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How To Treat Ketoacidosis At Home

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 >>

Alcoholic Ketoacidosis Treatment & Management

Alcoholic Ketoacidosis Treatment & Management

Approach Considerations Treatment of alcoholic ketoacidosis (AKA) is directed toward reversing the 3 major pathophysiologic causes of the syndrome, which are: This goal can usually be achieved through the administration of dextrose and saline solutions. [4] Carbohydrate and fluid replacement reverse the pathophysiologic derangements that lead to AKA by increasing serum insulin levels and suppressing the release of glucagon and other counterregulatory hormones. Dextrose stimulates the oxidation of NADH and aids in normalizing the NADH/NAD+ ratio. Fluids alone do not correct AKA as quickly as do fluids and carbohydrates together. Indeed, evidence-based guidelines by Flannery et al, on the management of intensive care unit patients with a chronic alcohol disorder, including symptoms that mimic or mask Wernicke encephalopathy, recommend that in cases of suspected AKA, dextrose-containing fluids be used in place of normal saline during the first day of admission. [23] In alcoholics, thiamine (100 mg IV or IM) should be administered prior to any glucose-containing solutions. This will decrease the risk of precipitating Wernicke encephalopathy or Korsakoff syndrome. [13] Phosphate depletion is also common in alcoholics. The plasma phosphate concentration may be normal on admission; however, it typically falls to low levels with therapy as insulin drives phosphate into the cells. When present, severe hypophosphatemia may be associated with marked and possibly life-threatening complications, such as myocardial dysfunction, in these patients. Institute appropriate treatment for serious, coexisting, acute illnesses. These may include pancreatitis, hepatitis, heart failure, or infection. Prevention of AKA involves the treatment of chronic alcohol abuse. Transfer considerations Pati 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 To Spot And Treat Diabetic Ketoacidosis (dka)

How To Spot And Treat Diabetic Ketoacidosis (dka)

Even if you work hard at your diabetes management and use technology to help keep your numbers in range, you can still experience high blood glucose, which can escalate to diabetic ketoacidosis (DKA). While DKA can be scary if left untreated, it is preventable if you know what to look for and what to do. Senior District Clinical Manager, Melinda Turenne, BSN, RN, CDE, has more than 15 years of diabetes clinical experience. Today she shares some valuable DKA risk factors and prevention tips. Living with diabetes involves a lot of duties. You are checking your blood glucose (BG), counting your carbohydrates, exercising, and keeping doctors’ appointments. I am sure you remember your doctor or diabetes educator telling you to check for ketones too, right? Checking my what? One more thing to add to my to-do list! Yes, and here is WHY. What are ketones? Ketones are acid molecules produced when we burn fat for energy or fuel. As fat is broken down, ketones build up in the blood and urine. In high levels, ketones are toxic and can make you very sick. When combined with dehydration, it can lead to Diabetic Ketoacidosis (DKA), a life threatening condition. Why would DKA happen? DKA occurs when there is not enough insulin present in the body. Without enough insulin, glucose builds up in the blood, causing high BG levels. Since the body is unable to use glucose without insulin for energy, it breaks down fat instead. This can occur for several reasons: Infection, injury, or serious illness A lack of insulin in the body due to missed injections, spoiled insulin, poor absorption Severe dehydration Combination of these things What are the signs of DKA? High BG levels Ketones (in blood and urine) Nausea, vomiting, and abdominal pain (cramps) Confusion Tired, sluggish, or weak Flushed, Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Causes Ketoacidosis is a complication that people with diabetes suffer from, and is caused due to the lack of insulin in the body. In ketoacidosis, there is a rapid build-up of toxic substances known as ‘ketones’ which makes the blood extremely acidic. Although it is most often observed in people who have type 1 diabetes, ketoacidosis may affect those with type 2 diabetes as well. It is a serious condition, which if left untreated, can lead to a diabetic coma or even death. Risk factors Diabetics in general are prone to ketoacidosis due to the very nature of the disease. But, in the case of type 2 diabetics, a patient’s pancreas is unable to produce sufficient insulin which in turn deprives their cells of glucose. Since glucose is extremely essential for the cells to perform their normal functions, the patient’s body looks for alternative sources of energy. In an attempt to fulfil this deficit, the patient’s body uses fat from fat cells – which is broken down – to obtain energy. Denatured fat cells lead to the formation of ketones which are then released into the patient’s blood stream. Over a period of time, these ketones start to accumulate in the patient’s blood, causing it to turn more acidic. Because of this, many important enzymes that control the body’s metabolic processes aren’t able to perform optimally, leading to an imbalance in the patient’s blood sugar and electrolyte levels. (Read: Diabetes – Symptoms, causes, diagnosis, treatment and complications) Symptoms The common symptoms of ketoacidosis include – Diagnosis Ideally, a diabetic should not wait for symptoms to show up, and must be screened for risk factors regularly. Timely assessment of one’s health parameters can help prevent the onset of ketoacidosis. One could opt for Continue reading >>

