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How Long Does Ketoacidosis Last

What You Should Know About Diabetic Ketoacidosis

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too. It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system. People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction. DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration. Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes. Call your doctor or go to the emergency room right away if that doesn't work, if you have any of the symptoms below and your ketones aren't normal, or if you have more than one symptom. You've been throwing up for more than 2 hours. You feel queasy or your belly hurts. Your breath smells fruity. You're tired, confused, or woozy. You're having a hard time breathing. Continue reading >>

Ketoacidosis: A Diabetes Complication

Ketoacidosis: A Diabetes Complication

Ketoacidosis can affect both type 1 diabetes and type 2 diabetes patients. It's a possible short-term complication of diabetes, one caused by hyperglycemia—and one that can be avoided. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two of the most serious complications of diabetes. These hyperglycemic emergencies continue to be important causes of mortality among persons with diabetes in spite of all of the advances in understanding diabetes. The annual incidence rate of DKA estimated from population-based studies ranges from 4.8 to 8 episodes per 1,000 patients with diabetes. Unfortunately, in the US, incidents of hospitalization due to DKA have increased. Currently, 4% to 9% of all hospital discharge summaries among patients with diabetes include DKA. The incidence of HHS is more difficult to determine because of lack of population studies but it is still high at around 15%. The prognosis of both conditions is substantially worsened at the extremes of age, and in the presence of coma and hypertension. Why and How Does Ketoacidosis Occur? The pathogenesis of DKA is more understood than HHS but both relate to the basic underlying reduction in the net effective action of circulating insulin coupled with a concomitant elevation of counter regulatory hormones such as glucagons, catecholamines, cortisol, and growth hormone. These hormonal alterations in both DKA and HHS lead to increased hepatic and renal glucose production and impaired use of glucose in peripheral tissues, which results in hyperglycemia and parallel changes in osmolality in extracellular space. This same combination also leads to release of free fatty acids into the circulation from adipose tissue and to unrestrained hepatic fatty acid oxidation to ketone bodies. Some drugs ca Continue reading >>

Viewer Comments: Diabetic Ketoacidosis - Symptoms

Viewer Comments: Diabetic Ketoacidosis - Symptoms

I didn't know anything about diabetic ketoacidosis (DKA) until I was admitted into the ICU. Learning about DKA now, I've had moderate DKA on and off for years. I thought my vomiting, stomach pain were the result of metformin and switched to Invokana. I experienced extreme weight loss and dehydration but thought these were normal (Invokana shown to help diabetics lose weight). I have been under extreme financial and emotional stress for the past few years as well. What I would want others to know is that it is difficult to identify DKA from medication side effects; until DKA is at the ICU level. I was given so much potassium and other electrolytes. Stress is also a huge factor for me. While in the ICU my ex-husband (knowing I was in the ICU) started more harassment. The nurses documented an over 100 jump in my blood sugar after a phone call to deal with the harassment. I've started tracking stress and my blood sugar. It is impossible to get control of my blood sugar during high stress. If I add more insulin, I have a dangerous crash later. Keeping a calm environment as much as I can helps. I have type 2 diabetes. I gave myself more than 300 shots. My doctor put me on metformin. This takes the place of insulin shots. There are three different doses. What made it for me was 850 mg per meal. I count my carbohydrates, 60 per meal, and take my pill. I have seen here, folks that have 200, 300, 695 mg/dl of glucose. It is tough to manage, but if you keep to it, you will do well. Check the bottoms of your feet daily. If you are ticklish, you are doing fine. Give up cakes, pies, ice cream and other things high in carbohydrates. If you do, you will be fine. By the way, my average glucose reading is less than 120. Set that as your goal. Have good days! I have been having really dif Continue reading >>

