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Is Dka Metabolic Or Respiratory Acidosis?

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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 blood sugar, low blood pH, and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin. Depending on the severity, insulin may be given intravenously or by injection under the skin. Usually potassium is also needed to prevent the development of low blood potassium. Throughout treatment blood sugar and potassium levels should be regularly checked. Antibiotics may be required in those with an underlying infection. In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended. Rates of DKA vary around the world. About 4% of people with type 1 diabetes in United Kingdom develop DKA a year, while in Malaysia the condition affects about 25% a year. DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost universally fatal. The risk of death with adequate and timely treatment is currently around 1–4%. Up to 1% of children with DKA develop a complication known as cerebral edema. The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. Those who measure their glucose levels themselves may notice hyperglycemia (high blood sugar levels). In severe DKA, breathing becomes labored and of a deep, gasping character (a state referred to as "Kussmaul respiration"). The abdomen may be tender to the point that an acute abdomen may be suspected, such as acute pancreatitis, appendicitis or gastrointestinal perforation. Coffee ground vomiting (vomiting of altered blood) occurs in a minority of people; this tends to originate from erosion of the esophagus. In severe DKA, there may be confusion, lethargy, stupor or even coma (a marked decrease in the level of consciousness). On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, tachycardia (a fast heart rate) and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity", often compared to the smell of pear drops whose scent is a ketone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.....

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 Continue reading >>

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  1. sethboss

    Ketogenic diet bad for you

    http://life.familyeducation.com/nutr...ght/35884.html

    Bad Diets
    The diets listed here are unhealthy, especially for an athlete. These diets do not provide enough calories, nutrition, or the right kind of fuel. They strain body organs. Instead of improving health, they risk destroying it. The longer you are on these diets, the greater the risks become.
    Low-Carb/High-Protein Diets
    These diets, including the Atkins Diet, the Ketogenic Diet, the Zone Diet, and the Scarsdale Diet, are extremely popular because of the quick water-weight loss that occurs at the start of the diet. This water-weight loss is mistaken for fat loss, and it quickly returns as soon as the dieting stops. These diets make you look thin and trim because eating proteins is dehydrating, and causes large amounts of body water loss. Although bodybuilders might follow these diets to look more defined, they quickly gain the weight back after competition when they stop dieting. Aerobic athletes, dancers, and performance athletes cannot function effectively on these diets because protein and fats are a terrible source of performance fuel, and the body requires extra water and calories to break them down.
    High-protein, low-carbohydrate diets cause a state of ketosis, chronic dehydration, low appetite, bad breath, and also nausea and depression. These diets are especially dangerous for people with high blood pressure, heart disease, and kidney problems. They can also cause gout. High-protein diets also cause your body to lose calcium, increasing your risk of fractures and osteoporosis. In athletes, the oversupply of protein puts a tremendous strain on your kidneys, which are already stressed by the breakdown products of intense exercise and occasional dehydration; combining these two types of stress on the body can be very dangerous. Also, by missing out on healthy fiber and vitamins found in fruits, vegetables, and grains, you are putting yourself at greater risk of heart and blood vessel problems, digestive problems, and many types of cancer. Women who go off the diet in search of more normal eating tend to immediately gain back weight as the water weight returns. Also, studies have shown that these diets do not cause weight and fat loss any quicker than other types do over the long term. So why take the health risks?
    Wow this person totally rips into keto, what do you think about her argument?

  2. Brakh

    I think she's an idiot. She also probably goes to the gym, does 4 hours of cardio, and goes home. "What's a dumbbell? No you can't lift that, you can injure yourself. Just run, it's good for your heart."

  3. Atavis

    I await something very important... "proof".

