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Is Dka Serious?

Diabetic Ketoacidosis

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 >>

How Do You Determine When Is Diabetic Ketoacidosis Serious Enough To Seek Professional Medical Assistance?

How Do You Determine When Is Diabetic Ketoacidosis Serious Enough To Seek Professional Medical Assistance?

If you have DKA, you should seek medical assistance. There is no “safe level.” It is potentially dangerous, and even if you don’t have any immediate perception of damage, over time the acidity of the acidosis can, over time, do a lot of damage to your body. How do you know if you have it? If you have high blood sugar readings and ketones are present in your urine, you should see a doctor as soon as possible. If the amount of ketones is “large”, it is a medical emergency, regardless of how you feel or what other symptoms you have. You test for ketones by using Ketostix. Dip the tip in fresh urine caught for the purpose, The tip will turn colors, indicating the presence of urine. The color will indicate the amount of ketones, with the most intense colors meaning the highest levels. Check the expiration date on the Ketostix. If you do not test for ketones frequently, they may expire before they are used up and you should not rely on them. They may be better than nothing if that is all you have. As a diabetic or the caregiver of a diabetic, you should have Ketostix on hand. The doctor can tell you at what blood sugar reading you should check for ketones. It might be something like above 300, which means that whenever you get a reading of 300 or above, you should check for ketones. Ketones cause the urine to have an identifiable smell often described as fruity or acetone-like. If you can smell that, your level of ketones is high enough that you should see a doctor, regardless of whether you have any Ketostix. Wikipedia has an article about diabetic ketoacidosis. Continue reading >>

How The Treatment Of Diabetic Ketoacidosis Has Improved

How The Treatment Of Diabetic Ketoacidosis Has Improved

For patients with type 1 diabetes, one of the most serious medical emergencies is diabetic ketoacidosis (DKA). It can be life-threatening and, in most cases, is caused by a shortage of insulin. Glucose is the “fuel” which feeds human cells. Without it, these cells are forced to “burn” fatty acids in order to survive. This process leads to the production of acidic ketone bodies which can cause serious symptoms and complications such as passing out, confusion, vomiting, dehydration, coma, and, if not corrected in a timely manner, even death. High levels of ketones poison the body. DKA can be diagnosed with blood and urine tests and is distinguished from other ketoacidosis by the presence of high blood sugar levels. Typical treatment for DKA consists of using intravenous fluids to correct the dehydration, insulin dosing to suppress the production of ketones, and treatment for any underlying causes such as infections. Medical history notes that DKA was first diagnosed and described in 1886 and until insulin therapy was introduced in the 1920’s, this condition was almost universally fatal. However, with availability and advances in insulin therapy, the mortality rate is less than one percent when timely treatment is applied. A Clinical Pharmacist Examines DKA Ron Fila (RPh) is a clinical pharmacist at McLaren Northern Michigan in Petoskey, MI. He has first-hand experience in treating patients with DKA and, as one of the early adaptors of EndoTool he has seen how this algorithmically-based glucose management software can help physicians save lives and improve patient outcomes. “We started using EndoTool in 2013, for treating patients in the ICU,” he noted in a recent interview. “Later, we expanded our use of this software for DKA and pediatrics. “Since DKA i Continue reading >>

Diabetic Ketoacidosis In Adults

Diabetic Ketoacidosis In Adults

What you should know Diabetic ketoacidosis (DKA) is a common, serious, and preventable complication of type 1 diabetes, with a mortality of 3-5%. It can also occur in patients with other types of diabetes It can be the first presentation of diabetes. This accounts for about 6% of cases The diagnosis is not always apparent and should be considered in anyone with diabetes who is unwell Diagnosis is based on biochemical criteria. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA Immediate treatment consists of intravenous fluids, insulin, and potassium, with careful monitoring of blood glucose and potassium levels to avoid hypoglycaemia and hypokalaemia Knowledge of the type of diabetes at the time of DKA does not affect immediate treatment, and all patients with DKA should be advised to continue with insulin on discharge Subsequent management should focus on patient education and support to avoid recurrence Patients should be managed by a specialist multidisciplinary team during and after an episode of DKA What is DKA? Diabetic ketoacidosis (DKA) is an extreme metabolic state caused by insulin deficiency. The breakdown of fatty acids (lipolysis) produces ketone bodies (ketogenesis), which are acidic. Acidosis occurs when ketone levels exceed the body’s buffering capacity (figure⇓).1 2 Diabetic ketoacidosis may follow absolute insulin deficiency or relative insulin deficiency. Relative insulin deficiency may occur in the presence of increased levels of counter-regulatory hormones such as glucagon, cortisol, and catecholamines. Insulin deficiency results in lipolysis and ketogenesis. Ketone bodies are acidic and may initially be buffered, but when levels are high enough, will result in acidosis How common Continue reading >>

