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Is Ketoacidosis Curable

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

Diabetic Ketoacidosis

A Preventable Crisis People who have had diabetic ketoacidosis, or DKA, will tell you it’s worse than any flu they’ve ever had, describing an overwhelming feeling of lethargy, unquenchable thirst, and unrelenting vomiting. “It’s sort of like having molasses for blood,” says George. “Everything moves so slow, the mouth can feel so dry, and there is a cloud over your head. Just before diagnosis, when I was in high school, I would get out of a class and go to the bathroom to pee for about 10–12 minutes. Then I would head to the water fountain and begin drinking water for minutes at a time, usually until well after the next class had begun.” George, generally an upbeat person, said that while he has experienced varying degrees of DKA in his 40 years or so of having diabetes, “…at its worst, there is one reprieve from its ill feeling: Unfortunately, that is a coma.” But DKA can be more than a feeling of extreme discomfort, and it can result in more than a coma. “It has the potential to kill,” says Richard Hellman, MD, past president of the American Association of Clinical Endocrinologists. “DKA is a medical emergency. It’s the biggest medical emergency related to diabetes. It’s also the most likely time for a child with diabetes to die.” DKA occurs when there is not enough insulin in the body, resulting in high blood glucose; the person is dehydrated; and too many ketones are present in the bloodstream, making it acidic. The initial insulin deficit is most often caused by the onset of diabetes, by an illness or infection, or by not taking insulin when it is needed. Ketones are your brain’s “second-best fuel,” Hellman says, with glucose being number one. If you don’t have enough glucose in your cells to supply energy to your brain, yo 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 >>

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 >>

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 >>

What Are The Consequences If A Patient Stops Taking Insulin In Type 1 Diabetes And Is Type 1 Is Curable?

What Are The Consequences If A Patient Stops Taking Insulin In Type 1 Diabetes And Is Type 1 Is Curable?

Thank you for A2A. I guess I am qualified enough to answer having worked at the treatment of T1D for almost 1.5 years. TLDR : There are adverse effects of insulin weaning. There is no cure of T1D yet. But we do have promising treatments under Phase 2 and 3 clinical trials (later stages of drug development) so there is hope. We might see a successful drug in coming decade. Animesh Agrawal has covered etiology (the cause of disease) very well. I will add a few things here. You are not alone : Type 1 or juvenile diabetes affects approximately 70,000 children under the age of 15 every year and around 3.2 million people in the world die due to diabetes or its related causes per year. We don’t know our enemy and hence winning it is difficult : Type I diabetes is an autoimmune disorder (our defence mechanism offends our body) and it may develop at any age. Incomplete understanding of the mechanism of disease development and progression prevents the development of any rationally designed drug. The reasons of T1D are varied and include susceptible genes , enterovirus infection, etc. Presently the treatment involves insulin administration by injection or pump. Both are invasive methods, painful enough and hence non-compliance is usually observed in patients. The present treatment is also an economic burden to patients. Consequences of stopping Insulin in T1D : In layman terms there can be following, Preliminary symptoms: Fever, headache, gastrointestinal disorders, reduction in weight Symptoms in longer run: metabolic disorders, vulnerability to other diseases But these are very generalised, symptoms depend on age group and other factors like gender, extent of destruction of beta cells (cells that make insulin in body). See Nandan Karn 's answer for details. Treatment : Insulin 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 >>

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 >>

What Causes Diabetes?

What Causes Diabetes?

