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 >>
How Dka Happens And What To Do About It
Certified Diabetes Educator Gary Scheiner offers an overview of diabetic ketoacidosis. (excerpted from Think Like A Pancreas: A Practical Guide to Managing Diabetes With Insulin by Gary Scheiner MS, CDE, DaCapo Press, 2011) Diabetic Ketoacidosis (DKA) is a condition in which the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production. When bodily fluids become acidic, some of the body’s systems stop functioning properly. It is a serious condition that will make you violently ill and it can kill you. The primary cause of DKA is a lack of working insulin in the body. Most of the body’s cells burn primarily sugar (glucose) for energy. Many cells also burn fat, but in much smaller amounts. Glucose happens to be a very “clean” form of energy—there are virtually no waste products left over when you burn it up. Fat, on the other hand, is a “dirty” source of energy. When fat is burned, there are waste products produced. These waste products are called “ketones.” Ketones are acid molecules that can pollute the bloodstream and affect the body’s delicate pH balance if produced in large quantities. Luckily, we don’t tend to burn huge amounts of fat at one time, and the ketones that are produced can be broken down during the process of glucose metabolism. Glucose and ketones can “jump into the fire” together. It is important to have an ample supply of glucose in the body’s cells. That requires two things: sugar (glucose) in the bloodstream, and insulin to shuttle the sugar into the cells. A number of things would start to go wrong if you have no insulin in the bloodstream: Without insulin, glucose cannot get into the body’s cells. As a result, the cells begin burning large amounts of fat for energy. This, of course, Continue reading >>
Diabetes With Ketone Bodies In Dogs
Studies show that female dogs (particularly non-spayed) are more prone to DKA, as are older canines. Diabetic ketoacidosis is best classified through the presence of ketones that exist in the liver, which are directly correlated to the lack of insulin being produced in the body. This is a very serious complication, requiring immediate veterinary intervention. Although a number of dogs can be affected mildly, the majority are very ill. Some dogs will not recover despite treatment, and concurrent disease has been documented in 70% of canines diagnosed with DKA. Diabetes with ketone bodies is also described in veterinary terms as diabetic ketoacidosis or DKA. It is a severe complication of diabetes mellitus. Excess ketone bodies result in acidosis and electrolyte abnormalities, which can lead to a crisis situation for your dog. If left in an untreated state, this condition can and will be fatal. Some dogs who are suffering from diabetic ketoacidosis may present as systemically well. Others will show severe illness. Symptoms may be seen as listed below: Change in appetite (either increase or decrease) Increased thirst Frequent urination Vomiting Abdominal pain Mental dullness Coughing Fatigue or weakness Weight loss Sometimes sweet smelling breath is evident Slow, deep respiration. There may also be other symptoms present that accompany diseases that can trigger DKA, such as hypothyroidism or Cushing’s disease. While some dogs may live fairly normal lives with this condition before it is diagnosed, most canines who become sick will do so within a week of the start of the illness. There are four influences that can bring on DKA: Fasting Insulin deficiency as a result of unknown and untreated diabetes, or insulin deficiency due to an underlying disease that in turn exacerba Continue reading >>
What Is Diabetic Ketoacidosis?
Having diabetes means that there is too much sugar (glucose) in your blood. When you eat food, your body breaks down much of the food into glucose. Your blood carries the glucose to the cells of your body. An organ in your upper belly, called the pancreas, makes and releases a hormone called insulin when it detects glucose. Your body uses insulin to help move the glucose from the bloodstream into the cells for energy. When your body does not make insulin (type 1 diabetes), or has trouble using insulin (type 2 diabetes), glucose cannot get into your cells. The glucose level in your blood goes up. Too much glucose in your blood (also called hyperglycemia or high blood sugar) can cause many problems. People with type 1 diabetes are at risk for a problem called diabetic ketoacidosis (DKA). It is very rare in people with type 2 diabetes. DKA happens when your body does not have enough insulin to move glucose into your cells, and your body begins to burn fat for energy. The burning of fats causes a build-up of dangerous levels of ketones in the blood. At the same time, sugar also builds up in the blood. DKA is an emergency that must be treated right away. If it is not treated right away, it can cause coma or death. What can I expect in the hospital? You will need to stay in the hospital in order to bring your blood sugar level under control and treat the cause of the DKA. Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include: Monitoring You will be checked often by the hospital staff. You may have fingersticks to check your blood sugar regularly. This may be done as often as every hour. You will learn how to check your blood sugar level in order to manage your diabetes when you go home. A heart (cardiac) monitor may Continue reading >>
> Hyperglycemia And Diabetic Ketoacidosis
When blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy. Hyperglycemia is the hallmark of diabetes — it happens when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia. If it's not treated, hyperglycemia can cause serious health problems. Too much sugar in the bloodstream for long periods of time can damage the vessels that supply blood to vital organs. And, too much sugar in the bloodstream can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, they can happen in adulthood in some people, particularly if they haven't managed or controlled their diabetes properly. Blood sugar levels are considered high when they're above someone's target range. The diabetes health care team will let you know what your child's target blood sugar levels are, which will vary based on factors like your child's age. A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible. It's a three-way balancing act of: diabetes medicines (such as in Continue reading >>
