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How Long Does It Take For Ketoacidosis To Set In?

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Dka For The First Time This Weekend

A perfect storm of sunny, hot day, dehydration and pump malfunction put me into my first episode of DKA this weekend. I have been Type 1 for almost 9 years and have never been that sick even when diagnosed. My body responded great to IV fluids and meds and was only in ICU overnight. However, when I woke up Sunday morning in the hospital, my mouth and throat were beyond painful and couldn't swallow anything more than water. Is this a typical side effect from the vomiting? It's been 3 days and I can't swallow anything other than liquids and yogurt. Just wondering if there are any at home treatments that I could try to speed the recovery period. Thanks to all! DKA is a rough experience no matter the severity! Out of curiosity (I assume they did), did your hospital check your electrolyte levels and what not? There could definitely be some lingering inflammation because of the out of whack chemical levels in your body. On a personal opinion, I think this can be fairly normal, especially if your vomiting was severe. Think of all the stomach acid that tore up your poor esophagus :( Especially since after the first two times, there was probably just some stomach juices and no substantial Continue reading >>

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  1. Shama

    I was diagnosed as t1 four weeks ago. I was admitted to hospital with BGLs of 19 and ketones were 5.5, so I was DKA.
    I spent 24 hours in emergency while they brought down my ketones to zero then spent another 8 days in hospital getting stabilised and learning how to inject insulin etc.
    My question is: how long does it take to fully recover from DKA? I went back to work yesterday and was exhausted after 7 hours (including a short lunchbreak). I deliberately didn't do very much; just got through my backlog of emails and did a bit of reading. When I got home, I perked up a bit after dinner. Today, it was the same at work but tonight I am SO tired I can barely walk and I can't do *anything* other than sit and watch tv. I can't keep doing this. I need to be able to function at least a bit in the evenings, and this is without me doing my usual job of answering complex (and long) phone calls and emails. Is this normal??
    I wasn't in a coma (I walked into emergency). I lost 3kg in the fortnight before I was admitted despite eating heaps, and lost more weight before that. I had a lot of muscle pain and muscle cramps before diagnosis, and couldn't walk up a hill without having to stop all the time to catch my breath. (plus the classic insatiable thirst and peeing heaps)
    When I first got out of hospital I basically just tried to get on with normal life and started exercising, ie a 20 minute walk most days. Then I carried lots of heavy boxes (long story) over several days. I was fine at the time then lost some stamina late last week. The DE (after I'd done all this exercise, not before!) said now was not the time to hit the gym, just as a throwaway comment. I didn't ask her to elaborate but did scale back my daily walks a bit.
    I'm going to ring the DE or endo tomorrow to see if this is normal and if I need more time before going back to work (I'm not driving yet, hubby can't afford to take time off to pick me up early each day and the bus home involves two 15 minute walks each end and a 45 minute bus ride). But I would like to know other people's experiences with DKA recovery, particularly if it was a pre-diagnosis one with several weeks of symptoms.
    Thanks in advance :)

  2. Magenta76

    Hi Shama, sucks that you have to be here, but glad that you found us!!
    I, unfortunately, have a LOT of experience with DKA's... (something like 9 or 10 in 13 years of diagnosis) Each of them the recovery time has been different.
    My diagnosis, I have no idea what my level of ketones was, I know my BSL was 30something, and I was incredibly ill, and weighed something ridiculous like 50kgs.... with hindsight I was probably presenting symptoms at least 2 or 3 months before I was diagnosed.
    After my diagnosis, I took the probably set standard, month off. I went back to work as a chef after that, I don't really remember what it felt like, I was 22 so I probably was not too bad. I think we all would have different recovery times to anything and everything, so I don't think anyone could give you a straight answer on how long it will take for your body to go back to "normal". Talk to your HP's but take it day by day would be the best bet. Not really helpful, I know, but can't say any more than that.
    My last DKA was extremely severe. We're talking coma, organ failure type stuff. That was 18 months ago. My body is still recuperating from that one. I know that for me, each time I have a DKA, the whole episode is worse, and I take longer each time to get better. I just wish I discovered and knew about all the triggers for me. Stress is a large factor for about half of mine, which unfortunately means that when I get the all clear to work again, I have to change my career.
    Good luck with everything, and I hope you are feeling better soon. Try not to overdo it. Your body would still be adjusting. Let it. :)

  3. tantan

    Hi Shama,
    I have a similar story to you. I was diagnosed about 4 years ago, with ++++ ketones (whatever that means), a BGL of 32.7, and weight loss of 9kg in the preceding 3 and a half weeks. My understanding is that DKA involves the body basically chewing up fat because the lack of insulin means it can't access the glucose in your body, even if you're eating lots of it! So a lot of that weight loss is coming from storage (and we all need some fat storage for normal functioning! :-) ). At the end of the day, it will take a body awhile to replenish those stores, work properly again, and get back to the state it was at prior to diagnosis (and prior to the weeks leading up to diagnosis).
    I can't remember how long it took me to recover fully. I was diagnosed several weeks before Christmas, which was a massively busy time at the company where I was working. The doctor at the hospital gave me a medical certificate for at least a week off, but I actually only took about two days. However, I only worked shorter days for at least a week, maybe two, once I went back. I wasn't allowed to drive, so my co-worker would pick me up in the morning on her way to work, and my husband would pick me up in the afternoon when he finished at his work (which was always about 1-2 hours earlier than my usual finishing time). I found that I felt better in the mornings, so that worked for me.
    I think the best one can do for one's body after something like DKA is to eat healthily and get plenty of sleep!
    All the best!
    Tanya

