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 of all diabetes-related hospital admissions in people with type 1 diabetes. Diabetic ketoacidosis triggers These include: infections and other illnesses not keeping up with recommended insulin injections Read more about potential causes of diabetic ketoacidosis. Diagnosing diabetic ketoacidosis This is a relatively straightforward process. Blood tests can be used to check your glucose levels and any chemical imbalances, such as low levels of potassium. Urine tests can be used to estimate the number of ketones in your body. Blood and urine tests can also be used to check for an underlying infec Continue reading >>
Canine Diabetic Ketoacidosis (dka)
Canine diabetic ketoacidosis, sometimes known as DKA, is a potentially fatal disease that most commonly occurs in dogs with uncontrolled diabetes mellitus, although in rare cases it has been known to appear in nondiabetic dogs. This condition symptomatically resembles that of diabetes but usually goes unnoticed until a near-fatal situation is at hand. For this reason, it is important to understand the causes, symptoms and treatment options. How Canine Diabetic Ketoacidosis Develops Under normal conditions, the pancreas is responsible for producing insulin, which helps to regulate the level of glucose in the blood cells. When the pancreas is ineffectively able to create enough insulin, a dog becomes diabetic. By default, a dog's body will begin looking for alternative fuel sources, such as fat. The problem is that when too much fat is consumed by the body, the liver then begins to produce ketones. This excessive level of ketones causes the condition known as canine diabetic ketoacidosis. There are two scenarios in which this can occur: in dogs with poorly controlled diabetes and in dogs with undiagnosed diabetes. Recognizing the Symptoms Because of the potentially deadly side effects, it is crucially important that dog owners be aware of the symptoms of canine diabetic ketoacidosis. One of the more common problems associated with this illness is the extreme similarity of the warning signs to a diabetic condition. While both conditions are harmful, canine diabetic ketoacidosis represents the last step taken by the body before it surrenders to the condition. The following are some of the recognizable symptoms of canine diabetic ketoacidosis: Drinking or urinating more than usual Sudden, excessive weight loss attributed to loss of appetite General fatigue Vomiting Sudden on Continue reading >>
Diabetes Complications In Dogs And Cats: Diabetes Ketoacidosis (dka)
Unfortunately, we veterinarians are seeing an increased prevalence of diabetes mellitus in dogs and cats. This is likely due to the growing prevalence of obesity (secondary to inactive lifestyle, a high carbohydrate diet, lack of exercise, etc.). So, if you just had a dog or cat diagnosed with diabetes mellitus, what do you do? First, we encourage you to take a look at these articles for an explanation of the disease: Diabetes Mellitus (Sugar Diabetes) in Dogs Once you have a basic understanding of diabetes mellitus (or if you already had one), this article will teach you about life-threatening complications that can occur as a result of the disease; specifically, I discuss a life-threatening condition called diabetes ketoacidosis (DKA) so that you know how to help prevent it! What is DKA? When diabetes goes undiagnosed, or when it is difficult to control or regulate, the complication of DKA can occur. DKA develops because the body is so lacking in insulin that the sugar can’t get into the cells -- resulting in cell starvation. Cell starvation causes the body to start breaking down fat in an attempt to provide energy (or a fuel source) to the body. Unfortunately, these fat breakdown products, called “ketones,” are also poisonous to the body. Symptoms of DKA Clinical signs of DKA include the following: Weakness Not moving (in cats, hanging out by the water bowl) Not eating to complete anorexia Large urinary clumps in the litter box (my guideline? If it’s bigger than a tennis ball, it’s abnormal) Weight loss (most commonly over the back), despite an overweight body condition Excessively dry or oily skin coat Abnormal breath (typically a sweet “ketotic” odor) In severe cases DKA can also result in more significant signs: Abnormal breathing pattern Jaundice Ab Continue reading >>
What Are The Most Important Things To Know Before Writing A Character Who Has Diabetes?