Everything You Need To Know About Insulin Pumps
Everyone needs insulin to live. Insulin is a hormone that helps our bodies use and store the food we eat. People with Type 1 Diabetes no longer make insulin and have to give insulin in order to sustain life. People with Type 2 Diabetes don’t use their own insulin well, and over time can have trouble making enough. So, all people with Type 1 diabetes and some people with Type 2 diabetes need insulin. When people give insulin injections, they may take 1-2 injections of a long acting insulin every day and 3+ injections of rapid acting insulin for meals and snacks. The typical person with Type 1 Diabetes could take anywhere from 4-7+ injections a day. Many people currently give insulin through an insulin pen or a syringe. But, there is another option, an insulin pump. An insulin pump delivers rapid acting insulin in two ways. First, the pump is programmed to give you insulin every hour throughout the hour referred to basal insulin. Basal, think “base,” is the insulin your body needs even in the absence of food, it is also referred to as background insulin. This basal rate replaces the long acting injection that you take. Second, is bolus, this is the insulin you take for food or to correct a high blood sugar. If you get basal and bolus confused, think “bowl”, as in you eat out of a bowl, to help you remember bolus is for food. Once you are on a pump, all insulin is delivered through the pump and shots are no longer necessary. Components There are a few things necessary to make a pump work. When a pump is shipped to someone: they will also need to send infusion sets, reservoirs, and possibly batteries, depending on your pump. Let’s talk about each component. Infusion Sets An infusion set is the part that is actually inserted into the body and has tubing that conn Continue reading >>
Ask D'mine: Our Lifespan Sans Insulin?
Got questions about navigating life with diabetes? Ask D'Mine! Our weekly advice column, that is — hosted by veteran type 1,diabetes author and educator Wil Dubois. This week, Wil offers some thoughts on that universal question: "How long can I really go without insulin?" Please take a read; his findings might surprise you and even bust a myth or two. But as a precautionary reminder: this topic would fall into the category of "Don't try this at home"! {Got your own questions? Email us at [email protected]} Jake, type 1 from Minneapolis, writes: I've had diabetes for 18 years and I had someone ask me a question the other day that I didn't really have an answer to. The question was how long I would be able to survive without any insulin. I told them 3-4 days, but I don't know if this is true. Any info from a cinnamon whiskey swizzling T1? Wil@Ask D'Mine answers: If Tom Hanks' character in Castaway had been one of us, he would've never lived long enough to go half-crazy and end up talking to a volleyball named Wilson. OK, so that's a mixed blessing. But I guess the lesson there is: don't get washed up on a deserted island if you can avoid it. To be honest, like you, I had always pegged my zero-insulin survival time in the "couple of days" zone; but once I got to thinking about your question I realized that I didn't know how I knew that, where I learned it, or if it was even correct at all. So I set out to do some fact-checking. Now, as background for you sugar-normals, type 2s, and type 3s—in type 1s like Jake and me, if we run out of insulin hyperglycemia sets in. That leads to diabetic ketoacidosis (known as DKA by its friends), which then (untreated) leads to death. This is old news. But how fast is the process, really? Well, there are a number of variables, Continue reading >>
How Long Does Diabetic Coma Last And How Is It Treated?
When immediately attended and given the right treatment, the diabetic patient can be quickly wakened up from the diabetic coma. Late attention to diabetic coma might take more glucose to be given to the person for better healing. The diabetic coma is connected to the metabolic abnormalities which forces the diabetic patient to the coma. If the diabetic patient stays in the coma for longer periods of time or if the patient is unattended for long time, permanant brain damage may take place or in rare instances it may lead to death of the patient. What is the Prognosis or Outlook for Diabetic Coma? Diabetic coma can be fatal. Late attention may prolong the period of treatment. A person who has been treated for long for diabetic coma is recorded to experience a brain damage. This is a dire situation but can be avoided by taking precautionary measures. Remain alert and aware to save yourself from diabetic coma. Manage your diabetic syndromes effectively to save your life. Even after the sugar level is normalized in a person, he or she will still experience nervous disorders like seizures or talking problems. Problems still persists even after recovering from diabetic coma. The recovery time cannot be predicted and depends on individual case. When immediately attended and given glucose biscuits, a person can be quickly wakened up. Late attention might take more glucose to be given to the person for better healing. Consult your doctor and take necessary guidelines on how to prevent any incident of diabetic coma or any other complexities if you are diabetic. Your doctor may prescribe you tests to determine the exact "dos and don'ts" to you on how to manage diabetes. Diabetic coma is caused by three major reasons: Severe hypolgycemia i.e., low blood sugar level Diabetic ketoacid Continue reading >>
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 >>
Management Of Adult Diabetic Ketoacidosis