Treatment Of Diabetic Ketoacidosis With Subcutaneous Insulin Aspart

Treatment Of Diabetic Ketoacidosis With Subcutaneous Insulin Aspart

Abstract OBJECTIVE—In this prospective, randomized, open trial, we compared the efficacy and safety of aspart insulin given subcutaneously at different time intervals to a standard low-dose intravenous (IV) infusion protocol of regular insulin in patients with uncomplicated diabetic ketoacidosis (DKA). RESEARCH DESIGN AND METHODS—A total of 45 consecutive patients admitted with DKA were randomly assigned to receive subcutaneous (SC) aspart insulin every hour (SC-1h, n = 15) or every 2 h (SC-2h, n = 15) or to receive IV infusion of regular insulin (n = 15). Response to medical therapy was evaluated by assessing the duration of treatment until resolution of hyperglycemia and ketoacidosis. Additional end points included total length of hospitalization, amount of insulin administration until resolution of hyperglycemia and ketoacidosis, and number of hypoglycemic events. RESULTS—Admission biochemical parameters in patients treated with SC-1h (glucose: 44 ± 21 mmol/l [means ± SD], bicarbonate: 7.1 ± 3 mmol/l, pH: 7.14 ± 0.09) were similar to those treated with SC-2h (glucose: 42 ± 21 mmol/l, bicarbonate: 7.6 ± 4 mmol/l, pH: 7.15 ± 0.12) and IV regular insulin (glucose: 40 ± 13 mmol/l, bicarbonate 7.1 ± 4 mmol/l, pH: 7.11 ± 0.17). There were no statistical differences in the mean duration of treatment until correction of hyperglycemia (6.9 ± 4, 6.1 ± 4, and 7.1 ± 5 h) or until resolution of ketoacidosis (10 ± 3, 10.7 ± 3, and 11 ± 3 h) among patients treated with SC-1h and SC-2h or with IV insulin, respectively (NS). There was no mortality and no differences in the length of hospital stay, total amount of insulin administration until resolution of hyperglycemia or ketoacidosis, or the number of hypoglycemic events among treatment groups. CONCLUSIONS—Ou 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 >>

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 >>

Understanding And Treating Diabetic Ketoacidosis

Understanding And Treating Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious metabolic disorder that can occur in animals with diabetes mellitus (DM).1,2 Veterinary technicians play an integral role in managing and treating patients with this life-threatening condition. In addition to recognizing the clinical signs of this disorder and evaluating the patient's response to therapy, technicians should understand how this disorder occurs. DM is caused by a relative or absolute lack of insulin production by the pancreatic b-cells or by inactivity or loss of insulin receptors, which are usually found on membranes of skeletal muscle, fat, and liver cells.1,3 In dogs and cats, DM is classified as either insulin-dependent (the body is unable to produce sufficient insulin) or non-insulin-dependent (the body produces insulin, but the tissues in the body are resistant to the insulin).4 Most dogs and cats that develop DKA have an insulin deficiency. Insulin has many functions, including the enhancement of glucose uptake by the cells for energy.1 Without insulin, the cells cannot access glucose, thereby causing them to undergo starvation.2 The unused glucose remains in the circulation, resulting in hyperglycemia. To provide cells with an alternative energy source, the body breaks down adipocytes, releasing free fatty acids (FFAs) into the bloodstream. The liver subsequently converts FFAs to triglycerides and ketone bodies. These ketone bodies (i.e., acetone, acetoacetic acid, b-hydroxybutyric acid) can be used as energy by the tissues when there is a lack of glucose or nutritional intake.1,2 The breakdown of fat, combined with the body's inability to use glucose, causes many pets with diabetes to present with weight loss, despite having a ravenous appetite. If diabetes is undiagnosed or uncontrolled, a series of metab Continue reading >>

