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How Does Infection Lead To Ketoacidosis?

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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.....

> Hyperglycemia And Diabetic Ketoacidosis

When blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy. Hyperglycemia is the hallmark of diabetes — it happens when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia. If it's not treated, hyperglycemia can cause serious health problems. Too much sugar in the bloodstream for long periods of time can damage the vessels that supply blood to vital organs. And, too much sugar in the bloodstream can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens w Continue reading >>

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  1. bluequestions

    I've searched through the forum and still couldn't quite find a certain answer. I understand in the starvation state, body is depleted of glucose and glycogen supply, so it turns to fat for energy fuel. And because fatty acids can't cross the BBB, it has to go through oxidation to be broken down first. Meanwhile, in liver, OAA is depleted for gluconeogenesis so acetyl-CoA accumulates. I guess my question is that why can't acetyl-CoA be delivered to other tissues directly but must be converted into ketone bodies first, where they will be converted back anyway. Does it have to do with the way acetyl-CoA transports in blood? I also read somewhere the reason could be to free up the CoA for more beta oxidation in liver? Thanks!

  2. rafterman

    bluequestions said: ↑
    I've searched through the forum and still couldn't quite find a certain answer. I understand in the starvation state, body is depleted of glucose and glycogen supply, so it turns to fat for energy fuel. And because fatty acids can't cross the BBB, it has to go through oxidation to be broken down first. Meanwhile, in liver, OAA is depleted for gluconeogenesis so acetyl-CoA accumulates. I guess my question is that why can't acetyl-CoA be delivered to other tissues directly but must be converted into ketone bodies first, where they will be converted back anyway. Does it have to do with the way acetyl-CoA transports in blood? I also read somewhere the reason could be to free up the CoA for more beta oxidation in liver? Thanks! I'm not certain that this is the correct answer, but just what intuition is telling me, the acetyl group of acetyl-CoA is small, the Coenzyme A (CoA) group is gigantic with all kinds of nasty polar groups and charges i.e. not going through membrane.
    https://upload.wikimedia.org/wikipedia/commons/thumb/e/e9/Coenzym_A.svg/2000px-Coenzym_A.svg.png
    I would assume that this cannot cross a membrane without a carrier protein. The ketone bodies have carbonyls in them, which help with the crossing of membranes. Body probably does ketogenesis to allow the ketone bodies to flux out of the liver and into the blood.

  3. bluequestions

    Thank you!

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What is KETOACIDOSIS? What does KETOACIDOSIS mean? KETOACIDOSIS meaning - KETOACIDOSIS definition - 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... Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and ß-hydroxybutyrate. Ketoacidosis is a pathological metabolic state marked by extreme and uncontrolled ketosis. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased. In extreme cases ketoacidosis can be fatal. Ketoacidosis is most common in untreated type 1 diabetes mellitus, when the liver breaks down fat and proteins in response to a perceived need for respiratory substrate. Prolonged alcoholism may lead to alcoholic ketoacidosis. Ketoacidosis can be smelled on a person's breath. This is due to acetone, a direct by-product of the spontaneous decomposition of acetoacetic acid. It is often described as smelling like fruit or nail polish remover. Ketosis may also smell, but the odor is usually more subtle due to lower concentrations of acetone. Treatment consists most simply of correcting blood sugar and insulin levels, which will halt ketone production. If the severity of the case warrants more aggressive measures, intravenous sodium bicarbonate infusion can be given to raise blood pH back to an acceptable range. However, serious caution must be exercised with IV sodium bicarbonate to avoid the risk of equally life-threatening hypernatremia. Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively. In diabetic ketoacidosis, a high concentration of ketone bodies is usually accompanied by insulin deficiency, hyperglycemia, and dehydration. Particularly in type 1 diabetics the lack of insulin in the bloodstream prevents glucose absorption, thereby inhibiting the production of oxaloacetate (a crucial molecule for processing Acetyl-CoA, the product of beta-oxidation of fatty acids, in the Krebs cycle) through reduced levels of pyruvate (a byproduct of glycolysis), and can cause unchecked ketone body production (through fatty acid metabolism) potentially leading to dangerous glucose and ketone levels in the blood. Hyperglycemia results in glucose overloading the kidneys and spilling into the urine (transport maximum for glucose is exceeded). Dehydration results following the osmotic movement of water into urine (Osmotic diuresis), exacerbating the acidosis. In alcoholic ketoacidosis, alcohol causes dehydration and blocks the first step of gluconeogenesis by depleting oxaloacetate. The body is unable to synthesize enough glucose to meet its needs, thus creating an energy crisis resulting in fatty acid metabolism, and ketone body formation.

