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Is Ketoacidosis Curable

Our Diabetes Story: My 11 Year Old Son Went Into Diabetic Ketoacidosis And Was Diagnosed With Type 1 Diabetes

Our Diabetes Story: My 11 Year Old Son Went Into Diabetic Ketoacidosis And Was Diagnosed With Type 1 Diabetes

We had a really scary time this week — my 11-year-old son ended up in the Pediatric ICU at the local children’s hospital for two days due to Diabetic Ketoacidosis and we found out he has Type 1 Diabetes. I’m sharing our story because I missed obvious signs. Maybe another parent or caregiver might miss signs too. Maybe this will save a kid from going into Diabetic Ketoacidosis. While Type 1 Diabetes is not curable; maybe if I had put things together, we could have prevented a 2 day stay in the Pediatric Intensive Care unit. Our Diabetes Story: My 11 Year old Son Went Into Diabetic Ketoacidosis and Has Type 1 Diabetes According to the Juvenile Diabetes Research Foundation: “Knowing the warning signs for type 1 diabetes could help save a life! Type 1 diabetes can often go undiagnosed in its early stages because the symptoms can be mistaken for more common illnesses, like the flu. Take notice if you or your loved one experiences the following: Extreme thirst Frequent urination Drowsiness and lethargy Sugar in urine Sudden vision changes Increased appetite Sudden weight loss Fruity, sweet, or wine-like odor on breath Heavy, labored breathing Stupor or unconsciousness Call your doctor immediately if one or more of these symptoms occurs in you or your loved one. It is extremely important to receive medical attention—misdiagnosis or leaving your condition untreated can have tragic consequences, including death.” This is how we wound up at the hospital: Last Friday night B vomited (food) late at night. I didn’t think anything of it because he had eaten ice cream with his cousins and then miso soup and samosas for dinner. Crazy combination, right? He was fine all weekend after that and I was watching him closely. He seemed tired and very thirsty. (WARNING SIGNS). Ho Continue reading >>

Diagnosis

Diagnosis

Print If your doctor suspects diabetic ketoacidosis, he or she will do a physical exam and various blood tests. In some cases, additional tests may be needed to help determine what triggered the diabetic ketoacidosis. Blood tests Blood tests used in the diagnosis of diabetic ketoacidosis will measure: Blood sugar level. If there isn't enough insulin in your body to allow sugar to enter your cells, your blood sugar level will rise (hyperglycemia). As your body breaks down fat and protein for energy, your blood sugar level will continue to rise. Ketone level. When your body breaks down fat and protein for energy, acids known as ketones enter your bloodstream. Blood acidity. If you have excess ketones in your blood, your blood will become acidic (acidosis). This can alter the normal function of organs throughout your body. Additional tests Your doctor may order tests to identify underlying health problems that might have contributed to diabetic ketoacidosis and to check for complications. Tests might include: Blood electrolyte tests Urinalysis Chest X-ray A recording of the electrical activity of the heart (electrocardiogram) Treatment If you're diagnosed with diabetic ketoacidosis, you might be treated in the emergency room or admitted to the hospital. Treatment usually involves: Fluid replacement. You'll receive fluids — either by mouth or through a vein (intravenously) — until you're rehydrated. The fluids will replace those you've lost through excessive urination, as well as help dilute the excess sugar in your blood. Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge, such as sodium, potassium and chloride. The absence of insulin can lower the level of several electrolytes in your blood. You'll receive electrolytes throu Continue reading >>