Writing as a type 1 diabetic ( not to be taken as medical opinion or advice): Whilst one would need to be careful of copyright: the scenes in the movie ‘Panic Room’ where Jodie Foster’s character as a mother of daughter played by Kirsten Stewart, shows the tension created when they fortify themselves in a panic room after criminals break into the house. The daughter who is diabetic has taken her insulin but has little food and is slipping into a state of low blood sugar.(hypoglycaemia or ‘hypo’). The best acted hypoglycaemic episode I have ever seen was by Julia Roberts in ‘Steel Magnolias’ - which opens with her playing the soon-to-be married daughter - someone who has had a long history of diabetes. In my 50 years as a diabetic the following has happened to me or are thoughts that I have had: ( and are not copyrighted !) we were carrying canoes down a mountain to the river below for a week long canoe trip through inhospitable terrain - the drum carrying my insulin and syringes/needles rolled down the mountain and was not found til the next day. Fortunately I had distributed spare kits to others before the descent. ( the glass vials containing the insulin were padded and put in an aluminium container. They survived the roll down the mountain intact inside the plastic drum. The drum did not fare quite as well). I once suffered from a severe hypo and needed some mouth to mouth resuscitation by my wife. Severe hypoglycaemia can cause brain damage. I became hypo once when body surfing but managed to stagger out onto the beach. i was in a hiking party with two of us being type 1 diabetics - the other diabetic was rather unstable with his control and sadly drowned in a waist-high river crossing during the trip. Exact reason for the accident unknown. An acquaint Continue reading >>
Diabetic ketoacidosis (DKA) is a serious complications of untreated diabetes. In this complication, severely insufficient insulin levels in the body results into high blood sugar that leads to the production and buildup of ketones in the blood. These ketones are slightly acidic, and large amounts of them can lead to ketoacidosis. If remained untreated, the condition leads to diabetic coma and may be fatal. Diabetic ketoacidosis (DKA) gets triggered by a stressful event on the body, such as an illness or severe lack of insulin. DKA is more common in people with type 1 diabetes. In some cases, identification of DKA is the first indication that a person has diabetes. Early Sluggish and extreme tiredness Fruity smell to breath (like acetone) Extreme thirst, despite large fluid intake Constant urination/bedwetting Extreme weight loss Presence of Oral Thrush or yeast infections that fail to go away Muscle wasting Agitation / Irritation / Aggression / Confusion Late At this stage, Diabetic ketoacidosis reaches a life-threatening level: Vomiting. Although this can be a sign of hyperglycemia and isn't always a late-stage sign, it can occur with or without ketoacidosis. Confusion Abdominal pain Loss of appetite Flu-like symptoms Unconsciousness (diabetic coma) Being lethargic and apathetic Extreme weakness Kussmaul breathing (air hunger). In this condition, patients breathe more deeply and/or more rapidly The major risk factors accelerating on set of diabetic ketoacidosis include the following: Diabetes mellitus: Type 1 diabetics are at a higher risk of DKA, because they must rely on outside insulin sources for survival. DKA can occur in patients with type 2, particularly in obese children. Age: DKA may occur at any age, but younger people below 19 years of age are more susceptib Continue reading >>
Diabetic Ketoacidosis (dka)
Diabetic ketoacidosis, also called DKA, is a life-threatening complication occurring with undiagnosed and/or untreated Type 1 diabetes in adults and children. DKA symptoms often remain undiagnosed because they can look like (mimic) influenza, a stomach bug, strep infections, and other common illnesses and conditions. However, someone may actually have a common illness and DKA at the same time, causing the common illness symptoms to hide (mask) the underlying DKA symptoms. Either way, untreated Type 1 diabetes and DKA are 100% fatal. IMPORTANT: Diabetic ketoacidosis is LIFE-THREATENING and can progress quickly–often within 24 hours! If you or a loved one have any of the following symptoms with VOMITING AND LETHARGY COMBINED WITH LABORED BREATHING, do not consume sugar and seek emergency medical care immediately. Insist medical personnel Test One Drop of blood or urine for glucose (sugar) levels. DKA can be fatal! SYMPTOMS OF DKA: excessive thirst frequent urination or bedwetting increased appetite or sugar cravings abdominal pain irritability, grouchiness, or mood changes headaches and/or vision changes itchy skin/genitals (yeast or thrush) sudden weight loss flushed, hot, dry skin nausea and vomiting* fruity/acetone scented breath* lethargy, drowsiness, or fatigue* labored, rapid, and/or deep breathing* confusion, stupor, or unconsciousness* *A combination of any of these symptoms can be life-threatening. Seek EMERGENCY CARE. When new onset Type 1 diabetes remains undiagnosed and untreated the shortage of insulin causes blood glucose (sugar) levels to climb above the normal range. Without adequate insulin to regulate levels of glucose in the blood, high levels of acids called ketones build up in the body causing diabetic ketoacidosis. Ketones are toxic and if l Continue reading >>
How Long Does Diabetes Ketoacidosis Last?
