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How Long Does It Take For Ketoacidosis To Set In?

Managing Diabetes Complicated By Ketoacidosis

Managing Diabetes Complicated By Ketoacidosis

Go to site For Pet Owners Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus that has to be aggressively treated. Diagnosis The diagnosis is based on the presence of ketonuria with signs of systemic illness. Management guidelines Goals of treatment include the correction of fluid deficits, acid-base balance and electrolyte balance, reduction of blood glucose and ketonuria, and beginning insulin therapy and treatment of concurrent diseases. Many protocols for treatment exist but rapid-acting insulin (regular) must be administered first, as decreases in the hyperglycemia must be achieved quickly. When blood sugar levels are lowered and maintained at 200−250 mg/dL for 4−10 hours, then Vetsulin® (porcine insulin zinc suspension) can be used. Evaluation of treatment When evaluating the regulation of insulin therapy, it is important to consider several areas including the evaluation of glycemia, urine monitoring, routine rechecks and glycated protein evaluations. Evaluation of the glycemia Creating a blood glucose curve is the most accurate way to evaluate glycemia in order to adjust the dose of Vetsulin. Indications for creating a blood glucose curve are: First, to establish insulin dose, dosing interval, and insulin type when beginning regulation. Second, to evaluate regulation especially if problems occur. Third, when rebound hyperglycemia (Somogyi effect) is suspected. Contraindications for creating a blood glucose curve are: Concurrent administration of drugs affecting glycemia. Presence of a known infection or disease. Stressed animal. The procedure is as follows: The most accurate way to assess response to management is by generating a blood glucose curve. Ideally, the first sample should be taken just prior to feeding Continue reading >>

Get Unlimited Access On Medscape.

Get Unlimited Access On Medscape.

You’ve become the New York Times and the Wall Street Journal of medicine. A must-read every morning. ” Continue reading >>

Mother Of 22-year-old Who Died From Diabetic Ketoacidosis Speaks Out

Mother Of 22-year-old Who Died From Diabetic Ketoacidosis Speaks Out

In the aftermath of her son's tragic death, Lyndall Hauver urges caregivers: People with type 1 diabetes who develop flu-like symptoms should head straight to the hospital. Will Hauver was feeling under the weather with aches, an upset stomach, and fever, but still had enough energy for varsity lacrosse practice at Rollins College in Florida the last day of January in 2015. It appeared he got the flu that already struck others on campus. The next day, a Sunday, the 22-year-old felt a bit better and visited his fraternity, rounding up some freshman pledges to clean his house. He went to bed early to rest up for an upcoming lacrosse trip. Monday morning, Will's roommate found him on the floor, passed out. By that afternoon, he had died. Will, who had type 1 diabetes, died from diabetic ketoacidosis (or DKA)1 a serious, acute complication of diabetes that results from too little insulin and can be brought on by the flu.2 When a person develops DKA it's the result of dangerously high levels of blood acids in the body called ketones. Ketones alter the chemical balance of blood in the body.3 After Will's death, his grief-stricken mom, Lyndall Hauver, of Towson, Maryland, decided to share Will's story in the hope that others will learn from her family's tragic loss. "As soon as you get a fever or have a sign of the flu or a stomach virus go to the hospital," Lyndall says. "It causes your blood sugar to go crazy, to go up and down and that wreaks havoc on your fluids and heart and everything else." "You have to be vigilant," she continues. "It's easy to get complacent when things are going well." She adds: "This was a fluke occurrence, bad luck, and I can't change it. It breaks my heart every minute." The Longest Hour Days before Will's death, the parents of some of Will's team Continue reading >>

