar is over 250. We’ll have to test for ketones, just to make sure you’re not spilling any.” The nurse stuck a label featuring my name and date of birth onto a plastic cup. “The bathroom is down the hall and to the right,” she said. By now, I was familiar with the drill, having experienced it a handful of times in the past: Provide urine sample to endocrinologist and keep my fingers crossed that it’s negative. Fortunately, it was—no ketones spilled. Though we often toss the word ketones around when we talk about diabetes, there tends to be confusion about what ketones are and when they’re dangerous. What are ketones? Ketone bodies are produced by the liver and are byproducts of fat metabolism. They occur when muscles in the body (which normally uses glucose as fuel) begin to use fat instead. This can happen when a person restricts carbohydrates (i.e., following a ketogenic diet—see below), eats too little, or feels ill. Simply put, ketones are markers of fat burning in the body. People with diabetes need to be concerned about ketones, though, because they can be a sign of a life-threatening condition. The presence of ketones makes the blood acidic and can result in an illness known as diabetic ketoacidosis (DKA), which occurs when blood sugar levels are very high. DKA can be caused by not getting enough insulin, and it may occur prior to a diagnosis of type one diabetes. DKA symptoms of concern include a dry mouth, blood sugar levels greater than 240 mg/dL, strong thirst, and frequent urination. Without treatment, these symptoms can worsen into confusion, extreme fatigue, flushed skin, fruity-smelling breath, nausea, vomiting, stomach pain, and difficulty breathing. The most serious effects include swelling in the brain, loss of conscio Continue reading >>
How To Treat Ketoacidosis
Immediately drink a large amount of non-caloric or low caloric fluid. Continue to drink 8 to 12 oz. every 30 minutes. Diluted Gatorade, water with Nu-Salt™ and similar fluids are good because they help restore potassium lost because of high blood sugars. Take larger-than-normal correction boluses every 3 hours until the blood sugar is below 200 mg/dl (11 mmol) and ketones are negative. It will take much more rapid insulin than normal to bring blood sugars down when ketones are present in the urine or blood. Often, one and a half to two times the normal insulin dose for a high blood sugar will be necessary. Higher insulin doses than these will be needed if there is an infection or other major stress. If nausea becomes severe or last 4 hours or more, call your physician. If vomiting starts or you can no longer drink fluids, have a friend or family member call your physician immediately, then go directly to an emergency room for treatment. Never omit your insulin, even if you cannot eat. A reduced insulin dose might be needed, but only if your blood sugar is currently low. When high blood sugars or ketoacidosis happen, it is critical that you drink lots of fluid to prevent dehydration. Take extra amounts of Humalog, Novolog or Regular insulin to bring the blood sugars down. Children with severe ketoacidosis lose 10-15 % of their previous body weight (i.e., a 60 lb. child can lose 6 to 9 lbs. of weight) due to severe dehydration. Replacement of fluids should be monitored carefully. The dehydration is caused by excess urination due to high blood sugars and is quickly worsened when vomiting starts due to the ketoacidosis. The start of vomiting requires immediate attention at an ER or hospital where IV fluid replacement can begin. If only nausea is present and it is possible Continue reading >>
Urine Test For Ketones
A A A Topic Overview Ketones are substances that are made when the body breaks down fat for energy. Normally, your body gets the energy it needs from glucose (sugar). If your body cannot use glucose for energy—for example, if your body doesn't make or use insulin—ketones are formed. You might also have ketones if you are not eating enough carbohydrates and your body uses fat for energy instead. Your body wants to get rid of ketones through urine. Ketones in urine is most common in people who have type 1 diabetes. It is an early sign that there is not enough insulin, and blood sugar may be dangerously high. This can lead to diabetic ketoacidosis, a very serious medical problem. You can test your urine for ketones at home using specially prepared tablets or plastic strips. Collect a urine sample in a clean container. Follow the manufacturer's directions on the bottle of test strips or tablets. If either the test strip or the urine changes color when the tablet is dropped into the sample, ketones are present in your urine sample. The test results are read as negative to 1+ to 4+ or small to large. If the results of your ketone test show that the ketone level in your urine is more than 2+, or moderate, call your doctor for advice. Credits Continue reading >>