Diabetic ketoacidosis (DKA) is a common complication of diabetes in children, which needs hospitalisation and can be fatal. In most cases of diabetic ketoacidosis, death is caused due to cerebral edema or complication of DKA. Diabetic ketoacidosis (DKA) can be the first sign or presenting symptom in some cases of type 1 diabetes (before diabetes is diagnosed or they have any other symptoms). According to studies, about 20 to 40% of newly diagnosed patients of type 1 diabetes are admitted in DKA. Duration of Diabetic ketoacidosis: with appropriate treatment (fluid replacement and insulin therapy), DKA can be corrected in about 24-48 hours (depending on the severity of DKA at presentation). In most cases, the duration of therapy is about 48 hours. Treatment for DKA aims to correct the metabolic abnormalities of DKA such as high blood sugar level, high ketone levels and serum osmolality with insulin and fluids. Treatment of DKA includes: Insulin replacement to correct blood glucose levels. Fluid and electrolyte replacement to correct dehydration and imbalance of electrolytes in the body. Treating the cause of DKA (such as infection, injury etc). Duration of fluid replacement: fluid is replaced slowly; if it is given at an excessive rate or more than required, it can cause brain swelling (cerebral edema). Most cases have a fluid deficit of about 10% or 100 ml/kg. Fluid is given intravenously (into a vein) slowly with the aim of replacing 50% of the fluid deficit during the first 12 hours of presentation and the remainder within the next 12-16 hours. As high blood sugar is corrected more rapidly than ketoacidosis (high blood ketone levels), glucose-containing fluids is given once the glucose falls to < 14 mmol/l to prevent the fall in blood glucose levels hypoglycaemia). Dur Continue reading >>
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 the sugar (glucose) they need for energy. This happens while there is plenty of glucose in the bloodstream, but not enough insulin to help convert glucose for use in the cells. The body recognizes this and starts breaking down muscle and fat for energy. This breakdown produces ketones (also called fatty acids), which cause an imbalance in our electrolyte system leading to the ketoacidosis (a metabolic acidosis). The sugar that cannot be used because of the lack of insulin stays in the bloodstream (rather than going into the cell and provide energy). The kidneys filter some of the glucose (suga Continue reading >>
Is It Normal To Wet Your Bed When You're 13?
