How To Reduce Ketoacidosis

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Recurrent Diabetic Ketoacidosis In Inner-city Minority Patients

OBJECTIVE To conduct a bedside study to determine the factors driving insulin noncompliance in inner-city patients with recurrent diabetic ketoacidosis (DKA). RESEARCH DESIGN AND METHODS We analyzed socioeconomic and psychological factors in 164 adult patients with DKA who were admitted to Grady Hospital between July 2007 and August 2010, including demographics, diabetes treatment, education, and mental illness. The Patient Health Questionnaire-9 and the Short Form-36 surveys were used to screen for depression and assess quality of life. RESULTS The average number of admissions was 4.5 ± 7 per patient. A total of 73 patients presented with first-time DKA, and 91 presented with recurrent DKA; 96% of patients were African American. Insulin discontinuation was the leading precipitating cause in 68% of patients; other causes were new-onset diabetes (10%), infection (15%), medical illness (4%), and undetermined causes (3%). Among those who stopped insulin, 32% gave no reasons for stopping, 27% reported lack of money to buy insulin, 19% felt sick, 15% were away from their supply, and 5% were stretching insulin. Compared with first-time DKA, those with recurrent episodes had longer durat Continue reading >>

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Popular Questions

  1. Beccaboo0713

    I was in triage last night for 6.5 hours for fever and dehydration. The baby was showing up as lethargic, the did a chest xray to rule out pneumonia, a flu test, and took tons of urine samples. It turns out I have the flu so they put me on the z pack (for underlying infection) and gave me tamiflu.
    The reason I was there so long is because they kept checking my urine and it kept showing moderate amounts of ketones. I had an IV and drank 1000cc's in liquid (juice and water). Finally they told me I could be discharged if I checked my keytones this morning at home and called them if they are still not 'normal'. Otherwise they wanted to admit me. Well I check this morning and they aren't normal.
    I looked it up and from what I found it's not from dehydration but from starvation.
    I was just wondering if ketones in urine are really that bad. The reason I am asking here and not just calling my doctor is because I think the doctor on call is an idiot. (this is not my first encounter with him)

  2. chicsub

    I had the norovirus twice this pregnancy (joy) and after the first bout I had a prenatal appointment and had ketones. I researched the crap out of it as usual b/c that's what I do! Ketones can stay in your urine for several days (vs. checking your blood) after you are back to normal, hydrated and no longer starving. It's a bigger deal when you have GD, but that's also up for debate.

  3. AllyInMaine

    I'm not an expert... but I believe ketones mean your body is in starvation mode, which for a growing baby, is a problem. Try to eat something (I know you have the flu). What did your doctor tell you? Are you eating enough?

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