Type 1 Diabetes Complications

Type 1 Diabetes Complications

Type 1 diabetes is complicated—and if you don’t manage it properly, there are complications, both short-term and long-term. “If you don’t manage it properly” is an important if statement: by carefully managing your blood glucose levels, you can stave off or prevent the short- and long-term complications. And if you’ve already developed diabetes complications, controlling your blood glucose levels can help you manage the symptoms and prevent further damage. Diabetes complications are all related to poor blood glucose control, so you must work carefully with your doctor and diabetes team to correctly manage your blood sugar (or your child’s blood sugar). Short-term Diabetes Complications Hypoglycemia: Hypoglycemia is low blood glucose (blood sugar). It develops when there’s too much insulin—meaning that you’ve taken (or given your child) too much insulin or that you haven’t properly planned insulin around meals or exercise. Other possible causes of hypoglycemia include certain medications (aspirin, for example, lowers the blood glucose level if you take a dose of more than 81mg) and alcohol (alcohol keeps the liver from releasing glucose). There are three levels of hypoglycemia, depending on how low the blood glucose level has dropped: mild, moderate, and severe. If you treat hypoglycemia when it’s in the mild or moderate stages, then you can prevent far more serious problems; severe hypoglycemia can cause a coma and even death (although very, very rarely). The signs and symptoms of low blood glucose are usually easy to recognize: Rapid heartbeat Sweating Paleness of skin Anxiety Numbness in fingers, toes, and lips Sleepiness Confusion Headache Slurred speech For more information about hypoglycemia and how to treat it, please read our article on hy Continue reading >>

Diabetic Ketoacidosis

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 >>

Emergency Management Of Diabetic Ketoacidosis In Adults

Emergency Management Of Diabetic Ketoacidosis In Adults

Diabetic ketoacidosis (DKA) is a potentially fatal metabolic disorder presenting most weeks in most accident and emergency (A&E) departments.1 The disorder can have significant mortality if misdiagnosed or mistreated. Numerous management strategies have been described. Our aim is to describe a regimen that is based, as far as possible, on available evidence but also on our experience in managing patients with DKA in the A&E department and on inpatient wards. A literature search was carried out on Medline and the Cochrane Databases using “diabetic ketoacidosis” as a MeSH heading and as textword. High yield journals were hand searched. Papers identified were appraised in the ways described in the Users’ guide series published in JAMA. We will not be discussing the derangements in intermediary metabolism involved, nor would we suggest extrapolating the proposed regimen to children. Although some of the issues discussed may be considered by some to be outwith the remit of A&E medicine it would seem prudent to ensure that A&E staff were aware of the probable management of such patients in the hours after they leave the A&E department. AETIOLOGY AND DEFINITION DKA may be the first presentation of diabetes. Insulin error (with or without intercurrent illness) is the most common precipitating factor, accounting for nearly two thirds of cases (excluding those where DKA was the first presentation of diabetes mellitus).2 The main features of DKA are hyperglycaemia, metabolic acidosis with a high anion gap and heavy ketonuria (box 1). This contrasts with the other hyperglycaemic diabetic emergency of hyperosmolar non-ketotic hyperglycaemia where there is no acidosis, absent or minimal ketonuria but often very high glucose levels (>33 mM) and very high serum sodium levels (>15 Continue reading >>

Diabetic Ketoacidosis

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 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 >>

What Is Diabetic Ketoacidosis?

What Is Diabetic Ketoacidosis?