Diabetic Ketoacidosis (dka) Among Children And Young People With Type 1 Diabetes

Diabetic Ketoacidosis (dka) Among Children And Young People With Type 1 Diabetes

This fact sheet provides the most recent available data on hospitalisations for diabetic ketoacidosis (DKA)—a serious complication of diabetes. It highlights that DKA continues to affect many children and young people with type 1 diabetes, in particular females and those living in regional and remote areas and in lower socioeconomic areas. People aged less than 25 years accounted for 54% of all DKA hospitalisations of those with type 1 diabetes DKA hospitalisation rates 1.5 times as high for Outer regional and Remote and very remote areas than for Major cities DKA hospitalisation rates were 1.4 times as high in females as males. 16% of DKA hospitalisation of young people had also a diagnosis of psychological or behavioural conditions Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

What Is It? Diabetic ketoacidosis is a potentially fatal complication of diabetes that occurs when you have much less insulin than your body needs. This problem causes the blood to become acidic and the body to become dangerously dehydrated. Diabetic ketoacidosis can occur when diabetes is not treated adequately, or it can occur during times of serious sickness. To understand this illness, you need to understand the way your body powers itself with sugar and other fuels. Foods we eat are broken down by the body, and much of what we eat becomes glucose (a type of sugar), which enters the bloodstream. Insulin helps glucose to pass from the bloodstream into body cells, where it is used for energy. Insulin normally is made by the pancreas, but people with type 1 diabetes (insulin-dependent diabetes) don't produce enough insulin and must inject it daily. Your body needs a constant source of energy. When you have plenty of insulin, your body cells can get all the energy they need from glucose. If you don't have enough insulin in your blood, your liver is programmed to manufacture emergency fuels. These fuels, made from fat, are called ketones (or keto acids). In a pinch, ketones can give you energy. However, if your body stays dependent on ketones for energy for too long, you soon will become ill. Ketones are acidic chemicals that are toxic at high concentrations. In diabetic ketoacidosis, ketones build up in the blood, seriously altering the normal chemistry of the blood and interfering with the function of multiple organs. They make the blood acidic, which causes vomiting and abdominal pain. If the acid level of the blood becomes extreme, ketoacidosis can cause falling blood pressure, coma and death. Ketoacidosis is always accompanied by dehydration, which is caused by high Continue reading >>