Diabetic Ketoacidosis Causes, Symptoms, Treatment, And Complications

Diabetic Ketoacidosis Causes, Symptoms, Treatment, And Complications

Diabetic ketoacidosis definition and facts Diabetic ketoacidosis is a life-threatening complication of type 1 diabetes (though rare, it can occur in people with type 2 diabetes) that occurs when the body produces high levels of ketones due to lack of insulin. Diabetic ketoacidosis occurs when the body cannot produce enough insulin. The signs and symptoms of diabetic ketoacidosis include Risk factors for diabetic ketoacidosis are type 1 diabetes, and missing insulin doses frequently, or being exposed to a stressor requiring higher insulin doses (infection, etc). Diabetic ketoacidosis is diagnosed by an elevated blood sugar (glucose) level, elevated blood ketones and acidity of the blood (acidosis). The treatment for diabetic ketoacidosis is insulin, fluids and electrolyte therapy. Diabetic ketoacidosis can be prevented by taking insulin as prescribed and monitoring glucose and ketone levels. The prognosis for a person with diabetic ketoacidosis depends on the severity of the disease and the other underlying medical conditions. Diabetic ketoacidosis (DKA) is a severe and life-threatening complication of diabetes. Diabetic ketoacidosis occurs when the cells in our body do not receive the sugar (glucose) they need for energy. This happens while there is plenty of glucose in the bloodstream, but not enough insulin to help convert glucose for use in the cells. The body recognizes this and starts breaking down muscle and fat for energy. This breakdown produces ketones (also called fatty acids), which cause an imbalance in our electrolyte system leading to the ketoacidosis (a metabolic acidosis). The sugar that cannot be used because of the lack of insulin stays in the bloodstream (rather than going into the cell and provide energy). The kidneys filter some of the glucose (suga Continue reading >>

Diabetes With Ketone Bodies In Dogs

Diabetes With Ketone Bodies In Dogs

Diabetes Mellitus with Ketoacidosis in Dogs Diabetes is a medical condition in which the body cannot absorb sufficient glucose, thus causing a rise the blood sugar levels. The term “ketoacidosis,” meanwhile, refers to a condition in which levels of acid abnormally increased in the blood due to presence of “ketone bodies”. In diabetes with ketoacidosis, ketoacidosis immediately follows diabetes. It should be considered a dire emergency, one in which immediate treatment is required to save the life of the animal. This condition typically affects older dogs as well as females. In addition, miniature poodles and dachshunds are predisposed to diabetes with ketoacidosis. Symptoms and Types Weakness Lethargy Depression Lack of appetite (anorexia) Muscle wasting Rough hair coat Dehydration Dandruff Sweet breath odor Causes Although the ketoacidosis is ultimately brought on by the dog's insulin dependency due to diabetes mellitus, underlying factors include stress, surgery, and infections of the skin, respiratory, and urinary tract systems. Concurrent diseases such as heart failure, kidney failure, asthma, cancer may also lead to this type of condition. Diagnosis You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then perform a complete physical examination, as well as a biochemistry profile and complete blood count (CBC). The most consistent finding in patients with diabetes is higher than normal levels of glucose in the blood. If infection is present, white blood cell count will also high. Other findings may include: high liver enzymes, high blood cholesterol levels, accumulation in the blood of nitrogenous waste products (urea) that are usually excreted in the urine (azo Continue reading >>

Diabetes Complications In Dogs And Cats: Diabetes Ketoacidosis (dka)

Diabetes Complications In Dogs And Cats: Diabetes Ketoacidosis (dka)

Unfortunately, we veterinarians are seeing an increased prevalence of diabetes mellitus in dogs and cats. This is likely due to the growing prevalence of obesity (secondary to inactive lifestyle, a high carbohydrate diet, lack of exercise, etc.). So, if you just had a dog or cat diagnosed with diabetes mellitus, what do you do? First, we encourage you to take a look at these articles for an explanation of the disease: Diabetes Mellitus (Sugar Diabetes) in Dogs Once you have a basic understanding of diabetes mellitus (or if you already had one), this article will teach you about life-threatening complications that can occur as a result of the disease; specifically, I discuss a life-threatening condition called diabetes ketoacidosis (DKA) so that you know how to help prevent it! What is DKA? When diabetes goes undiagnosed, or when it is difficult to control or regulate, the complication of DKA can occur. DKA develops because the body is so lacking in insulin that the sugar can’t get into the cells -- resulting in cell starvation. Cell starvation causes the body to start breaking down fat in an attempt to provide energy (or a fuel source) to the body. Unfortunately, these fat breakdown products, called “ketones,” are also poisonous to the body. Symptoms of DKA Clinical signs of DKA include the following: Weakness Not moving (in cats, hanging out by the water bowl) Not eating to complete anorexia Large urinary clumps in the litter box (my guideline? If it’s bigger than a tennis ball, it’s abnormal) Weight loss (most commonly over the back), despite an overweight body condition Excessively dry or oily skin coat Abnormal breath (typically a sweet “ketotic” odor) In severe cases DKA can also result in more significant signs: Abnormal breathing pattern Jaundice Ab Continue reading >>