Note: One Μg Is Equivalent To One Microgram

Note: One Μg Is Equivalent To One Microgram

DIABETES Diabetes (diabetes mellitus) is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin or because cells do not respond to the insulin that is produced. High blood sugar (hyperglycaemia) produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). Some oral medications can cause hypoglycaemia (low blood sugars), which can be dangerous if severe. The following are the different types of diabetes: Type 1 diabetes: Insulin-dependent diabetes mellitus or juvenile diabetes. This results from the body's failure to produce insulin. Diabetes type 1 can develop at any time in life but generally appears in childhood and before the age of 40. Diabetes type 1 is caused by the immune system attacking and destroying the beta cells that create insulin which is the hormone required to keep blood sugar levels under control. The unique antibodies that people with diabetes type 1 make target five protein compounds in the body. Glutamate decarboxylase IA-2 Insulin Tetraspanin-7 Zinc transporter-8 Diabetes type 1 is impossible to treat naturally but scientists are hoping that by learning why the immune system develops the antibodies that attack these particular proteins, they may be able to find a way to stop it occurring. Pancreas transplants have been tried with limited success i Continue reading >>

Risks Of Diabetic Ketoacidosis

Risks Of Diabetic Ketoacidosis

People suffering from diabetes could develop diabetic ketoacidosis. This serious complication develops from extremely low level or absence of insulin in the body. Usually type 1 diabetes patients have the greatest risk of developing diabetic ketoacidosis. If left untreated this health disorder could lead to severe health problems and in the worst case, it can even cause death. Diabetic ketoacidosis causes Sugar is the primarily fuel source of your body. Insulin helps the body cells to absorb the sugar. If the insulin level is low, the cells and tissues of your body will not be able to absorb the sugar. To sustain the body functions, your body will now look for an alternate source of energy. Your body will now increase secretion of hormones that break down fat to release energy. In this process of increased fat metabolism, toxins, known as ketones, are produced in the body. Rise in these toxic acids cause severe damage to the organs of the body. If diabetics on insulin treatment miss their insulin medications, the insulin level will drop, triggering diabetic ketoacidosis. Due to an ailment if your body produces excess hormones, such as adrenaline, these hormones will inhibit the activity of insulin, leading to diabetic ketoacidosis. This health disorder could also develop from alcoholism and drug abuse. Stress, trauma, stroke, heart attack, high fever and surgery could increase the risk of developing diabetic ketoacidosis. People suffering from any form of diabetes – type 1 diabetes, type 2 diabetes or gestational diabetes could develop diabetic ketoacidosis any time. However, people with type 1 diabetes, who are below 19, have the greatest risk of developing this health problem. Diabetic ketoacidosis symptoms The symptoms of diabetic ketoacidosis develop rapidly. You Continue reading >>

Diabetes: What Is Ketoacidosis And How Can Be Avoided & Treated?

Diabetes: What Is Ketoacidosis And How Can Be Avoided & Treated?

Good question! According to Wikipedia: Diabetic ketoacidosis is a potentially life-threatening complication in patients with diabetes mellitus. In order to define ketoacidosis a little better, let's go back to the source: diabetes. Someone who is diabetic is unable to produce insulin, a hormone necessary for the transfer of sugar from the bloodstream to the cells, which in turn produce energy. If this progression is disrupted, through lack of insulin for example, the body has to try to compensate by creating energy elsewhere. And so the body starts to burn fat and muscle to meet its energy needs. Unfortunately, this chemical reaction produces molecules known as ketone bodies. In small quantities, these are fine, and it is in fact normal to have traces of them in your blood (approximately 1mg/dl). However, if the quantity of ketones surpasses this threshold by too much, it starts to affect the pH of your blood (which becomes progressively more acidic). Even the slightest drop in pH can have dangerous effects: as the quantity of the ketones in your blood increases, and the blood pH diminishes, your kidneys start having problems. Eventually, if the ketoacidosis is left untreated, your kidneys can fail and you can die from dehydration, tachycardia and hypotension. A number of other symptoms can appear in extreme cases. Fortunately for us, the quantity of ketones has to be consequential, and it usually takes a while before individuals start manifesting symptoms. In my case, my diabetes went undiagnosed for a month and a half before it was discovered, and even then my ketone levels were relatively normal. If you're a diabetic, ketoacidosis can be easily avoided by controlling your blood sugar levels and maintaining a healthy lifestyle. Some doctors, preferring to stay on the Continue reading >>