Go to: Abstract Diabetic ketoacidosis (DKA) is a rare yet potentially fatal hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. Due to its increasing incidence and economic impact related to the treatment and associated morbidity, effective management and prevention is key. Elements of management include making the appropriate diagnosis using current laboratory tools and clinical criteria and coordinating fluid resuscitation, insulin therapy, and electrolyte replacement through feedback obtained from timely patient monitoring and knowledge of resolution criteria. In addition, awareness of special populations such as patients with renal disease presenting with DKA is important. During the DKA therapy, complications may arise and appropriate strategies to prevent these complications are required. DKA prevention strategies including patient and provider education are important. This review aims to provide a brief overview of DKA from its pathophysiology to clinical presentation with in depth focus on up-to-date therapeutic management. Keywords: DKA treatment, insulin, prevention, ESKD Go to: Introduction In 2009, there were 140,000 hospitalizations for diabetic ketoacidosis (DKA) with an average length of stay of 3.4 days.1 The direct and indirect annual cost of DKA hospitalizations is 2.4 billion US dollars. Omission of insulin is the most common precipitant of DKA.2,3 Infections, acute medical illnesses involving the cardiovascular system (myocardial infarction, stroke) and gastrointestinal tract (bleeding, pancreatitis), diseases of the endocrine axis (acromegaly, Cushing’s syndrome), and stress of recent surgical procedures can contribute to the development of DKA by causing dehydration, increase in insulin counter-regulatory hor Continue reading >>
Diabetic Ketoacidosis
Print Overview Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care. Symptoms Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: Excessive thirst Frequent urination Nausea and vomiting Abdominal pain Weakness or fatigue Shortness of breath Fruity-scented breath Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: High blood sugar level (hyperglycemia) High ketone levels in your urine When to see a doctor If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit. Contact your doctor immediately if: You're vomiting and unable to tolerate food or liquid Your blood sugar level is higher than your target range and doesn't respond to home treatment Your urine ketone level is moderate or high Seek emergency care if: Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 mill Continue reading >>
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 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 ?
I am a type 1 diabetic and I have a problem that I cant seem to figure out. I have an appointment with my doctor in about a month, because they cant get me in any earlier. But what happens is I get really sick to my stomach, my blood sugar usually drops EXTREMELY fast, I get dizzy, a headache, and I always seem to yawn a lot. I have some ideas about what it might be, like ketoacidosis. But I am not entirely sure. Do you have any ideas? I would suggest that you go to your local drug store and obtain a canister of ketosticks. Check your urine for ketone. It is a very simple test. This will tell if you have ketonuria. If this is the case it is important that you see a doctor immediately. Call you doctor and tell them what is happening and you need help very quickly. If your doctor does not see you, go to an emergency room. This is a very serious situation. Take care, Wanda QUOTE posted on the "about portions'' thread: "The presence of ketones is called "ketonuria," and further dehydration and ketone build-up can result in ketoacidosis which is a medical emergency. The bottom line is that the presence of ketones in someone with type 1 diabetes shows a dangerous lack of insulin and the immediate need for more insulin. Exercise, at this time, will only burn more fat and produce more ketones. " (+ info) diabetic ketoacidosis? if you die of diabetic ketoacidosis are there warning signs before you die and when does it alert your body? and is this something that just happens to some one or is it due to the fact of foul play by the person or someone else. how is foul pay involved. if you die at the age of 40 is it required for an autopsy to be preformed There are major warning signs if diabetic ketoacidosis (DKA). Once the DKA is advanced the diabetic will vomit everything he or s Continue reading >>
Diabetic Ketoacidosis
A Preventable Crisis People who have had diabetic ketoacidosis, or DKA, will tell you it’s worse than any flu they’ve ever had, describing an overwhelming feeling of lethargy, unquenchable thirst, and unrelenting vomiting. “It’s sort of like having molasses for blood,” says George. “Everything moves so slow, the mouth can feel so dry, and there is a cloud over your head. Just before diagnosis, when I was in high school, I would get out of a class and go to the bathroom to pee for about 10–12 minutes. Then I would head to the water fountain and begin drinking water for minutes at a time, usually until well after the next class had begun.” George, generally an upbeat person, said that while he has experienced varying degrees of DKA in his 40 years or so of having diabetes, “…at its worst, there is one reprieve from its ill feeling: Unfortunately, that is a coma.” But DKA can be more than a feeling of extreme discomfort, and it can result in more than a coma. “It has the potential to kill,” says Richard Hellman, MD, past president of the American Association of Clinical Endocrinologists. “DKA is a medical emergency. It’s the biggest medical emergency related to diabetes. It’s also the most likely time for a child with diabetes to die.” DKA occurs when there is not enough insulin in the body, resulting in high blood glucose; the person is dehydrated; and too many ketones are present in the bloodstream, making it acidic. The initial insulin deficit is most often caused by the onset of diabetes, by an illness or infection, or by not taking insulin when it is needed. Ketones are your brain’s “second-best fuel,” Hellman says, with glucose being number one. If you don’t have enough glucose in your cells to supply energy to your brain, yo Continue reading >>