Diabetes With Ketone Bodies In Dogs

Diabetes With Ketone Bodies In Dogs

Studies show that female dogs (particularly non-spayed) are more prone to DKA, as are older canines. Diabetic ketoacidosis is best classified through the presence of ketones that exist in the liver, which are directly correlated to the lack of insulin being produced in the body. This is a very serious complication, requiring immediate veterinary intervention. Although a number of dogs can be affected mildly, the majority are very ill. Some dogs will not recover despite treatment, and concurrent disease has been documented in 70% of canines diagnosed with DKA. Diabetes with ketone bodies is also described in veterinary terms as diabetic ketoacidosis or DKA. It is a severe complication of diabetes mellitus. Excess ketone bodies result in acidosis and electrolyte abnormalities, which can lead to a crisis situation for your dog. If left in an untreated state, this condition can and will be fatal. Some dogs who are suffering from diabetic ketoacidosis may present as systemically well. Others will show severe illness. Symptoms may be seen as listed below: Change in appetite (either increase or decrease) Increased thirst Frequent urination Vomiting Abdominal pain Mental dullness Coughing Fatigue or weakness Weight loss Sometimes sweet smelling breath is evident Slow, deep respiration. There may also be other symptoms present that accompany diseases that can trigger DKA, such as hypothyroidism or Cushing’s disease. While some dogs may live fairly normal lives with this condition before it is diagnosed, most canines who become sick will do so within a week of the start of the illness. There are four influences that can bring on DKA: Fasting Insulin deficiency as a result of unknown and untreated diabetes, or insulin deficiency due to an underlying disease that in turn exacerba Continue reading >>

Diabetic Ketoacidosis As A Presenting Symptom Of Complicated Pancreatic Cancer

Diabetic Ketoacidosis As A Presenting Symptom Of Complicated Pancreatic Cancer

To the Editor, Pancreatic adenocarcinoma is an aggressive cancer; the tumor is localized and potentially curable in fewer than 20% of patients at diagnosis. Thus, the overall 5-year survival rate of pancreatic cancer is less than 5%. Several studies have found an increased incidence of pancreatic cancer in patients with diabetes mellitus (DM); however, other studies have shown that pancreatic cancer may cause glucose intolerance. Diabetic ketoacidosis (DKA) is a lethal complication of DM characterized by severe hyperglycemia and metabolic ketoacidosis caused by absolute or relative insulin def iciency. However, DKA is rarely an initial presenting symptom of complicated pancreatic adenocarcinoma. Here we present a case of pancreatic adenocarcinoma that manifested as DKA and its diagnosis was delayed because of a coexisting pancreatic abscess; additionally, we review the relevant literature. A 36-year-old woman visited our emergency department complaining of dyspnea, fever, and abdominal discomfort. She had a history of gestational diabetes mellitus (GDM) during her second pregnancy (6 years ago) and had no familial history of DM or malignancies including pancreatic cancer. She had no history of smoking or alcohol consumption. On arrival, her vital signs were as follows: blood pressure 130/80 mmHg, heart rate 130 per minute, respiration rate 32 per minute, and body temperature 38.6℃. Physical examination showed a soft and non-tender abdomen and no abnormal findings. Laboratory f indings were as follows: urinalysis (glucose [+++], ketone [++++], protein [+]), random serum glucose 334 mg/dL, arterial blood gas analysis (pH 7.1, HCO3 4.5 mmol/L, anion gap 17.6), serum osmolality 285 mOsm/kg, white blood cell count 27.95 (4.8-10.8)×103/µL, high-sensitivity C-reactive prot Continue reading >>

Questions To Ask The Hospitalist When Diagnosed With Dka Or Diabetic Ketoacidosis

Questions To Ask The Hospitalist When Diagnosed With Dka Or Diabetic Ketoacidosis