Diabetic ketoacidosis is a buildup of acids in the blood. It is a life-threatening complication of diabetes resulting from not having enough insulin. It may happen with type 1 diabetes. (It rarely happens with type 2 diabetes.) It’s an emergency that must be treated right away. If ketoacidosis is not treated right away, it can cause coma or death. What is the cause? Diabetic ketoacidosis happens when the body does not have enough insulin. Without insulin, sugars in the blood cannot move out of the blood and into the body’s cells, so the cells burn fats instead of sugar for energy. The burning of fats makes byproducts called ketones. The ketones build up to poisonous and dangerous levels in the blood. Usually the blood sugar is also very high. Ketoacidosis can happen if you skip doses of insulin. Or it may happen if there is a change in your life, such as: Infection Injury Heart attack Surgery Pregnancy Other types of physical or emotional stress If you are using an insulin pump, it may happen if you stop getting insulin because there is a kink in the tube or the tube comes out. Sometimes you may not know you have diabetes until ketoacidosis occurs. When the pancreas stops making insulin, it happens over a short period of time. In just a few days your blood sugar can get very high and ketones can build up to a high level very fast. It may happen so fast that ketoacidosis symptoms are the first symptoms of diabetes that you have. What are the symptoms? Symptoms of ketoacidosis may include: Shortness of breath Fruity smelling breath Very dry mouth Nausea and vomiting Symptoms of high blood sugar may include: Blurry vision Dry mouth Feeling very thirsty and drinking a lot Urinating a lot Tiredness Several hours to a couple of days after symptoms start, ketoacidosis may Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) happens when your blood sugar is high and your insulin level is low. This imbalance in the body causes a build-up of ketones. Ketones are toxic. If DKA isn’t treated, it can lead to diabetic coma and even death. DKA mainly affects people who have type 1 diabetes. But it can also happen with other types of diabetes, including type 2 diabetes and gestational diabetes (during pregnancy). DKA is a very serious condition. If you have diabetes and think you may have DKA, contact your doctor or get to a hospital right away. The first symptoms to appear are usually: frequent urination. The next stage of DKA symptoms include: vomiting (usually more than once) confusion or trouble concentrating a fruity odor on the breath. The main cause of DKA is not enough insulin. A lack of insulin means sugar can’t get into your cells. Your cells need sugar for energy. This causes your body’s glucose levels to rise. To get energy, the body starts to burn fat. This process causes ketones to build up. Ketones can poison the body. High blood glucose levels can also cause you to urinate often. This leads to a lack of fluids in the body (dehydration). DKA can be caused by missing an insulin dose, eating poorly, or feeling stressed. An infection or other illness (such as pneumonia or a urinary tract infection) can also lead to DKA. If you have signs of infection (fever, cough, or sore throat), contact your doctor. You will want to make sure you are getting the right treatment. For some people, DKA may be the first sign that they have diabetes. When you are sick, you need to watch your blood sugar level very closely so that it doesn’t get too high or too low. Ask your doctor what your critical blood sugar level is. Most patients should watch their glucose levels c Continue reading >>

Thirty Years Of Personal Experience In Hyperglycemic Crises: Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar State

Thirty Years Of Personal Experience In Hyperglycemic Crises: Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar State

The Journal of Clinical Endocrinology & Metabolism Thirty Years of Personal Experience in Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State Division of Endocrinology, Diabetes, and Metabolism (A.E.K., J.N.F., M.B.M., F.B.S.), University of Tennessee Health Science Center, Memphis, Tennessee 38163 Address all correspondence and requests for reprints to: Abbas E. Kitabchi, Ph.D., M.D., Division of Endocrinology, Diabetes, and Metabolism, University of Tennessee Health Science Center, 920 Madison Avenue, #909, Memphis, Tennessee 38163. Search for other works by this author on: Division of Endocrinology (G.E.U.), Emory University School of Medicine, Atlanta, Georgia 30322 Search for other works by this author on: Division of Endocrinology, Diabetes, and Metabolism (A.E.K., J.N.F., M.B.M., F.B.S.), University of Tennessee Health Science Center, Memphis, Tennessee 38163 Search for other works by this author on: Division of Endocrinology, Diabetes, and Metabolism (A.E.K., J.N.F., M.B.M., F.B.S.), University of Tennessee Health Science Center, Memphis, Tennessee 38163 Search for other works by this author on: Division of Endocrinology, Diabetes, and Metabolism (A.E.K., J.N.F., M.B.M., F.B.S.), University of Tennessee Health Science Center, Memphis, Tennessee 38163 Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 5, 1 May 2008, Pages 15411552, Abbas E. Kitabchi, Guillermo E. Umpierrez, Joseph N. Fisher, Mary Beth Murphy, Frankie B. Stentz; Thirty Years of Personal Experience in Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State, The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 5, 1 May 2008, Pages 15411552, Context: Diabetic ketoacidosis Continue reading >>