Diabetic Ketoacidosis

Introduction Diabetic ketoacidosis (DKA) is a dangerous complication of diabetes caused by a lack of insulin in the body. Diabetic ketoacidosis occurs when the body is unable to use blood sugar (glucose) because there isn't enough insulin. Instead, it breaks down fat as an alternative source of fuel. This causes a build-up of a by-product called ketones. Most cases of diabetic ketoacidosis occur in people with type 1 diabetes, although it can also be a complication of type 2 diabetes. Symptoms of diabetic ketoacidosis include: passing large amounts of urine feeling very thirsty vomiting abdominal pain Seek immediate medical assistance if you have any of these symptoms and your blood sugar levels are high. Read more about the symptoms of diabetic ketoacidosis. Who is affected by diabetic ketoacidosis? Diabetic ketoacidosis is a relatively common complication in people with diabetes, particularly children and younger adults who have type 1 diabetes. Younger children under four years of age are thought to be most at risk. In about 1 in 4 cases, diabetic ketoacidosis develops in people who were previously unaware they had type 1 diabetes. Diabetic ketoacidosis accounts for around half Continue reading >>

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  1. greencup13

    Are any of you having success with weight loss? I feel like my weight loss is EXTREMELY SLOW and Im wondering if PCOS has anything to do with it.
    I used to be on metformin but went off because I lost insurance but Im going to get back on it in Jan. I am currently on the depo provero shot and I know all BC have weight gain as a side effect.
    Ive been on this diet for almost a year now and have only lost 11 lbs but havent gained any. I feel much better and healthier doing keto but Im getting really frustrated with not loosing weight.

  2. SereneRose

    Over here (waves hand frantically).
    Yes I have pcos and all the horrible symptoms that come with it and I'm doing keto. I began this diet in September and when I actually stick to plan without cheating it makes losing weight alot easier (approx 1.6-2lbs pw) I just need to stop the carb binges. I'm not on metformin as it just gave me terrible stomach pains and I noticed no good effects from it.
    I know some say to avoid cardio on this lifestyle at least at first but I do Turbo fire and Chalean Extreme and don't feel fatigued usually pumped.
    Maybe if you checked whether your in ketosis or if you need to go lower with your carb intake, I aim for under 20 because any higher and I stall and more carbs send me hurtling towards a binge big time.
    I hope the scales move for you soon. Calorie cycling and intermittent fasting are another big help so i've heard, I fast 16/8 and remember to drink loads of water.
    Good luck.
    Serene

  3. karimcb

    I also have PCOS. I just posted in r/keto today about my issues. I've been doing this diet since April. In the beginning I was losing. I lost up to 37 pounds....but about 2 months ago my body was just like mmm no thanks, let's not do that anymore. And of course, my cycle left with it.
    So I'm two months now with no period, no weight loss, but I'm still doing all the stuff I was doing before. Meanwhile, my husband has lost 70 pounds, talk about unfair.
    It really sucks. I'm not on metformin anymore either. I hurt my stomach too bad to take it, but I haven't tried in years. How much do you have to lose? I think it was easier for me to lose in the beginning because I'm 5'3 and I was 255 when I started. Now I'm to 215, which is still a lot for my height, but who knows?
    I feel like people with PCOS just have to realize we have body's that are total jerks. It sucks. I haven't had a single cheat day, but my body reacts poorly to things that even mimic that kind of food. I have to avoid sucralose, coconut flour, etc. If you get on metformin and it changes anything, let us know!!