Diabetic Ketoacidosis What is DKA? Diabetic ketoacidosis is a condition that affects diabetes mellitus patients; it is a serious complication of diabetes mellitus whereby the body produces ketone bodies. These ketone bodies are high levels of blood acids. How do I suspect DKA? The signs and symptoms of diabetic ketoacidosis usually develop and appear rapidly, sometimes in 24 hours or less. Some of the signs and symptoms that may be noticed include: Frequent urination Frequent thirst Fruity scented breath Excessive thirst Nausea and vomiting Abdominal pain Shortness of breath Hyperglycemia Ketone bodies in blood Why do I have DKA? Diabetic ketoacidosis can occur in only diabetic patients. Sometimes it is the first sign in people with type 1 diabetes who haven’t been diagnosed; it can also occur in those who have been. It occurs less commonly in people with type 2 diabetes. Ketoacidosis can be caused by any of the following: Missed doses of insulin shots Infections Injuries or surgery Uncontrolled blood sugar Missed doses of medicines Serious illnesses Is DKA curable? No, diabetic acidosis isn’t curable but there are medications that can help you control the signs and symptoms and the slow down the progression of the disease so that you can live an almost normal life. The major goals of the treatment are to correct the high blood glucose level using insulin and to replace the fluids and electrolytes lost. Is DKA hereditary? Diabetic ketoacidosis is not hereditary but diabetic mellitus is. Ketoacidosis is only a complication of diabetic mellitus. How to prevent hospitalization and when should I alert the doctor? If you have diabetes, your health care provider must have told you the warning signs of DKA. If you suspect DKA, test for ketones using a urine strip or your g 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 >>

Mucormycosis In A Diabetic Ketoacidosis Patient: A Case Report

Mucormycosis In A Diabetic Ketoacidosis Patient: A Case Report

Go to: Case Report A 55-year-old male presented to the hospital with fever and cough since the past one week. The fever was on and off with intermittent headache. He had been diagnosed with diabetes mellitus (DM) five years back for which he had taken oral hypoglycaemic which he discontinued after four months and has been on herbal therapy since. On admission the patient was afebrile (36.4degree), his pulse rate was 100 beats per minute and BP of 120/70 mmHg. Physical examination was normal, on auscultation of chest occasional coarse crepitations were found and rest of the systems was normal. Laboratory investigations revealed haemoglobin of 16.8 g/dL, total white blood cell of 28000 cells per cumm (80% neutrophil) and ESR of 50mm in first hour. Serum biochemistry showed creatinine 2.3mg/dL, blood glucose level was 374 mg/dL, sodium 131 mmol/L, potassium 4.7 mmol/L. Urine analysis revealed a 1.5% glucose, ketone bodies, and albumin 2+. Chest radiograph showed left upper lobe homogenous opacity suggesting consolidation [Table/Fig-1]. He was empirically started on ceftriaxone. His sputum was sent for analysis which showed fungal elements on KOH mount. Diagnostic nasal endoscopy showed extensive crests filling left nasal cavity and maxillary sinus which was suggestive of mucormycosis. The patient was started on insulin therapy and amphotericin B intravenously at 1.5mg/kg body weight for 21 days with oral fluconazole of 150mg daily for six weeks. Renal profile was monitored every three days to check for nephrotoxicity from amphotericin. During the treatment the patient’s symptoms subsided and serial chest x rays showed clearing of the left upper lobe infiltrates [Table/Fig-2]. A CT chest was done to check the extent of damage left by the cavitation [Table/Fig-3]. The pati Continue reading >>