Diabetes: Diabetic Ketoacidosis

Diabetes: Diabetic Ketoacidosis

www.CardioSmart.org When you have diabetes (especially type 1 diabetes), you are at risk for diabetic ketoacidosis (DKA). This is a dangerous illness that happens when the body does not have enough insulin to use sugar for fuel, and so it breaks down fat and muscle instead. This process breaks down fat into fatty acids, which are turned into another type of acid called ketones. The ketones build up in your blood and change the chemical balance in your body. If not treated, DKA can lead to a coma or even death. DKA can happen if you have little or no insulin in your body and your blood sugar level gets too high. This can happen when you do not take enough insulin or when you have an infection or other illness such as the flu. Being severely dehydrated can also cause it. DKA occurs mostly in people with type 1 diabetes. It occurs less often in people with type 2 diabetes. Symptoms of DKA Symptoms include: • You have flushed, hot, dry skin. • You have a strong, fruity breath odor. • You have loss of appetite, belly pain, and vomiting. • You feel restless. • You have rapid, deep breathing. • You feel confused. • You feel very sleepy, or you have trouble waking up. Young children may not care about doing their normal activities. How to prevent DKA You can help prevent DKA if you: • Take your insulin and other diabetes medicines on time and in the right dose. • Test your blood sugar before meals and at bedtime. Or test as often as your doctor tells you to. This is the best way to know when your blood sugar is high so you can treat it early.Watching for symptoms is not as good. You may not notice them until you have already started making ketones and your blood sugar is very high. • Teach others at work, home, or scho Continue reading >>

Diabetes With Ketone Bodies In Cats

Diabetes With Ketone Bodies In Cats

Diabetic ketoacidosis is an extreme medical emergency that requires immediate veterinary attention. The condition can result in an accumulation of fluid in the brain and lungs, renal failure or heart failure. Affected animals that are not treated are likely to die. With timely intervention and proper treatment, it is likely that an affected cat can recover with little to no side effects. Diabetes mellitus occurs when the pancreas fails to produce sufficient insulin, creating an inability to efficiently process the sugars, fats, and proteins needed for energy. The resulting build-up of sugar causes extreme thirst and frequent urination. Since sugar levels help to control appetite, affected animals may experience a spike in hunger and lose weight at the same time due to the inability to properly process nutrients. In extreme cases, diabetes may be accompanied by a condition known as ketoacidosis. This is a serious ailment that causes energy crisis and abnormal blood-acid levels in affected pets. Cats affected with diabetic ketoacidosis are likely to present with one or more of the following symptoms: Vomiting Weakness Lethargy Depression Excessive Thirst Refusal to drink water Refusal to eat Sudden weight loss Loss of muscle tone Increased urination Dehydration Rough coat Dandruff Rapid breathing Sweet-smelling breath Jaundice The exact cause of diabetes in cats is unknown, but it is often accompanied by obesity, chronic pancreatitis, hormonal disease, or the use of corticosteroids like Prednisone. Ketoacidosis, the buildup of ketone waste products in the blood that occurs when the body burns fat and protein for energy instead of using glucose, is caused by insulin-dependent diabetes. Diabetic ketoacidosis is commonly preceded by other conditions including: Stress Surgery Continue reading >>

Alcoholic Ketoacidosis

Alcoholic Ketoacidosis

Alcoholic ketoacidosis is a complication of alcohol use and starvation that causes excess acid in the bloodstream, resulting in vomiting and abdominal pain. People who go on a major alcohol binge often vomit repeatedly and stop eating. If the vomiting and starvation go on for a day or more, the liver's normal stores of sugar (glucose) decrease. The low glucose stores combined with lack of food intake cause low blood glucose levels. The low blood glucose levels decrease insulin secretion. Without insulin, most cells cannot get energy from the glucose that is in the blood. Cells still need energy to survive, so they switch to a back-up mechanism to obtain energy. Fat cells begin breaking down, producing compounds called ketones. Ketones provide some energy to cells but also make the blood too acidic (ketoacidosis). This ketoacidosis is similar to the ketoacidosis that occurs in diabetes except that, unlike in diabetic ketoacidosis, blood glucose levels are low. Symptoms Symptoms of alcoholic ketoacidosis include Breathing tends to become deep and rapid as the body attempts to correct the blood’s acidity. Similar symptoms in a person with alcoholism may result from acute pancreatitis, methanol or ethylene glycol poisoning, or diabetic ketoacidosis. The doctor must exclude these other causes before diagnosing alcoholic ketoacidosis. Continue reading >>

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