Diabetic Ketoacidosis: A Serious Complication

Diabetic Ketoacidosis: A Serious Complication

A balanced body chemistry is crucial for a healthy human body. A sudden drop in pH can cause significant damage to organ systems and even death. This lesson takes a closer look at a condition in which the pH of the body is severely compromised called diabetic ketoacidosis. Definition Diabetic ketoacidosis, sometimes abbreviated as DKA, is a condition in which a high amount of acid in the body is caused by a high concentration of ketone bodies. That definition might sound complicated, but it's really not. Acidosis itself is the state of too many hydrogen ions, and therefore too much acid, in the blood. A pH in the blood leaving the heart of 7.35 or less indicates acidosis. Ketones are the biochemicals produced when fat is broken down and used for energy. While a healthy body makes a very low level of ketones and is able to use them for energy, when ketone levels become too high, they make the body's fluids very acidic. Let's talk about the three Ws of ketoacidosis: who, when, and why. Type one diabetics are the group at the greatest risk for ketoacidosis, although the condition can occur in other groups of people, such as alcoholics. Ketoacidosis usually occurs in type one diabetics either before diagnosis or when they are subjected to a metabolic stress, such as a severe infection. Although it is possible for type two diabetics to develop ketoacidosis, it doesn't happen as frequently. To understand why diabetic ketoacidosis occurs, let's quickly review what causes diabetes. Diabetics suffer from a lack of insulin, the protein hormone responsible for enabling glucose to get into cells. This inability to get glucose into cells means that the body is forced to turn elsewhere to get energy, and that source is fat. As anyone who exercises or eats a low-calorie diet knows, fa Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious problem that can happen in people with diabetes. DKA should be treated as a medical emergency. This is because it can lead to coma or death. If you have the symptoms of DKA, get medical help right away. DKA happens more often in people with type 1 diabetes. But it can happen in people with type 2 diabetes. It can also happen in women with diabetes during pregnancy. This is often known as gestational diabetes. DKA happens when insulin levels are too low. Without enough insulin, sugar (glucose) can’t get to the cells of your body. The glucose stays in the blood. This causes high blood glucose (hyperglycemia). Without glucose, your body breaks down stored fat for energy. When this happens, acids called ketones are released into the blood. This is known as ketosis. High levels of ketones (ketoacidosis) can be harmful to you. Hyperglycemia and ketoacidosis can also cause serious problems in the blood and your body, such as: Low levels of potassium (hypokalemia) Swelling inside the brain (cerebral edema) Fluid in the lungs (pulmonary edema) Damage to kidneys or other organs What causes diabetic ketoacidosis? In people with diabetes, DKA is most often caused by too little insulin in the body. It is also caused by: Poor management of diabetes Infections like a urinary tract infection or pneumonia Serious health problems, such as a heart attack Reactions to certain prescribed medicines and illicit drugs Symptoms of diabetic ketoacidosis DKA most often happens slowly over time. But it can worsen in a few hours if you are vomiting. The first symptoms are: Thirst and dry mouth Urinating a lot Belly pain Nausea or vomiting Breath that smells fruity (from the ketones) Over time, these symptoms may happen: Dry or flushed skin Nausea and vomit Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus. Before the availability of insulin in the 1920s, DKA was a uniformly fatal disorder. Even after the discovery of insulin, DKA continued to carry a grave prognosis with a reported mortality rate in humans ranging from 10% to 30%. However, with the expanding knowledge regarding the pathophysiology of DKA and the application of new treatment techniques for the complications of DKA, the mortality rate for this disorder has decreased to less than 5% in experienced human medical centers (Kitabchi et al, 2008). We have experienced a similar decrease in the mortality rate for DKA in our hospital over the past two decades. DKA remains a challenging disorder to treat, in part because of the deleterious impact of DKA on multiple organ systems and the frequent occurrence of concurrent often serious disorders that are responsible for the high mortality rate of DKA. In humans, the incidence of DKA has not decreased, appropriate therapy remains controversial, and patients continue to succumb to this complication of diabetes mellitus. This chapter summarizes current concepts regarding the pathophysiology and management of DKA in dogs and cats. • Diabetic ketoacidosis (DKA) is a severe form of complicated diabetes mellitus that requires emergency care. • Acidosis and electrolyte abnormalities can be life threatening. • Fluid therapy and correction of electrolyte abnormalities are the two most important components of therapy. • Concurrent disease increases the risk for DKA and must be addressed as part of the diagnostic and therapeutic plan. • Bicarbonate therapy usually is not needed and its use is controversial. • About 70% of treated dogs and cats are discharged from the hospital after 5 to 6 days Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Practice Essentials Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria. Signs and symptoms The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia History of failure to comply with insulin therapy or missed insulin injections due to vomiting or psychological reasons or history of mechanical failure of insulin infusion pump Altered consciousness (eg, mild disorientation, confusion); frank coma is uncommon but may occur when the condition is neglected or with severe dehydration/acidosis Signs and symptoms of DKA associated with possible intercurrent infection are as follows: See Clinical Presentation for more detail. Diagnosis On examination, general findings of DKA may include the following: Characteristic acetone (ketotic) breath odor In addition, evaluate patients for signs of possible intercurrent illnesses such as MI, UTI, pneumonia, and perinephric abscess. Search for signs of infection is mandatory in all cases. Testing Initial and repeat laboratory studies for patients with DKA include the following: Serum electrolyte levels (eg, potassium, sodium, chloride, magnesium, calcium, phosphorus) Note that high serum glucose levels may lead to dilutional hyponatremia; high triglyceride levels may lead to factitious low glucose levels; and high levels of ketone bodies may lead to factitious elevation of creatinine levels. Continue reading >>

Diabetic Ketoacidosis - Symptoms

Diabetic Ketoacidosis - Symptoms

A A A Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel. In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common. The most common Continue reading >>