It’s something abnormal at that age and therefore you’d see a doctor as it can be a symptom of an underlying disease. Also, if the doctors aren’t helping, Sleeping on your back may help. Your head can face any direction but the rest of the body has to face up properly. So far 28 men have tried my procedure and have all succeeded, and the best thing about it is that there is no limit to the amount of water you can take before sleeping. The only one woman who tried it didn’t succeed but there’s a very big possibility she changed her sleeping position. For the beginning, I’d strongly recommend recording yourself while sleeping. This will help you know if you changed position because I’ve seen people who’ve failed to stay on their back all through their sleep and not know it. I’d really love to hear from you after a week of trying as it’ll help me know more about my research. Get me on roymbscit[@]gmail[.]com Continue reading >>
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 >>
Diabetic Ketoacidosis And Hyperglycaemic Hyperosmolar State
The hallmark of diabetes is a raised plasma glucose resulting from an absolute or relative lack of insulin action. Untreated, this can lead to two distinct yet overlapping life-threatening emergencies. Near-complete lack of insulin will result in diabetic ketoacidosis, which is therefore more characteristic of type 1 diabetes, whereas partial insulin deficiency will suppress hepatic ketogenesis but not hepatic glucose output, resulting in hyperglycaemia and dehydration, and culminating in the hyperglycaemic hyperosmolar state. Hyperglycaemia is characteristic of diabetic ketoacidosis, particularly in the previously undiagnosed, but it is the acidosis and the associated electrolyte disorders that make this a life-threatening condition. Hyperglycaemia is the dominant feature of the hyperglycaemic hyperosmolar state, causing severe polyuria and fluid loss and leading to cellular dehydration. Progression from uncontrolled diabetes to a metabolic emergency may result from unrecognised diabetes, sometimes aggravated by glucose containing drinks, or metabolic stress due to infection or intercurrent illness and associated with increased levels of counter-regulatory hormones. Since diabetic ketoacidosis and the hyperglycaemic hyperosmolar state have a similar underlying pathophysiology the principles of treatment are similar (but not identical), and the conditions may be considered two extremes of a spectrum of disease, with individual patients often showing aspects of both. Pathogenesis of DKA and HHS Insulin is a powerful anabolic hormone which helps nutrients to enter the cells, where these nutrients can be used either as fuel or as building blocks for cell growth and expansion. The complementary action of insulin is to antagonise the breakdown of fuel stores. Thus, the relea Continue reading >>
Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find one of our health articles more useful. Diabetic ketoacidosis (DKA) is the leading cause of mortality in childhood diabetes.The primary cause of DKA is absolute or relative insulin deficiency: Absolute - eg, previously undiagnosed type 1 diabetes mellitus or a patient with known type 1 diabetes who does not take their insulin. Relative - stress causes a rise in counter-regulatory hormones with relative insulin deficiency. DKA can be fatal The usual causes of death are: Cerebral oedema - associated with 25% mortality (see 'Cerebral odedema', below). Hypokalaemia - which is preventable with good monitoring. Aspiration pneumonia - thus, use of a nasogastric tube in the semi-conscious or unconscious is advised. Deficiency of insulin. Rise in counter-regulatory hormones, including glucagon, cortisol, growth hormone, and catecholamines. Thus, inappropriate gluconeogenesis and liver glycogenolysis occur compounding the hyperglycaemia, which causes hyperosmolarity and ensuing polyuria, dehydration and loss of electrolytes. Accelerated catabolism from lipolysis of adipose tissue leads to increased free fatty acid circulation, which on hepatic oxidation produces the ketone bodies (acetoacetic acid and beta-hydroxybutyric acid) that cause the metabolic acidosis. A vicious circle is usually set up as vomiting usually occurs compounding the stress and dehydration; the cycle can only be broken by providing insulin and fluids; otherwise, severe acidosis occurs and can be fatal. Biochemical criteria The biochemical criteria required for a diagnosis of DKA to be made are Continue reading >>
What Is The Nursing Diagnosis For Hyperkalemia?
