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How Does Ketoacidosis Happen

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Diagnosis And Treatment Of Diabetic Ketoacidosis And The Hyperglycemic Hyperosmolar State

Go to: Pathogenesis In both DKA and HHS, the underlying metabolic abnormality results from the combination of absolute or relative insulin deficiency and increased amounts of counterregulatory hormones. Glucose and lipid metabolism When insulin is deficient, the elevated levels of glucagon, catecholamines and cortisol will stimulate hepatic glucose production through increased glycogenolysis and enhanced gluconeogenesis4 (Fig. 1). Hypercortisolemia will result in increased proteolysis, thus providing amino acid precursors for gluconeogenesis. Low insulin and high catecholamine concentrations will reduce glucose uptake by peripheral tissues. The combination of elevated hepatic glucose production and decreased peripheral glucose use is the main pathogenic disturbance responsible for hyperglycemia in DKA and HHS. The hyperglycemia will lead to glycosuria, osmotic diuresis and dehydration. This will be associated with decreased kidney perfusion, particularly in HHS, that will result in decreased glucose clearance by the kidney and thus further exacerbation of the hyperglycemia. In DKA, the low insulin levels combined with increased levels of catecholamines, cortisol and growth hormone Continue reading >>

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  1. Mark Simpson

    (edit: it's worth pointing out that "Ketosis " on it's own is not a bad thing, but Diabetic ketoacidosis is. I assume this is the point of the question)
    Diabetic Ketoacidosis comes from High (hyper) Blood Sugar not Low (Hypo). They could happen together, if you had high blood sugar for too long, the Ketoacidosis happened then you over treated the high and it went low. In this case you'd have 2 separate problems. Hypoglaycemia and Ketoacidosis. Low blood sugar will make you pass out and go into a coma eventually. Ketoacidosis is very painful and horrible to be part of. But I wouldn't say they increase each others danger very much.
    (i am a diabetic, not a medical professional)

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  2. Dennis Kitainik

    I'm not a doctor, but from what I know of diabetic conditions, both of these can be dangerous, and especially if they occur together (especially since ketosis would probably indicate serious hypoglycemia).

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