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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 b

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious, life-threatening complication of diabetes mellitus. DKA is characterized by the triad of hyperglycemia, anion gap metabolic acidosis, and ketonemia. It is part of a spectrum of hyperglycemia on which lies hyperosmolar hyperglycemic state (HHS). Though the two are distinct entities, they do share some commonalities. DKA is caused by the reduced effect of insulin, either due to deficit or reduction of levels, with concomitant elevation of counter regulatory hormones (glucagon, catecholamines, cortisol, and growth hormones), generally due to a precipitating stress. Increased gluconeogenesis, glycogenolysis, and decreased glucose uptake by cells leads to hyperglycemia, while insulin deficiency leads to mobilization and oxidization of fatty acids leading to ketogenesis. Although DKA may be the initial manifestation of diabetes, it is typically precipitated by other factors. It is critical for a clinician to identify and treat these factors. Infection can be found in 40-50% of patients with hyperglycemic crisis, with urinary tract infection and pneumonia accounting for the majority of cases. DKA is a life-threatening medical emergency with a mor Continue reading >>

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  1. Shama

    I was diagnosed as t1 four weeks ago. I was admitted to hospital with BGLs of 19 and ketones were 5.5, so I was DKA.
    I spent 24 hours in emergency while they brought down my ketones to zero then spent another 8 days in hospital getting stabilised and learning how to inject insulin etc.
    My question is: how long does it take to fully recover from DKA? I went back to work yesterday and was exhausted after 7 hours (including a short lunchbreak). I deliberately didn't do very much; just got through my backlog of emails and did a bit of reading. When I got home, I perked up a bit after dinner. Today, it was the same at work but tonight I am SO tired I can barely walk and I can't do *anything* other than sit and watch tv. I can't keep doing this. I need to be able to function at least a bit in the evenings, and this is without me doing my usual job of answering complex (and long) phone calls and emails. Is this normal??
    I wasn't in a coma (I walked into emergency). I lost 3kg in the fortnight before I was admitted despite eating heaps, and lost more weight before that. I had a lot of muscle pain and muscle cramps before diagnosis, and couldn't walk up a hill without having to stop all the time to catch my breath. (plus the classic insatiable thirst and peeing heaps)
    When I first got out of hospital I basically just tried to get on with normal life and started exercising, ie a 20 minute walk most days. Then I carried lots of heavy boxes (long story) over several days. I was fine at the time then lost some stamina late last week. The DE (after I'd done all this exercise, not before!) said now was not the time to hit the gym, just as a throwaway comment. I didn't ask her to elaborate but did scale back my daily walks a bit.
    I'm going to ring the DE or endo tomorrow to see if this is normal and if I need more time before going back to work (I'm not driving yet, hubby can't afford to take time off to pick me up early each day and the bus home involves two 15 minute walks each end and a 45 minute bus ride). But I would like to know other people's experiences with DKA recovery, particularly if it was a pre-diagnosis one with several weeks of symptoms.
    Thanks in advance :)

  2. Magenta76

    Hi Shama, sucks that you have to be here, but glad that you found us!!
    I, unfortunately, have a LOT of experience with DKA's... (something like 9 or 10 in 13 years of diagnosis) Each of them the recovery time has been different.
    My diagnosis, I have no idea what my level of ketones was, I know my BSL was 30something, and I was incredibly ill, and weighed something ridiculous like 50kgs.... with hindsight I was probably presenting symptoms at least 2 or 3 months before I was diagnosed.
    After my diagnosis, I took the probably set standard, month off. I went back to work as a chef after that, I don't really remember what it felt like, I was 22 so I probably was not too bad. I think we all would have different recovery times to anything and everything, so I don't think anyone could give you a straight answer on how long it will take for your body to go back to "normal". Talk to your HP's but take it day by day would be the best bet. Not really helpful, I know, but can't say any more than that.
    My last DKA was extremely severe. We're talking coma, organ failure type stuff. That was 18 months ago. My body is still recuperating from that one. I know that for me, each time I have a DKA, the whole episode is worse, and I take longer each time to get better. I just wish I discovered and knew about all the triggers for me. Stress is a large factor for about half of mine, which unfortunately means that when I get the all clear to work again, I have to change my career.
    Good luck with everything, and I hope you are feeling better soon. Try not to overdo it. Your body would still be adjusting. Let it. :)