Little Known Factors That Lead To Diabetes What are some of the lifestyle, genetics and other not-so-obvious factors that can trigger diabetes? What can you do to prevent this condition? Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood. It affects over 29.1 million people in the U.S. – 9.3 percent of the population in the U.S. Another 86 million Americans have prediabetes and aren’t even aware of it. The cause of diabetes is the absence or insufficient production of the hormone insulin, which lowers blood sugar in the body. Two types of diabetes There are two types of diabetes: type 1 and type 2, which are also known as insulin-dependent and non-insulin-dependent diabetes. Type 1 diabetes is less common: it affects only 1 in 250 Americans and only occurs in individuals younger than age 20. It has no known cure. A majority of type 2 diabetes cases can be prevented or cured. Signs and symptoms Among the symptoms of type 1 and type 2 diabetes are: Increased urine Excessive thirst Weight loss Hunger Fatigue Skin problems Slow-healing wounds Yeast infections Tingling or numbness in feet or toes Various factors Research has proven that there are certain lifestyle and genetic factors that lead to diabetes. Among them are: Leading a non-active lifestyle A family history of diabetes High blood pressure (hypertension) Low levels of the good cholesterol (HDL) Elevated levels of triglycerides (a type of fat) in the blood Increasing age Polycystic ovary syndrome Impaired glucose tolerance Insulin resistance Gestational diabetes during a pregnancy Some ethnic backgrounds (African Americans, Hispanic/Latino Americans, Asian Americans, Pacific Islanders, Native Americans and Alaska natives) are at greater risk of diabetes. Get t Continue reading >>

My Cat Has Diabetes :: Treatment

My Cat Has Diabetes :: Treatment

Living with a diabetic cat Each diabetic cat responds differently to different therapies. Some cats are easier to regulate; others require more complex types of treatment. Some cats can be treated successfully through changes in diet and with oral medications. In cats with more severe diabetes, insulin injections may be required for the remainder of their lives. In general, treatment for diabetes falls into three categories: Insulin injections Oral hypoglycemic medications Diet Home monitoring & testing Ongoing and frequent home monitoring of your cat's glucose level is important both for ensuring that diabetes is under control and the long-term health maintenance of your pet. Home monitoring usually results in less stress on the cat and allows for closer, more precise control of blood glucose levels on a regular basis, which helps avoid the risk of hypoglycemic episodes. Home testing of glucose levels can be done with a similar type of blood glucose monitor used by humans. This method requires a small sample of blood that is taken from the cat for testing and generally provides an immediate reading of your cat's blood glucose level. In addition to monitoring glucose levels through the blood, caretakers can use urine glucose monitoring. However, urine glucose monitoring is generally not as accurate due to the lag time for glucose to go from the blood to the urine in the cat's body. It is recommended to consult with your veterinarian on the best way to monitor your cat's glucose. They can also provide valuable advice on which type(s) of monitors work best in cats, as well as train you on how to use and interpret the test results. When at home, you also should continually be aware of your cat's appetite, water consumption and urine output to determine what is normal behav Continue reading >>

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 >>

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 >>

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 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 >>

Feline Diabetic Ketoacidosis

Feline Diabetic Ketoacidosis

Fall 2008 Ketoacidosis is a metabolic imbalance that is most commonly seen as a sequel to unmanaged or poorly regulated diabetes mellitus. It is caused by the breakdown of fat and protein in a compensatory effort for the need of more metabolic energy. The excessive breakdown of these stored reserves creates a toxic by-product in the form of ketones. As ketones build up in the blood stream, pH and electrolyte imbalances proceed. This condition is a potentially life-threatening emergency that requires immediate medical attention. Diabetes mellitus is a common endocrine disease in geriatric felines. It is caused by a dysfunction in the beta cells of the exocrine pancreas resulting in an absolute or relative deficiency of insulin. Insulin has been called the cells' gatekeeper. It attaches to the surface of cells and permits glucose, the cells' primary energy source, to enter from the blood. A lack of insulin results in a build up of glucose in the blood, physiologically causing a state of cellular starvation. In response to this condition the body begins to increase the mobilization of protein and fat storage. Fatty acids are released from adipose tissue, which are then oxidized by the liver. Normally, these fatty acids are formed into triglycerides. However, without insulin, these fatty acids are converted into ketone bodies, which cannot be utilized by the body. Together with the increased production and decreased utilization an abnormally high concentration of ketone bodies develop. These fixed acids are buffered by bicarbonate; however, the excessive amounts overwhelm and deplete the bicarbonate leading to an increase in arterial hydrogen ion concentration and a decrease in serum bicarbonate. This increase in hydrogen ions lowers the body's pH, leading to a metabolic ac Continue reading >>

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