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Is Ketoacidosis Hereditary

Diabetic Ketoacidosis In Dogs

Diabetic Ketoacidosis In Dogs

My dog is diabetic. He has been doing pretty well overall, but recently he became really ill. He stopped eating well, started drinking lots of water, and got really weak. His veterinarian said that he had a condition called “ketoacidosis,” and he had to spend several days in the hospital. I’m not sure I understand this disorder. Diabetic ketoacidosis is a medical emergency that occurs when there is not enough insulin in the body to control blood sugar (glucose) levels. The body can’t use glucose properly without insulin, so blood glucose levels get very high, and the body creates ketone bodies as an emergency fuel source. When these are broken down, it creates byproducts that cause the body’s acid/base balance to shift, and the body becomes more acidic (acidosis), and it can’t maintain appropriate fluid balance. The electrolyte (mineral) balance becomes disrupted which can lead to abnormal heart rhythms and abnormal muscle function. If left untreated, diabetic ketoacidosis is fatal. How could this disorder have happened? If a diabetic dog undergoes a stress event of some kind, the body secretes stress hormones that interfere with appropriate insulin activity. Examples of stress events that can lead to diabetic ketoacidosis include infection, inflammation, and heart disease. What are the signs of diabetic ketoacidosis? The signs of diabetic ketoacidosis include: Excessive thirst/drinking Increased urination Lethargy Weakness Vomiting Increased respiratory rate Decreased appetite Weight loss (unplanned) with muscle wasting Dehydration Unkempt haircoat These same clinical signs can occur with other medical conditions, so it is important for your veterinarian to perform appropriate diagnostic tests to determine if diabetic ketoacidosis in truly the issue at hand Continue reading >>

Diabetes Mellitus Type 1

Diabetes Mellitus Type 1

Diabetes mellitus type 1 (also known as type 1 diabetes) is a form of diabetes mellitus in which not enough insulin is produced.[4] This results in high blood sugar levels in the body.[1] The classical symptoms are frequent urination, increased thirst, increased hunger, and weight loss.[4] Additional symptoms may include blurry vision, feeling tired, and poor healing.[2] Symptoms typically develop over a short period of time.[1] The cause of type 1 diabetes is unknown.[4] However, it is believed to involve a combination of genetic and environmental factors.[1] Risk factors include having a family member with the condition.[5] The underlying mechanism involves an autoimmune destruction of the insulin-producing beta cells in the pancreas.[2] Diabetes is diagnosed by testing the level of sugar or A1C in the blood.[5][7] Type 1 diabetes can be distinguished from type 2 by testing for the presence of autoantibodies.[5] There is no known way to prevent type 1 diabetes.[4] Treatment with insulin is required for survival.[1] Insulin therapy is usually given by injection just under the skin but can also be delivered by an insulin pump.[9] A diabetic diet and exercise are an important part of management.[2] Untreated, diabetes can cause many complications.[4] Complications of relatively rapid onset include diabetic ketoacidosis and nonketotic hyperosmolar coma.[5] Long-term complications include heart disease, stroke, kidney failure, foot ulcers and damage to the eyes.[4] Furthermore, complications may arise from low blood sugar caused by excessive dosing of insulin.[5] Type 1 diabetes makes up an estimated 5–10% of all diabetes cases.[8] The number of people affected globally is unknown, although it is estimated that about 80,000 children develop the disease each year.[5] With Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (DKA) Diabetic ketoacidosis (DKA) occurs when the body does not have enough insulin. Insulin is what breaks down sugar into energy. When insulin is not present to break down sugars, our body begins to break down fat. Fat break down produces ketones which spill into the urine and cause glucose build up in the blood, thus acidifying the body. Because sugar is not entering into our body’s cells for energy breakdown, the sugar is being processed by the kidneys and excreted through the urine; as a result, we become dehydrated and our blood becomes even more acidic. This leads to sickness and hospitalization if not treated. If a person’s blood sugar is over 240, they should start checking their blood for ketones. If you have diabetes, or love someone who does, being aware of warning signs of diabetic ketoacidosis (DKA) can help save a life. Early Symptoms of DKA: High blood glucose level, usually > 300 High volume to ketones present in blood or urine Frequent urination or thirst that lasts for a day or more Dry skin and mouth Rapid shallow breathing Abdominal pain (especially in children) Muscle stiffness or aches Flushed face As DKA Worsens: Decreases alertness, confusion – brain is dehydrating Deep, labored, and gasping breathing Headache Breath that smells fruity or like fingernail polish remover Nausea and/or vomiting Abdomen may be tender and hurt if touched Decreased consciousness, coma, death If you think you might have DKA, test for ketones. If ketones are present, call your health care provider right away. To treat high blood sugar, hydrate with water or sugar free, caffeine free drinks. Sugar free popsicles and snacks are also good alternatives. Always call the doctor if vomiting goes on for more than two hours. Symptoms can go from mild Continue reading >>