As is frequently the case with “what is the nursing diagnosis for X” questions on Quora, there is a disclaimer that must be made: This is a MEDICAL diagnosis. There are no nursing diagnoses for it. There are likely nursing diagnoses ASSOCIATED with it. Lets look at why it means to be hyperkalemic… or in laymen’s terms, having high potassium in your bloodstream. It means that somewhere, most likely in the gastrointestinal, renal, or endocrine systems a problem has occurred. Before we can figure out how to fix the kyperkalemia, we need to know WHY the patient is in this state. It it excessive intake? Diabetic ketoacidosis (DKA)? Renal failure? A licensed independent practitioner (LIP) will need to figure this one out for the nurse (or at least officially make the decision as it is out of the scope of the RN to make this call). The nursing role will be to support the medical diagnosis and selected interventions. This is where we start to see some nursing diagnosis actually emerge. IV access will most likely be needed. Associated nursing diagnosis: Risk for bleeding, risk for infection, risk for impaired healing, risk for altered body image. If this is a DKA issue, then it is possible the you can include: Need for further education, lack of effecting coping mechanisms, or even the dreaded and controversial Risk for noncompliance. Please note that your patients with diabetes (DM1, to be precise in this case) are not always in DKA because they have “failed” at their treatment regimen. DM is a complicated disease process and homeostatic imbalances can become a runaway nightmare that push even the most ardent adherents of blood sugar management into a very bad place. Also remember that they may be serum hyperkalemic on the labs, but are at high Risk for HYPOkalemia Continue reading >>
Why Would Scientists Use Transformation To Make An Insulin Protein?
When it comes to insulin, there are a lot of questions. Why is it so expensive? Why don’t we use insulin from animals anymore? Why do we use the more expensive stuff? I think there are some valid reasons on why pharmaceuticals chose to only sell insulin made from DNA replication. One of the points is that it relates better to our systems. If scientists can make insulin as close to human’s as possible, then it theoretically should work the best. This is usually the case. The insulin today allows people to go longer without needing it. Not only that, but it matches up with our DNA very well. This was one of the biggest reasons for going away from the animal protein. However, some people react better from the animal insulin. I think the question, “Why would scientists use transformation to make insulin proteins?” comes down to a search for a perfect medicine. Everyone wants diabetes to be cured. The next best thing would be a perfect insulin that created no problems. That is why scientists used transformation to create proteins. Their goal was to find a solution to this problem. The insulin might be better for people, but it cost a lot more money. Scientists use genetically modified bacteria in order to produce the insulin that is needed. Scientists use these because they need to make mass amounts of it. With the diabetes epidemic that is dropping upon this country, insulin is in high demand. Therefore, scientists can’t naturally make enough of it to keep up with society. They have to take materials and modify them in order to produce mass amounts. That then brings up the question of “why do they use a more expensive process and not offer the cheaper option?” This is not a conspiracy that pharmacists are in this for the money. I think that in the case of insu Continue reading >>
Is It Better For A Child With Type 1 Diabetes To Have Glucose Control As Tight As Possible Without Hypoglycemia, Or Is It Usual Care To Have Daily Readings In The 300s And Cover With Insulin?
blood sugar closest to normal for as long as possible is always best. But remember that your doctor's answer to this question will be affected by other factors: * Doctor's confidence in his patients' ability to comply with instructions (over the course of his career). If a doctor sees that most of his patients can't or won't comply with difficult diet and monitoring instructions, he will modify his instructions to something he sees as more likely to be complied with, even if it's not the best for the patient. * Doctor's confidence in YOUR ability to comply with instructions. Same as above, but will involve doctor's opinion of your ability, willingness, and skill to undertake the long-term monitoring of your daughter, and hers to take over when she can. * Whatever studies the doctor has read lately, most of which seem to be measuring long-term the effects of tighter vs. looser diabetic control, but even their tighter controls tend to be much looser than is healthy. The conclusion these studies generally reach is that there's not much difference. My conclusion might be that all these studies stop short of actual tight blood glucose control. For actual tight control and its results, you may find the work of diabetic journalist Jenny Ruhl helpful. Although she concentrates on type-2 diabetes, her blood sugar monitoring tips and diet tips are even more important for type-1. * and of course, 'do no harm". If high blood sugaar does harm long term, but the doctor isn't sure of your ability to avoid an immediately dangerous hypo incident, the doctor must advise you to keep blood sugar high. Continue reading >>
- Could going low-carb help you fight off diabetes? The usual advice for Type 2 is to eat plenty. But now a number of patients and doctors are leading a growing rebellion
- NIHR Signal Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes
- Can You Have Hypoglycemia Without Having Diabetes?