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How Does Infection Trigger Dka?

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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.....

What Is Diabetic Ketoacidosis?

Diabetic ketoacidosis is a serious condition characterized by high blood sugar (hyperglycemia), low insulin, and the presence of moderate to large amounts of ketones in the blood. It's a medical emergency that requires treatment in a hospital. If not treated in a timely fashion, ketoacidosis can lead to coma and death. While diabetic ketoacidosis (or DKA) is much more common among people with type 1 diabetes, it can also occur in people with type 2 diabetes, so ketone monitoring is something everyone with diabetes should understand. Diabetic Ketoacidosis Symptoms Signs and symptoms of ketoacidosis include: Thirst or a very dry mouth Frequent urination Fatigue and weakness Nausea Vomiting Dry or flushed skin Abdominal pain Deep breathing A fruity breath odor What Are Ketones? Ketones, or ketone bodies, are acidic byproducts of fat metabolism. It's normal for everyone to have a small amount of ketones in the bloodstream, and after a fast of 12 to16 hours, there may be detectable amounts in the urine. As is the case with glucose, if blood levels of ketones get too high, they spill over into the urine. An elevated level of ketones in the blood is known as ketosis. People who follow low Continue reading >>

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  1. mikki

    this perplexes me......i keep reading it everywhere and it hurts my brain....
    exercise (activity) depletes glycogen, muscle uses more energy (food or fat stores)....what am i missing?
    is it just verbiage? "weight" (scale) vs fat (composition)?

    please enlighten me

  2. Bartdorman

    read this...

  3. Dmes10

    I've heard this "exercise thing" called Keto in fast forward.

    I think it helps to maintain good strong ketone production. But definitely not a sole tool in the quest for weight loss IMHO.

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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

Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP more... Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria. The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Malaise, generalized weakness, and fatigability Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia Rapid weight loss in patients newly diagnosed with type 1 diabetes History of failure to comply with insulin therapy or missed insulin injections due to vomiting or psychological reasons or history of mechanical failure of insulin infusion pump Altered consciousness (eg, mild disorientation, confusion); frank coma is uncommon but may occur when the condition is neglected or with severe dehydration/acidosis Signs and symptoms of DKA associated with possible intercurrent infection are as follows: Gl Continue reading >>

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  1. pamb

    My, but life is full of little challenges. Our latest is the observation that our bedroom, where my CFS husband spends 20 hrs/day or so, is just plain stinky.
    This post is mostly a curious one, wondering if anyone else has ever noticed this?
    We've washed everything, change sheets and his clothes very often and still a stinky bedroom. I've even moved everything and taken every drawer out so see if we had a dead mouse somewhere. nope.
    All I can conclude is that is it from dear husband's breath. It definitely smells like he has ketosis, something I'm familar with from our past competitive athletic days when serious over-training would lead your body to start living off itself, resulting in very weird breath. And for sure the stinky part would be compounded by the fact he is always cold, so has the heat cranked up and is always closing the door to keep the heat in. When he is not in the room we open the door and windows, even just a bit if it is cold, and wide open if warm. That helps a bit but not for long. If we had two bedrooms I'd rotate him day to day, but alas, just one.
    So, is it just us, or has anyone else noticed something similar? Of course, if so, any and all suggestions to alleviate are welcome.

  2. George

    After my CFS became active I noticed a distinct body oder change. I smelled 'sour', my sweat, breath, urine everything it seemed had gone sour on me. (grins) I was watching Rocky and Bullwinkel (long story) when I saw a short on using chlorophyll to get rid of onion breath. I remembered something about this from middle school chemistry so I looked it up on the web. Sure enough it's suppose to help with body odor. So I order some and I've been drinking a teaspoon in water twice a day for just over three months now.
    It has worked for me like a charm. Plus my digestive process seems to be working better as well. Now my house is back to just smelling like dogs. (big grins)