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You may notice the round lesions on the left leg of this gentleman, friend of mine, who is having a foot/leg massage at the Burmese beach of Ngapali and which are typical of Erythema Multiforme. Video taken with his kind permission

Diabetic Ketoacidosis With Two Life Threatening Infections: Mucormycosis, And Bilateral Emphysematous Pyelonepritis, Preciptating Erythema Nodosum Leprosum As The Initial Presentation Of Diabetes

Ahmed Daoud1*, Amira Elbendary2,3, Mohanad Elfishawi1, Mahmoud Rabea1, Mostafa Alfishawy1,4, Sholkamy Amany MD and Wasfy Ayda MD 1Internal Medicine department – Kasr Alainy Hospital, Cairo University, Egypt 2Dermatology Department, Kasr Alainy Hospital, Cairo University, Egypt 3Ackerman Academy of Dermatopathology, New York, New York, USA 4Ichan School of Medicine, Mount Sinai/ Queens General Hospital, New York, USA Corresponding Author : Ahmed Daoud, MD 2250 Holly Hall street Apartment 126, Houston , Tx 77054 Tel: 8239297124 E-mail: [email protected] Received June 19, 2014; Accepted September 16, 2014; Published September 24, 2014 Citation: Daoud A, Elbendary A, Elfishawi M, Rabea M, Alfishawy M, et al. (2014) Diabetic Ketoacidosis with Two Life Threatening Infections: Mucormycosis, and Bilateral Emphysematous Pyelonepritis, Preciptating Erythema Nodosum Leprosum as the Initial Presentation of Diabetes. J Diabetes Metab 5:433 doi:10.4172/2155-6156.1000433 Copyright: © 2014 Daoud A, 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, prov Continue reading >>

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  1. betterfretter

    According to Arnold's encyclopedia, going into a ketogenic state causes your body to burn amino acids for energy which is bad for muscle maintenance/growth. (Not quoting directly, but that's the gist)
    Been reading some new research:
    According to the American Heart Association (AHA) Nutrition Committee, "Some popular high-protein/low-carbohydrate diets limit carbohydrates to 10 to 20 g/d, which is one fifth of the minimum 100 g/day that is necessary to prevent loss of lean muscle tissue [1]." Clearly, this is an incorrect statement since catabolism of lean body mass is reduced by ketone bodies (possibly through suppression of the activity of the branched-chain 2-oxo acid dehydrogenase), which and probably explains the preservation of lean tissue observed during very-low-carbohydrate diets. Unfortunately, the leading exercise physiology textbook also claims a "low-carbohydrate diet sets the stage for a significant loss of lean tissue as the body recruits amino acids from muscle to maintain blood glucose via gluconeogenesis [2]." Thus, it is certainly time to set the record straight.
    Source: http://www.jissn.com/content/1/2/7
    What are your thoughts on this? Ketosis is OK for fat loss while maintaining/growing?

  2. myhipsi

    According to Arnold's encyclopedia, going into a ketogenic state causes your body to burn amino acids for energy which is bad for muscle maintenance/growth.
    This is correct. Carbohydrates are protein sparing and glucose (the end product of carbohydrate) is REQUIRED for explosive muscular contraction/tension. So, if you fail to eat adequate amounts of carbohydrate to replenish glycogen stores, it will have a definite impact on strength. When glucose is severely lacking in the diet, the body will ramp up gluconeogenesis which is when the body uses fats and AMINO ACIDS to produce the required glucose your body uses, so you end up converting much of the protein you eat (and possibly muscle tissue itself) into glucose for fuel.
    In short: Ketosis (severe carbohydrate restriction) can be used as a dietary tool for people that are severely overweight/obese and SEDENTARY. For those that endeavor into weight training/body building or any other high performance based activity/sport, carbohydrates are required maximum performance.

  3. Bojangles010

    Yep. Did a research paper on this and came to the same conclusion. Keto is fantastic for weight loss, but not for any type of athletes or those looking to gain strength/mass. I really like your quick summary.

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