Diabetic Ketoacidosis

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 Treat Ketoacidosis

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 >>

Diabetic Ketoacidosis (dka) - Topic Overview

Diabetic Ketoacidosis (dka) - Topic Overview

Diabetic ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are unable to get the sugar (glucose) they need for energy because there is not enough insulin. When the sugar cannot get into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood and remove it from the body through urine. Because the cells cannot receive sugar for energy, the body begins to break down fat and muscle for energy. When this happens, ketones, or fatty acids, are produced and enter the bloodstream, causing the chemical imbalance (metabolic acidosis) called diabetic ketoacidosis. Ketoacidosis can be caused by not getting enough insulin, having a severe infection or other illness, becoming severely dehydrated, or some combination of these things. It can occur in people who have little or no insulin in their bodies (mostly people with type 1 diabetes but it can happen with type 2 diabetes, especially children) when their blood sugar levels are high. Your blood sugar may be quite high before you notice symptoms, which include: Flushed, hot, dry skin. Feeling thirsty and urinating a lot. Drowsiness or difficulty waking up. Young children may lack interest in their normal activities. Rapid, deep breathing. A strong, fruity breath odor. Loss of appetite, belly pain, and vomiting. Confusion. Laboratory tests, including blood and urine tests, are used to confirm a diagnosis of diabetic ketoacidosis. Tests for ketones are available for home use. Keep some test strips nearby in case your blood sugar level becomes high. When ketoacidosis is severe, it must be treated in the hospital, often in an intensive care unit. Treatment involves giving insulin and fluids through your vein and closely watching certain chemicals in your blood (electrolyt Continue reading >>

How To Treat Diabetic Ketoacidosis

How To Treat Diabetic Ketoacidosis

1 Call emergency services. Diabetic ketoacidosis can be a life-threatening condition. If you are experiencing symptoms like your blood sugar not lowering, you should immediately call emergency services or visit the emergency room.[2] Symptoms that require you to call emergency services include severe nausea, being nauseous for four or more hours, vomiting, being unable to keep fluids down, inability to get your blood sugar levels down, or high levels of ketones in your urine.[3] Leaving DKA untreated can lead to irreparable damage and even death. It is important to seek medical care as soon as you suspect you are having a problem. 2 Stay in the hospital. Ketoacidosis is usually treated in the hospital. You may be admitted to a regular room or treated in ICU depending on the severity of your symptoms. During the first hours you are there, the doctors will work on getting your fluids and electrolytes balanced, then they will focus on other symptoms. Most of the time, patients remain in the hospital until they are ready to return to their normal insulin regimen.[4] The doctor will monitor you for any other conditions that may cause complications, like infection, heart attack, brain problems, sepsis, or blood clots in deep veins. 3 Increase your fluid intake. One of the first things that will be done to treat your diabetic ketoacidosis is to replace fluids. This can be in the hospital, a doctor’s office, or home. If you are receiving medical care, they will give you an IV. At home, you can drink fluids by mouth.[6] Fluids are lost through frequent urination and must be replaced. Replacing fluids helps balance out the sugar levels in your blood. 4 Replace your electrolytes. Electrolytes, such as sodium, potassium, and chloride, are important to keep your body functioning p Continue reading >>

How Fast Does It Take For Ketoacidosis To Set In?

How Fast Does It Take For Ketoacidosis To Set In?

how fast does it take for ketoacidosis to set in? cause today i found my aunt laying on the floor at her house. she was slurring her speech and wouldn't get up when i told her to. i asked her how long she had been lying there and she said "i don't know". anyways, she has been admitted into the hospital with ketoacidosis. so i'm trying to figure out how long she had been lying on the floor. and yes, she is diabetic! i'm not sure what "type" of diabetic she is. she takes insulin though. and i doubt she was eating, i don't know. i don't live with her. i had tried calling her all day yesterday and i got no answer so this could have started yesterday. i don't know! I'm assuming you are after a simple answer to your question - Ketoacidosis does not always happen quickly. Sometimes there can be ketones present at low levels for quite a few days - or in the case of illness (not associated with Diabetes) such as a cold or the flu, can be enough to elevate blood glucose levels due to stress effect of being ill -(not always due to bad management.) This being the case Ketones can elevate quickly and thus the need for hospitalisation. What I can say is your aunt is very lucky that you found her when you did. Don't feel guilty - you acted quickly and sought medical help. I commend you for your actions! Your aunt is now safe and getting the treatment she needs. I wish you and your aunt well !! Source(s): Mother of a 6 year old Type 1 diabetic. Large ketones can set in quickly. DKA follows and can happen as quickly as one or a few days. How fast depends if she was skipping meals/skipping insulin, or if she has a flu bug or bad cold. The flu for example, DKA will set in much quicker because of all the vomiting and diarrhea. Vomiting and diarrhea is the worst! It sets in so much quicker Continue reading >>

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