Ketoacidosis

Ketoacidosis

Ketones in the urine, as detected by urine testing stix or a blood ketone testing meter[1], may indicate the beginning of diabetic ketoacidosis (DKA), a dangerous and often quickly fatal condition caused by low insulin levels combined with certain other systemic stresses. DKA can be fixed if caught quickly. Diabetics of all species therefore need to be checked for ketones with urine testing stix, available at any pharmacy, whenever insulin level may be too low, and any of the following signs or triggers are present: Ketone Monitoring Needed: Little or no insulin in last 12 hours High blood sugar over 16 mmol/L or 300 mg/dL (though with low insulin, lower as well...) Dehydration (skin doesn't jump back after pulling a bit gums are tacky or dry)[2] Not eating for over 12 hours due to Inappetance or Fasting Vomiting Lethargy Infection or illness High stress levels Breath smells like acetone (nail-polish remover) or fruit. Note that the triggers and signs are somewhat interchangeable because ketoacidosis is, once begun, a set of vicious circles which will make itself worse. So dehydration, hyperglycemia, fasting, and presence of ketones are not only signs, they're also sometimes triggers. In a diabetic, any urinary ketones above trace, or any increase in urinary ketone level, or trace urinary ketones plus some of the symptoms above, are cause to call an emergency vet immediately, at any hour of the day. Possible False Urine Ketone Test Results Drugs and Supplements Valproic Acid (brand names) Depakene, Depakote, Divalproex Sodium[3] Positive. Common use: Treatment of epilepsy. Cefixime/Suprax[4] Positive with nitroprusside-based urine testing. Common use: Antibiotic. Levadopa Metabolites[5] Positive with high concentrations[6]. Tricyclic Ring Compounds[7][8] Positive. Commo Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

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 the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia:[1] Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA.[2] Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA.[2] However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>

Children With Type 1 Diabetes At Risk For Life-threatening Diabetic Ketoacidosis

Children With Type 1 Diabetes At Risk For Life-threatening Diabetic Ketoacidosis

Two weeks before a family vacation last spring, 10-year-old Hailey Evans started to drink a lot more water. Her parents didn’t think much of it, given that Hailey had just joined a running team at her school in Northern Virginia and was exercising more. Not long after landing in Bolivia, where one of Hailey’s grandparents lives, she complained of a stomachache and nausea. Altitude sickness, her parents figured. Then Hailey took a sudden turn for the worse. Hospitalized the next day, she was diagnosed with Type 1 diabetes within an hour. A few hours after that, she was in coma caused by swelling in her brain and severe dehydration. The next morning, April 20th, Hailey died, two weeks shy of her 11th birthday. Hailey’s devastated parents, Vanessa and Derrick Evans, now have joined a growing chorus of voices determined to raise awareness of Type 1 diabetes and push for more regular blood sugar testing. While Type 1 diabetes is the second most common chronic illness of childhood—trailing only asthma—it can mimic other common ailments and often is missed until it has taken a potentially deadly turn. “We had no idea,” Vanessa Evans says. “I wish I would have known, because maybe taking her to the doctor sooner would have saved her life. I would have never thought this could happen to anyone, much less us, yet here we are, left without our beautiful daughter. I don’t wish this pain on anyone. As we learned the hard way, with this disease, every minute, every hour, every day counts.” Cases of Type 1 diabetes are increasing worldwide, particularly in young children. Warning signs can include extreme thirst, frequent urination, a fruity breath odor and blurred vision, as well as generalized symptoms such as fatigue, nausea, stomachache, appetite changes and we Continue reading >>

Diabetic Ketoacidosis Treatment & Management

Diabetic Ketoacidosis Treatment & Management

Approach Considerations Managing diabetic ketoacidosis (DKA) in an intensive care unit during the first 24-48 hours always is advisable. When treating patients with DKA, the following points must be considered and closely monitored: It is essential to maintain extreme vigilance for any concomitant process, such as infection, cerebrovascular accident, myocardial infarction, sepsis, or deep venous thrombosis. It is important to pay close attention to the correction of fluid and electrolyte loss during the first hour of treatment. This always should be followed by gradual correction of hyperglycemia and acidosis. Correction of fluid loss makes the clinical picture clearer and may be sufficient to correct acidosis. The presence of even mild signs of dehydration indicates that at least 3 L of fluid has already been lost. Patients usually are not discharged from the hospital unless they have been able to switch back to their daily insulin regimen without a recurrence of ketosis. When the condition is stable, pH exceeds 7.3, and bicarbonate is greater than 18 mEq/L, the patient is allowed to eat a meal preceded by a subcutaneous (SC) dose of regular insulin. Insulin infusion can be discontinued 30 minutes later. If the patient is still nauseated and cannot eat, dextrose infusion should be continued and regular or ultra–short-acting insulin should be administered SC every 4 hours, according to blood glucose level, while trying to maintain blood glucose values at 100-180 mg/dL. The 2011 JBDS guideline recommends the intravenous infusion of insulin at a weight-based fixed rate until ketosis has subsided. Should blood glucose fall below 14 mmol/L (250 mg/dL), 10% glucose should be added to allow for the continuation of fixed-rate insulin infusion. [19, 20] In established patient Continue reading >>

's Experience With Ketoacidosis.

's Experience With Ketoacidosis.