Diabetic Coma Treatments

Diabetic Coma Treatments

Diabetic coma is a condition that poses a dangerous threat to individuals with diabetes. Treatment is more effective the earlier it is started but depends on the cause of the coma as this defines which type of diabetic coma a patient has. The three causes of diabetic coma are severe hypolgycemia or lowering of the blood sugar level, diabetic ketoacidosis which causes high blood glucose levels, and hyperglycaemic hyperosmolar state which also causes raised blood glucose. Therefore, when a diabetic patient is unconscious, the first action taken is blood sugar testing. If the cause is hypoglycemia, treatment is aimed at raising the blood sugar levels, whereas it is aimed at reducing the blood sugar with either of the other two conditions. Treatment Severe hypoglycemia If the blood sugar levels in the blood and brain drop to below normal, the risk of losing consciousness and falling into a diabetic coma is increased. Coma due to severe hypoglycemia is more likely to occur if a patient has taken a large overdose of insulin or other anti-diabetic medications, if alcohol is present in the system while the patient is hypoglycemic or if exercise has reduced the body's supply of glycogen. Glucagon may be administered to treat hypoglycemia. In healthy individuals, a fall in blood sugar is compensated for by the release of glucagon, which increases blood sugar levels. However, in the diabetic individual, this reaction fails to occur and exogenous glucagon needs to be administered. As an immediate measure, glucose rich foods such as glucose biscuits may be eaten or an injection of glucose solution may be administered. People with diabetes are advised to carry glucose biscuits with them to eat and counteract hypoglycemia as soon as symptoms manifest. Diabetic ketoacidosis This is mor 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 >>

How To Treat Ketoacidosis

How To Treat Ketoacidosis

Immediately drink a large amount of non-caloric or low caloric fluid. Continue to drink 8 to 12 oz. every 30 minutes. Diluted Gatorade, water with Nu-Salt™ and similar fluids are good because they help restore potassium lost because of high blood sugars. Take larger-than-normal correction boluses every 3 hours until the blood sugar is below 200 mg/dl (11 mmol) and ketones are negative. It will take much more rapid insulin than normal to bring blood sugars down when ketones are present in the urine or blood. Often, one and a half to two times the normal insulin dose for a high blood sugar will be necessary. Higher insulin doses than these will be needed if there is an infection or other major stress. If nausea becomes severe or last 4 hours or more, call your physician. If vomiting starts or you can no longer drink fluids, have a friend or family member call your physician immediately, then go directly to an emergency room for treatment. Never omit your insulin, even if you cannot eat. A reduced insulin dose might be needed, but only if your blood sugar is currently low. When high blood sugars or ketoacidosis happen, it is critical that you drink lots of fluid to prevent dehydration. Take extra amounts of Humalog, Novolog or Regular insulin to bring the blood sugars down. Children with severe ketoacidosis lose 10-15 % of their previous body weight (i.e., a 60 lb. child can lose 6 to 9 lbs. of weight) due to severe dehydration. Replacement of fluids should be monitored carefully. The dehydration is caused by excess urination due to high blood sugars and is quickly worsened when vomiting starts due to the ketoacidosis. The start of vomiting requires immediate attention at an ER or hospital where IV fluid replacement can begin. If only nausea is present and it is possible 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 >>

Ketosis: Symptoms, Signs & More

Ketosis: Symptoms, Signs & More

Every cell in your body needs energy to survive. Most of the time, you create energy from the sugar (glucose) in your bloodstream. Insulin helps regulate glucose levels in the blood and stimulate the absorption of glucose by the cells in your body. If you don’t have enough glucose or insufficient insulin to get the job done, your body will break down fat instead for energy. This supply of fat is an alternative energy source that keeps you from starvation. When you break down fat, you produce a compound called a ketone body. This process is called ketosis. Insulin is required by your cells in order to use the glucose in your blood, but ketones do not require insulin. The ketones that don’t get used for energy pass through your kidneys and out through your urine. Ketosis is most likely to occur in people who have diabetes, a condition in which the body produces little or no insulin. Ketosis and Ketoacidosis: What You Need To Know Ketosis simply means that your body is producing ketone bodies. You’re burning fat instead of glucose. Ketosis isn’t necessarily harmful to your health. If you don’t have diabetes and you maintain a healthy diet, it’s unlikely to be a problem. While ketosis itself isn’t particularly dangerous, it’s definitely something to keep an eye on, especially if you have diabetes. Ketosis can be a precursor to ketoacidosis, also known as diabetic ketoacidosis. Ketoacidosis is a condition in which you have both high glucose and high ketone levels. Having ketoacidosis results in your blood becoming too acidic. It’s more common for those with type 1 diabetes rather than type 2. Once symptoms of ketoacidosis begin, they can escalate very quickly. Symptoms include: breath that smells fruity or like nail polish or nail polish remover rapid breat Continue reading >>

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