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Do you know how to get rid of gas pains? Find out how to get rid of gas pains in video , check What To Do For Gas Pains ! Many people suffer from severe GAS PAINS and it usually occurs when you eat too much food and allow air to enter into the stomach. The pains can also be brought on by leaving your stomach empty for a long time and drinking aerated drinks. Whatever may be the cause of GAS, the PAIN is uncomfortable and at times it can be excruciating. However, there are ways to handle and cope with gas pains. find out How To Get Rid Of Gas Pains Learn how to get rid of gas, and get tips on how to prevent it. Having gas pains are very uncomfortable and irritating feeling. Several factors cause gas pains such as belching, flatulence, abdominal bloating and distention, and abdominal pain and pressure. If ever you are feeling gassy and bloated, there are some remedies on how you can get rid of gas pain in back How To Get Rid Of Gas Pains | Stomach Gas Pain | What To Do For Gas Pains Gas pains often strikes at a most inconvenient time, which is why simple remedies must be at hand for unexpected discomforts such as gas and bloating. Before effective treatment for gas pain can be undertaken however, it must first be evaluated which factors have perpetrated the condition. There are in fact several possible reasons for experiencing gas and by realizing the exact cause for excessive gas in the stomach you will be able to relieve yourself from the symptoms without having to leave your home. There are a host of effective home treatments for gas pain, and the best thing is that they don't cost a lot extra tags : how to get rid of gas how to get rid of gas pains stomach gas pain how to get rid of gas and bloating how to get rid of stomach pain How to get rid of Gas trouble using Natural Home Remedies GAS PAINS! Stomache Ache and Gas Relief Technique Instructional: How To Alleviate Gas Pain How To Get Rid of Gas How to get rid of gas naturally How To Get Rid Of Gas - Learn How To Get Rid Of Gas Easily! How to Get Rid of Gas Pains! How to get rid of gas pains How to Get Rid of Gas

Blood Gas Measurements In Dka: Are We Searching For A Unicorn?

Introduction Recently there have been numerous publications and discussions about whether VBGs can replace ABGs in DKA. The growing consensus is that VBGs are indeed adequate. Eliminating painful, time-consuming arterial blood draws is a huge step in the right direction. However, the ABG vs. VBG debate overlooks a larger point: neither ABG nor VBG measurements are usually helpful. It is widely recommended to routinely obtain an ABG or VBG, for example by both American and British guidelines. Why? Is it helping our patients, or is it something that we do out of a sense of habit or obligation? Diagnosis of DKA: Blood gas doesn’t help These are the diagnostic criteria for DKA from the America Diabetes Association. They utilize either pH or bicarbonate in a redundant fashion to quantify the severity of acidosis. It is unclear what independent information the pH adds beyond what is provided by the bicarbonate. Practically speaking, the blood gas doesn’t help diagnose DKA. This diagnosis should be based on analysis of the metabolic derangements in the acid-base status (e.g. anion gap, beta-hydroxybutyrate level). The addition of a blood gas to serum chemistries only adds information Continue reading >>

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  1. metalmd06

    Does acute DKA cause hyperkalemia, or is the potassium normal or low due to osmotic diuresis? I get the acute affect of metabolic acidosis on potassium (K+ shifts from intracellular to extracellular compartments). According to MedEssentials, the initial response (<24 hours) is increased serum potassium. The chronic effect occuring within 24 hours is a compensatory increase in Aldosterone that normalizes or ultimatley decreases the serum K+. Then it says on another page that because of osmotic diuresis, there is K+ wasting with DKA. On top of that, I had a question about a diabetic patient in DKA with signs of hyperkalemia. Needless to say, I'm a bit confused. Any help is appreciated.

  2. FutureDoc4

    I remember this being a tricky point:
    1) DKA leads to a decreased TOTAL body K+ (due to diuresis) (increase urine flow, increase K+ loss)
    2) Like you said, during DKA, acidosis causes an exchange of H+/K+ leading to hyperkalemia.
    So, TOTAL body K+ is low, but the patient presents with hyperkalemia. Why is this important? Give, insulin, pushes the K+ back into the cells and can quickly precipitate hypokalemia and (which we all know is bad). Hope that is helpful.

  3. Cooolguy

    DKA-->Anion gap M. Acidosis-->K+ shift to extracellular component--> hyperkalemia-->symptoms and signs
    DKA--> increased osmoles-->Osmotic diuresis-->loss of K+ in urine-->decreased total body K+ (because more has been seeped from the cells)
    --dont confuse total body K+ with EC K+
    Note: osmotic diuresis also causes polyuria, ketonuria, glycosuria, and loss of Na+ in urine--> Hyponatremia
    DKA tx: Insulin (helps put K+ back into cells), and K+ (to replenish the low total potassium
    Hope it helps

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In this video we present a patient with DKA who is exhibiting the Kussmaul breathing pattern associated with metabolic acidosis.