Signs Treatment Zama's experience Diabetic ketoacidosis is caused by a lack of insulin or an insufficient amount of insulin. Since the lack of insulin means that glucose in not able to be used, the body searches for a new source of energy. In this condition, the diabetic breaks down body fat (lipolysis) to use as energy. During lipolysis, waste products called ketones are produced. Ketones are eliminated in the urine and through the lungs. Under normal conditions, the body can tolerate and eliminate ketones. But in diabetic ketoacidosis, fats are being broken down at such a high rate that the body can not eliminate the ketones fast enough and they build up in the blood. In high amounts, ketones are toxic to the body. They cause the acid-base balance to change and serious electrolyte and fluid imbalances result. Some of the signs of ketoacidosis include polyuria polydipsia lethargy anorexia weakness vomiting dehydration There will probably be ketones in the urine (ketonuria) The breath may have a sweet chemical smell similar to nail polish remover. However, some owners have said that even during documented ketoacidosis, their pet's breath did NOT have any unusual odor. Treatment Mildly ketoacidotic animals can be alert and well hydrated. After your pet is stabilized, your pet can return home and be treated with proper diabetes management techniques including insulin therapy, diet, and exercise. "Sick" ketoacidotic animals require intensive medical management in the vet hospital. This is a life-threatening emergency that requires complex medical management and monitoring. It may take several days for the animal to be out of danger. Treatment involves injections of regular insulin, intravenous fluids, electrolytes, and frequent monitoring of blood glucose, blood chemistry, 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 acidosis is a life-threatening condition that can occur in people with type 1 diabetes. Less commonly, it can also occur with type 2 diabetes. Term watch Ketones: breakdown products from the use of fat stores for energy. Ketoacidosis: another name for diabetic acidosis. It happens when a lack of insulin leads to: Diabetic acidosis requires immediate hospitalisation for urgent treatment with fluids and intravenous insulin. It can usually be avoided through proper treatment of Type 1 diabetes. However, ketoacidosis can also occur with well-controlled diabetes if you get a severe infection or other serious illness, such as a heart attack or stroke, which can cause vomiting and resistance to the normal dose of injected insulin. What causes diabetic acidosis? The condition is caused by a lack of insulin, most commonly when doses are missed. While insulin's main function is to lower the blood sugar level, it also reduces the burning of body fat. If the insulin level drops significantly, the body will start burning fat uncontrollably while blood sugar levels rise. Glucose will then begin to show up in your urine, along with ketone bodies from fat breakdown that turn the body acidic. The body attempts to reduce the level of acid by increasing the rate and depth of breathing. This blows off carbon dioxide in the breath, which tends to correct the acidosis temporarily (known as acidotic breathing). At the same time, the high secretion of glucose into the urine causes large quantities of water and salts to be lost, putting the body at serious risk of dehydration. Eventually, over-breathing becomes inadequate to control the acidosis. What are the symptoms? Since diabetic acidosis is most often linked with high blood sugar levels, symptoms are the same as those for diabetes Continue reading >>

Diabetic Coma

Diabetic Coma

Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency.[1] Three different types of diabetic coma are identified: Severe low blood sugar in a diabetic person Diabetic ketoacidosis (usually type 1) advanced enough to result in unconsciousness from a combination of a severely increased blood sugar level, dehydration and shock, and exhaustion Hyperosmolar nonketotic coma (usually type 2) in which an extremely high blood sugar level and dehydration alone are sufficient to cause unconsciousness. In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious patient about whom nothing is known except that they have diabetes. An example might be a physician working in an emergency department who receives an unconscious patient wearing a medical identification tag saying DIABETIC. Paramedics may be called to rescue an unconscious person by friends who identify them as diabetic. Brief descriptions of the three major conditions are followed by a discussion of the diagnostic process used to distinguish among them, as well as a few other conditions which must be considered. An estimated 2 to 15 percent of diabetics will suffer from at least one episode of diabetic coma in their lifetimes as a result of severe hypoglycemia. Types[edit] Severe hypoglycemia[edit] People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia. It is usually mild enough to reverse by eating or drinking carbohydrates, but blood glucose occasionally can fall fast enough and low enough to produce unconsciousness before hypoglycemia can be recognized and reversed. Hypoglycemia can be severe enough to cause un Continue reading >>

Canine Diabetic Ketoacidosis (dka)