  3. tantan

    Hi Shama,
    I have a similar story to you. I was diagnosed about 4 years ago, with ++++ ketones (whatever that means), a BGL of 32.7, and weight loss of 9kg in the preceding 3 and a half weeks. My understanding is that DKA involves the body basically chewing up fat because the lack of insulin means it can't access the glucose in your body, even if you're eating lots of it! So a lot of that weight loss is coming from storage (and we all need some fat storage for normal functioning! :-) ). At the end of the day, it will take a body awhile to replenish those stores, work properly again, and get back to the state it was at prior to diagnosis (and prior to the weeks leading up to diagnosis).
    I can't remember how long it took me to recover fully. I was diagnosed several weeks before Christmas, which was a massively busy time at the company where I was working. The doctor at the hospital gave me a medical certificate for at least a week off, but I actually only took about two days. However, I only worked shorter days for at least a week, maybe two, once I went back. I wasn't allowed to drive, so my co-worker would pick me up in the morning on her way to work, and my husband would pick me up in the afternoon when he finished at his work (which was always about 1-2 hours earlier than my usual finishing time). I found that I felt better in the mornings, so that worked for me.
    I think the best one can do for one's body after something like DKA is to eat healthily and get plenty of sleep!
    All the best!
    Tanya

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Is Ketosis Dangerous?

You may have heard from your doctor that ketosis is a life-threatening condition. If so, your doctor is confusing diabetic ketoacidosis (DKA) with nutritional ketosis, or keto-adaptation. First, some semantics. Our body can produce, from fat and some amino acids, three ketone bodies (a “ketone” refers to the chemical structure where oxygen is double-bonded to carbon sandwiched between at least 2 other carbons). These ketone bodies we produce are: acetone, acetoacetone, and beta-hydroxybutyrate (B-OHB). [For anyone who is interested, they are the 3 most right structures on the figure, below.] Why do we make ketones? For starters, it’s a vital evolutionary advantage. Our brain can only function with glucose and ketones. Since we can’t store more than about 24 hours’ worth of glucose, we would all die of hypoglycemia if ever forced to fast for more than a day. Fortunately, our liver can take fat and select amino acids (the building blocks of proteins) and turn them into ketones, first and foremost to feed our brains. Hence, our body’s ability to produce ketones is required for basic survival. What is diabetic ketoacidosis? When diabetics (usually Type I diabetics, but some Continue reading >>

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  1. Hankpiggy

    Throwaway account for obvious reasons.
    Husband (55) was just diagnosed with adult-onset diabetes (misdiagnosed for 5 years as panic attacks) but refuses to do anything about it. He had a fasting glucose test (360mg/dL) and a follow-up a1c blood test (11.4%). That's literally the only testing he's had done for it.
    As soon as the initial diagnosis came back, he "fired" his primary care physician for misdiagnosing his condition. But he refuses to talk to his new PCM about it (the PCM has threatened to drop him as a patient because of it). He insists that he'll be fine, "or if not at least I know what's going to kill me."
    Won't change his diet, which has always been high in sugar. He can drink a 2liter bottle of soda a day, jokes that the suggested serving size for cinnamon buns is "all of them," etc. I've made some sneaky changes around the house. There's no snacks in easy reach. I'm cutting down on portion sizes and cooking with fewer carbs. But I have no control over what he does when he leaves for work, and I'm sure there are daily Dunkin Donut runs and fast food lunches.
    He gets blurred vision and what we used to call panic attacks but now we're calling "blood sugar events" about once a week. They're debilitating. He's unable to function for close to an hour and then shaky for another three or four. I did notice that he had a tiny cut on his foot that took forever to heal last year. In retrospect, I should have forced him to get tested then. No cardio or other issues. We regularly go on hikes with steep grades and 1,000' changes in altitude.
    I'm scared (and super pissed off) about his attitude. How long do I have to dig this grave?

  2. Ceanot

    Unfortunately, he can live for many years with horrible complications. You need to figure out what kind of life/partner you want. Are you happy to be sneaky and watch your partner slowly kill himself; or do you want a partner who will take care of himself so he can be around to do fun things? Are you partners or are you his caregiver?

  3. cdn_SW

    I'm so sorry your going through this, you must be incredibly frustrated. In my opinion it's not about how long it will take to kill him, it's about what it will do to his quality of life. Two of the more common and horrible complications of diabetes are problems with the eyes and neuropathy. He could go blind or end up losing a limb. You mentioned a cut that took forever to heal, uncontrolled blood sugar makes you prone to infections that can be difficult to heal, he could end up losing a toe, foot, or part of his leg. Neuropathy can also be horribly painful.
    Your husband needs to get a grip on dealing with this, it's really not that difficult once you make a decision to make some changes and get the proper treatment. You may also need to let him know whether or not you feel you would be able to be his caregiver if his health goes to shit due to his own negligence. It's a harsh reality, but better to come to grips with it now than when it's too late. It's hard to give a timeline, like in many things some people seem to fair reasonably well even with horrible control, and others may do all the right things and still end up with complications. Hopefully you can talk some sense into your husband, maybe have him google some images of diabetic neuropathy or diabetic foot ulcers, and see if that is enough to scare him into doing something.

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