Symptoms Of Diabetic Ketoacidosis & Treatment Options

Symptoms Of Diabetic Ketoacidosis & Treatment Options

Let’s set the stage first: the sugars in your food are ingested and travel to your intestines where they are released into your bloodstream. This sugar is called glucose. The sugar tries to enter your cells to provide energy but can’t because the sugar molecules are too big. At this point your pancreas produces insulin which attaches to your cells to create openings for the glucose to enter which gives you energy. Now here’s where diabetic ketoacidosis comes in: when the cells in your body are unable to get the sugar they need for energy because you aren’t producing enough insulin, your body starts to break down fat and muscle as fuel. This causes DKA which is when high levels of blood acids called ketones enter the bloodstream. DKA is a serious condition that can lead to a diabetic coma or even death. Diabetic Ketoacidosis: Symptoms DKA is a serious condition and it is important to be aware of its warning signs. Early signs of DKA may include: Thirst or a very dry mouth Frequent urination High blood glucose (sugar) levels Symptoms that follow: Feeling continually tired Dry or flushed skin Nausea or abdominal pain Vomiting that continues for more than 2 hours Difficulty breathings A hard time paying attention or feeling confused Diabetic Ketoacdosis: Treatment Options If your are diagnosed with DKA, you may be treated in the emergency room or admitted into the hospital. From there, you will be given fluids to prevent dehydration and dilute blood sugar. Next, your doctor will replace your electrolytes since those levels probably decreased when your insulin levels dropped. (Electrolytes are minerals that carry an electric charge in your body that help your heart, muscles and nerve cells to function normally.) Finally, you’ll be given insulin to get your body wor Continue reading >>

The Serious Side Of The Flu For People With T1d

The Serious Side Of The Flu For People With T1d

The flu can increase the risk of diabetic ketoacidosis (DKA), a serious acute complication of type 1 diabetes (T1D) that results from too little insulin DKA is normally seen in states of prolonged fasting or starvation. The body shifts metabolism from primarily using glucose to using an alternate fuel pathway, ketones, derived from fatty acids. A key signal for this shift is very low insulin levels. However, in T1D this shift can happen within a few hours when too little insulin is administered, often in the setting of another illness such as an infection or flu (the basal insulin in a basal/bolus insulin regimen typically blocks the production of ketones). The ketones build up in the blood stream and make the blood more acidic and can be associated with dangerous shifts in many of the essential electrolytes. Usually the low insulin levels that can result in DKA are also associated with a rise in blood glucose (typically above 250 mg/dL), which can be an early warning signal. Other signs of DKA include flu-like symptoms (feeling tired, weak, aches, nausea or vomiting, abdominal pain), dehydration and also a fruity smell to the breath with more rapid breathing, which happens when the body is trying to eliminate the ketones and acid. In more severe cases there can be confusion or coma. Unfortunately, DKA is a relatively common occurrence at the time of initial diagnosis of T1D and 4.8% of adults living with T1D reported one or more episodes of DKA in the past year. Although treatment of DKA has improved greatly, it still accounts for about 1 out of 14 deaths in people with T1D. Seven things that you can you do: Talk about DKA with your diabetes care team! Often we talk a lot about DKA around the time of diagnosis, but not so much in the years afterward. Discuss whether te Continue reading >>

Diabetic Ketoacidosis (dka) - Topic Overview

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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Introduction Diabetic ketoacidosis (DKA) is a dangerous complication of diabetes caused by a lack of insulin in the body. Diabetic ketoacidosis occurs when the body is unable to use blood sugar (glucose) because there isn't enough insulin. Instead, it breaks down fat as an alternative source of fuel. This causes a build-up of a by-product called ketones. Most cases of diabetic ketoacidosis occur in people with type 1 diabetes, although it can also be a complication of type 2 diabetes. Symptoms of diabetic ketoacidosis include: passing large amounts of urine feeling very thirsty vomiting abdominal pain Seek immediate medical assistance if you have any of these symptoms and your blood sugar levels are high. Read more about the symptoms of diabetic ketoacidosis. Who is affected by diabetic ketoacidosis? Diabetic ketoacidosis is a relatively common complication in people with diabetes, particularly children and younger adults who have type 1 diabetes. Younger children under four years of age are thought to be most at risk. In about 1 in 4 cases, diabetic ketoacidosis develops in people who were previously unaware they had type 1 diabetes. Diabetic ketoacidosis accounts for around half of all diabetes-related hospital admissions in people with type 1 diabetes. Diabetic ketoacidosis triggers These include: infections and other illnesses not keeping up with recommended insulin injections Read more about potential causes of diabetic ketoacidosis. Diagnosing diabetic ketoacidosis This is a relatively straightforward process. Blood tests can be used to check your glucose levels and any chemical imbalances, such as low levels of potassium. Urine tests can be used to estimate the number of ketones in your body. Blood and urine tests can also be used to check for an underlying infec Continue reading >>

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