  3. richvank

    Ketosis in CFS
    pamb said: ↑
    My, but life is full of little challenges. Our latest is the observation that our bedroom, where my CFS husband spends 20 hrs/day or so, is just plain stinky.
    This post is mostly a curious one, wondering if anyone else has ever noticed this?
    We've washed everything, change sheets and his clothes very often and still a stinky bedroom. I've even moved everything and taken every drawer out so see if we had a dead mouse somewhere. nope.
    All I can conclude is that is it from dear husband's breath. It definitely smells like he has ketosis, something I'm familar with from our past competitive athletic days when serious over-training would lead your body to start living off itself, resulting in very weird breath. And for sure the stinky part would be compounded by the fact he is always cold, so has the heat cranked up and is always closing the door to keep the heat in. When he is not in the room we open the door and windows, even just a bit if it is cold, and wide open if warm. That helps a bit but not for long. If we had two bedrooms I'd rotate him day to day, but alas, just one.
    So, is it just us, or has anyone else noticed something similar? Of course, if so, any and all suggestions to alleviate are welcome.
    Hi, pamd.
    As far as I know, this degree of ketosis is unusual in CFS. Most PWCs have some elevation of beta hydroxybutyrate in their urine organic acids tests, but I don't think that having such severe ketosis that acetone is exhaled in significant quantities is very common in CFS. Maybe others will correct me if I am wrong about this.
    I do have some concern about your husband, because if ketosis becomes too severe, it results in ketoacidosis, which can be life-threatening. In this situation, the levels of the ketones become high enough in the blood to overcome the body's ability to buffer their acidity, so that the blood pH drops too low. I think it would be a good idea to have the pH of his blood measured. If it is too low, a doctor could help to raise it up. That would not stop the generation of ketones, but it would protect your husband.
    I would be very interested to see the results of a urine organic acids test on your husband. I see that Genova Diagnostics serves France through [email protected] Their urine organic acids test is called the Metabolic Analysis Profile.
    Generally speaking, ketosis occurs when acetyl-CoA rises high compared to normal in the cells.
    This is usually a result of the cells not being able to get enough glucose. The usual causes of ketosis are diabetes, starvation, a very high-fat ("ketogenic") diet, or prolonged, severe exercise, as you mentioned. When the cells do not get enough glucose, they cannot make oxaloacetate fast enough, and thus there is not enough of it to react with acetyl-CoA, so acetyl-CoA rises. It then reacts with itself to produce ketones.
    In your husband's case, I doubt that any of the usual causes of ketosis are present. I think that it is more likely that he has a severe block in his Krebs cycle, causing a very high rise in citrate, and that for some reason (perhaps genetic), his body is not able to divert the high citrate into the synthesis of fat. The result is back-pressure on the citrate synthase reaction, which would cause acetyl CoA to rise, thus generating ketones. I'm guessing that your husband does not gain weight. Is that correct?
    I think that most PWCs, who also have a Krebs cycle block, are able to divert citrate into making stored fat, and that prevents them from developing severe ketosis. It also causes them to tend to gain weight.
    The fact that your husband always feels cold is evidence of mitochondrial dysfunction (note that the Krebs cycle is located in the mitochondria, so a block in the Krebs cycle would be consistent with this).
    You asked for suggestions of how to alleviate this problem. Elsewhere on this forum I have posted about the Simplified Treatment Approach for lifting the partial methylation cycle block in CFS. When this treatment is successful (as in about two-thirds of the PWCs who have tried it) it allows glutathione to come up to normal, and that should eventually correct the problems in the mitochondria. If this worked in your husband's case, I think it would stop the ketosis. If you want to look into this further, you could go to this website: http://www.cfsresearch.org Click on M.E./CFS, and then on my name. As I've noted elsewhere, my position is that a person needs to be monitored by a physician while on this treatment. I also favor running the methylation pathways panel to determine whether there is a partial methylation cycle block before trying the treatment. This panel is offered by the Vitamin Diagnostics lab in the U.S. and by the European Laboratory of Nutrients in the Netherlands.
    I hope this is helpful.
    Best regards,
    Rich

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Diabetic Ketoacidosis Causes, Symptoms, Treatment, And Complications

Diabetic ketoacidosis definition and facts Diabetic ketoacidosis is a life-threatening complication of type 1 diabetes (though rare, it can occur in people with type 2 diabetes) that occurs when the body produces high levels of ketones due to lack of insulin. Diabetic ketoacidosis occurs when the body cannot produce enough insulin. The signs and symptoms of diabetic ketoacidosis include Risk factors for diabetic ketoacidosis are type 1 diabetes, and missing insulin doses frequently, or being exposed to a stressor requiring higher insulin doses (infection, etc). Diabetic ketoacidosis is diagnosed by an elevated blood sugar (glucose) level, elevated blood ketones and acidity of the blood (acidosis). The treatment for diabetic ketoacidosis is insulin, fluids and electrolyte therapy. Diabetic ketoacidosis can be prevented by taking insulin as prescribed and monitoring glucose and ketone levels. The prognosis for a person with diabetic ketoacidosis depends on the severity of the disease and the other underlying medical conditions. Diabetic ketoacidosis (DKA) is a severe and life-threatening complication of diabetes. Diabetic ketoacidosis occurs when the cells in our body do not receive Continue reading >>

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  1. aceclipse

    So, I've been ketoing for over a month now and it's been going pretty great. However, I am still a bit confused/unclear on a certain aspect. When it comes to getting "kicked out" of keto, what exactly triggers that? It's it simply having too many carbs, causing your body to temporarily switch back over to carb energy? I keep seeing a lot of..."debate" in regards to substances that cause a raise/spike in blood sugar. Does the spike in blood sugar contribute to getting out of ketosis or would it be more an insulin related thing? I'm asking because I rely on Monster Ultra "0 carb" energy drinks and do indulge occasionally in low carb dark chocolate with maltitol, and wanted to see if that would affect my ketosis. Any input or advice would be appreciated!

  2. DownhillYardSale

    There are 2 responses to this.
    Ketosis as defined by 0.2 mmol/L of beta-hydroxybutyrate or greater in the blood.
    Ketosis as defined by the state of burning primarily fat via beta-oxidation for energy requirements.
    In order for both thresholds to be crossed one must simply take in enough carbohydrates to increase insulin to the point that glucose becomes the primary fuel source.
    The spike in bloods sugar increases insulin because that intense amount of carbohydrates needs to be dealt with pronto - too much sugar in our blood is detrimental to our health.
    I'm asking because I rely on Monster Ultra "0 carb" energy drinks and do indulge occasionally in low carb dark chocolate with maltitol, and wanted to see if that would affect my ketosis.
    Sugar alcohols do not affect ketosis that I am aware of. Your low-carb dark chocolate? Depends how many carbs you eat in one sitting but it's doubtful this will kick you out although your body may temporarily need to switch to burning off the sugar.
    Either way I wouldn't worry about it.

  3. [deleted]

    Glucose in the liver. Liver produces ketones when the there is no glucose. A certain amount of carbs gets absorbed by your muscles before hitting the liver so you can have a few. Sometimes bodybuilders will eat a lot of carbs before a work out and remain in ketosis.

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