Kussmaul Breathing - An Overview | Sciencedirect Topics

Nicholas J. White, in Manson's Tropical Infectious Diseases (Twenty-third Edition) , 2014 Hyperventilation or Kussmaul's breathing (sometimes termed respiratory distress) is a poor prognostic sign in malaria. In the tachypnoea associated with high fever, breathing is shallow compared with the ominous laboured hyperventilation associated with metabolic acidosis, pulmonary oedema or bronchopneumonia. Acute pulmonary oedema (acute respiratory distress syndrome) may develop at any time in severe falciparum malaria. It is particularly common in pregnant women, but rare in children. In some cases malaria ARDS may be difficult to distinguish clinically from pneumonia. The heart sounds are normal. The central venous pressure and pulmonary artery occlusion pressures are usually normal, the cardiac index is high and systemic vascular resistance is low. This points to an increase in capillary permeability (unless the patient has been overhydrated). The chest radiograph shows increased interstitial shadowing and a normal heart size. Julian L. Seifter, in Goldman's Cecil Medicine (Twenty Fourth Edition) , 2012 Symptoms include nausea, vomiting, anorexia, polydipsia, and polyuria. Patients ofte Continue reading >>

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  1. Steve Rapaport

    Correlation isn't causation, so the question's presupposition of high blood sugar 'resulting' in diabetic coma is wrong. They both result from common causes.
    Diabetic coma (advanced diabetic ketoacidosis or DKA) is not the result of high blood sugar, but of low insulin and water levels. Low insulin levels lead to high blood sugar AND to ketoacidosis. Hence there's no minimum blood sugar level to watch for (though there may be for a given individual).
    The best way to avoid DKA is to keep insulin levels steady in the bloodstream, keep well hydrated, and keep small amounts of food in the system at all times.
    DKA is a result of the body demanding sugar for fuel, and being denied it through lack of insulin. The body burns fat instead, which produces ketone bodies as a byproduct. The ketones build up in blood, making it acid and highly concentrated. Concentrated blood sucks water out of cells by osmosis. Dehydration makes this worse. The ketones signal the liver that glucose is desperately needed, so it dumps stored glucose to help out, but in the absence of insulin this just makes things worse -- now the blood is full of ketones AND glucose, and even more highly concentrated. Both of these conditions will get worse until fast-acting insulin and missing electrolytes are added in carefully controlled doses, including a drip-feed for hydration and frequent recheck and adjustment of all those values.

  2. Suhail Malhotra

    First we must know that there are 2 types of diabetes.
    IDDM(insulin dependent diabetes mellitus) aka Type 1
    NIDDM( non insulin dependent diabetes mellitus) aka Type 2.
    Type 1 is due to loss of insulin secretion by pancreas as in destruction of pancreas.
    Type 2 is due to insulin resistance that is insulin secretion is ok but body cells don't respond to it.
    Now the comas in these two types are different to the extent that they are named differently.
    The coma of type 1 is called the DKA(diabetic ketoacidosis) and that of type 2 is HONK( hyperosmotic non ketotic coma) now known as HHS(hyperglycemic hyperosmolar state).
    DKA occurs in type 1 diabetes or situations simulating type 1 mechanism like when a patient forgets to take his dose of insulin or in states when patient is regular with insulin but the body needs more than normal as in cases of surgery or illness or pregnancy.
    Blood glucose ranges in DKA from 250 to 600 mg/dl( 13 to 33 mmol/l) with increased ketones in blood which being acidic drive the blood ph to acidic levels ( <7.3). Symptoms include vomiting,increased urination, increased thirst, abdominal pain,increased rate of respiration(Kussumaul breathing) and in the end coma.
    HONK or HHS is caused by type 2 diabetes or situations similar to it like relative insulin deficiency combined with inadequate fluid intake and often precipitated in patients with type2 DM and a concurrent illness.
    Blood glucose ranges from 600 to 1200 mg/dl (33 to 66 mmol/l). The blood ph is normal (>=7.3) as ketones are absent. Patient is lethargic with increased thirst and increased urination leading to coma.
    Symptoms absent in HONK are nausea, vomiting, abdominal pain and increased rate of respiration which were very much a part of DKA.

  3. Jae Won Joh

    If you are asking what blood sugar levels are commonly seen in diabetic coma[1], there is a very wide range. Patients naive to the condition typically present with blood glucoses around the 300s, while those with chronic poorly-managed diabetes can present with blood glucoses over 1000.
    [1] As Steve Rapaport already pointed out in his answer, the high glucose level is not, in and of itself, the problem.

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