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 >>

The Scary Experience Of Diabetic Ketoacidosis

The Scary Experience Of Diabetic Ketoacidosis

Today, we’re excited to share with you another guest blog from Katie Janowiak, who works for the Medtronic Foundation, our company’s philanthropic arm. When she first told me her story about food poisoning and Diabetic Ketoacidosis (DKA), I knew others could benefit from hearing it as well. Thanks Katie for your openness and allowing us to share your scary story so that the LOOP community can learn from it. Throughout this past year, I’ve had the honor of sharing with you, the amazing LOOP community, my personal journey and the often humorous sequence of events that is my life with T1. Humor is, after all, the best (and cheapest) therapy. Allow me to pause today to share with you the down and dirty of what it feels like to have something that is not the slightest bit humorous: diabetic ketoacidosis.You are hot. You are freezing. You are confused. You are blacked out but coherent. You go to talk but words fail you. Time flies and goes in slow motion simultaneously. You will likely smell and look like death. In my instance, this was brought on by the combination of excessive vomiting and dehydration caused by food poisoning and the diabetic ketoacidosis that followed after my body had gone through so much. In hindsight, I was lucky, my husband knew that I had food poisoning because I began vomiting after our meal. But I had never prepped him on diabetic ketoacidosis and the symptoms (because DKA was for those other diabetics.) Upon finding me in our living room with a bowl of blood and bile by my side (no, I am not exaggerating), he got me into the car and took me to emergency care. It was 5:30 p.m. – and I thought it was 11:00 a.m. The series of events that led up to my stay in the ICU began innocently enough. It was a warm summer night and my husband and I walke Continue reading >>

Doctor, You Aren’t Listening To Me... What If I Do Nothing?

Doctor, You Aren’t Listening To Me... What If I Do Nothing?

A month ago my sister wanted to know if her Jack Russell Terrier could be sick because he was drinking and peeing all the time. I told her he needed to go to the vet; he could have a simple urinary tract infection or he could have more going on. Inside my head, I was screaming “diabetes” as polyuria/polydipsia (drinks a lot and pees a lot), or PU/PD as medical types call it, is a hallmark for diabetes mellitus in dogs, cats, and people. In dogs, diabetes mellitus rarely responds to dietary changes - unlike some people and some cats - and almost always requires twice daily insulin injections to control the disease. Having seen clients react to a diagnosis of diabetes, I wondered how my sister and her husband would react if they had to take care of this chronic condition that requires significant planning and scheduling. It’s not for every owner: while it’s not expensive, it requires insulin injections every 12 hours, 7 days a week for the rest of the pet’s life, with no time off for good behavior. It requires considerable commitment, which can be particularly difficult for people like my sister and her husband who work outside the home and can’t drop everything to give a pet medication at the appropriate times. I wondered what they would choose to do if their dog did have diabetes rather than a urinary tract infection. Receiving a diagnosis of a chronic disease can be difficult to wrap your mind around. During my years in practice, I noticed that there are some pretty universal questions most clients ask. “What are my options and what will happen if I do nothing?” When I hear this, I translate this into: a. How will the disease progress? Will this be a disease that progresses quickly or is it going to be something that is a nagging problem for years to co Continue reading >>

Diabetic Coma Recovery: What You Need To Know

Diabetic Coma Recovery: What You Need To Know

In people with diabetes, a diabetic coma occurs when severe levels of either high or low uncontrolled blood sugar are not corrected. If treated quickly, a person will make a rapid recovery from a diabetic coma. However, diabetic coma can be fatal or result in brain damage. It is important for people with diabetes to control their blood sugars and know what to do when their blood sugar levels are not within their target range. The severe symptoms of uncontrolled blood sugar that can come before a diabetic coma include vomiting, difficulty breathing, confusion, weakness, and dizziness. Recovery from diabetic coma If a diabetic coma is not treated within a couple of hours of it developing, it can cause irreversible brain damage. If no treatment is received, a diabetic coma will be fatal. In addition, having blood sugar levels that continue to be too low or too high can be bad for long-term health. This remains true even if they do not develop into diabetic coma. Recognizing the early signs of low or high blood sugar levels and regular monitoring can help people with diabetes keep their blood sugar levels within the healthy range. Doing so will also reduce the risk of associated complications and diabetic coma. What is diabetes? Diabetes is a long-term condition in which the body is unable to control the level of a sugar called glucose in the blood. Diabetes is caused by either a lack of insulin, the body's inability to use insulin correctly, or both. In people who don't have diabetes, insulin usually ensures that excess glucose is removed from the bloodstream. It does this by stimulating cells to absorb the glucose they need for energy from the blood. Insulin also causes any remaining glucose to be stored in the liver as a substance called glycogen. The production of insul Continue reading >>

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