Diabetes Mellitus (diabetes) In Cats

Diabetes Mellitus (diabetes) In Cats

Animals Affected Cats of any breed, usually middle-aged. Overview Diabetes mellitus (known simply as diabetes) is a common and serious disease of cats. The main characteristic of diabetes is an inability to control the level of sugar in the blood. This leads to chronically high blood sugar levels, which in turn lead to the symptoms of the disease. Management of diabetes in cats is challenging but, in most cases, it is successful. With proper treatment, many diabetic cats lead essentially normal lives. However, without treatment the disease inevitably leads to serious complications. Diabetes in cats is similar to type 2 (adult onset) diabetes in humans. Symptoms Symptoms of diabetes include: Weight loss Normal or increased appetite in the early stages of the disease; appetite may decline in the later stages. Lethargy In the end stages of the disease, coma and death An individual genetic or hereditary predisposition to diabetes very likely is involved in most cases. Dental disease leads to chronic inflammation which may predispose cats to diabetes. Some authorities contend that high levels of sugar and carbohydrates in dry commercial cat foods play a role in the development of diabetes. However, this belief is not universally accepted. Recent studies have not found a link between dry food consumption and diabetes in cats. Some medications, especially prednisone or depo-medrol (a long-acting, injected form of prednisone) can trigger diabetes. Complications Untreated diabetes leads to emaciation, chronic lethargy and weakness. Diabetic cats are prone to urinary tract infections. House soiling may occur as well, due to increased frequency of urination. Insulin administration is the main method of treating diabetes in cats. However, some cats may be subject to accidental over Continue reading >>

Chapter 57. Biochemical Case Histories

Chapter 57. Biochemical Case Histories

After studying this chapter, you should be able to: Appreciate the importance of a sound knowledge of Biochemistry and Genetics in understanding and managing many clinical conditions. Understand the general features and some aspects of management of the following conditions: adenosine deaminase deficiency; Alzheimer disease; cholera; colorectal cancer; cystic fibrosis; diabetic ketoacidosis; Duchenne muscular dystrophy; acute ethanol intoxication; acute gout; hereditary hemochromatosis; primary hypothyroidism; kwashiorkor and protein-energy malnutrition; myocardial infarction; obesity; primary osteoporosis; xeroderma pigmentosum. In this final chapter, 16 case histories are presented and discussed. They illustrate the importance of knowledge of Biochemistry for the understanding of disease. Of course, as has been shown throughout the text, Biochemistry is also crucial for the understanding of health and wellness. Most of the diseases discussed here are prevalent, or relatively prevalent, in a global sense. (Prevalence is the proportion of persons in a given population that has a particular disease at a point or interval of time.) However, two (xeroderma pigmentosum and severe combined immunodeficiency disease due to deficiency of adenosine deaminase [ADA]) are relatively rare. They are included because they illustrate two crucial biologic facts: the importance of DNA repair and of the immune system as protective mechanisms. In addition, ADA deficiency is the first disease for which gene therapy was performed in humans. The reference values for laboratory tests cited in the cases below may differ from these listed by laboratories with which the reader may be familiar. This is because reference values from different laboratories vary somewhat, in part due to different met Continue reading >>

What Is The Biochemistry Of Insulin Resistance?

What Is The Biochemistry Of Insulin Resistance?

Insulin resistance is a condition that impairs the ability to efficiently remove and process glucose from the bloodstream. Glucose, or blood sugar, is a vital energy source required by all cells, organs and systems of the body for normal function. The inability to utilize glucose in the blood results in excess levels in the blood, effects metabolism, and significantly increasing the chances of developing type 2 diabetes. How Does Insulin Resistance Happen Much like leptin resistance, insulin resistance occurs when a needed substance is present in the body, but unable to be utilized by the cells of the body. Specifically, the muscles and cells of the body do not respond or recognize the presence of insulin, resulting in decreased amounts of glucose being delivered to the cells. Insulin is a hormone produced in the pancreas and important for glucose regulation and energy production. The body reacts to this decrease in glucose in the cells by sending signals demanding more glucose for energy, As long as the pancreas can produce enough insulin, meeting the demand for increased amounts of glucose, the body appears to functions normally and glucose levels remain at healthy levels. Should the demand for glucose exceed the ability to produce insulin, blood glucose levels increase which increases the health risks associated with this condition. Causes of Insulin Resistance While researchers have yet to determine an exact cause of insulin resistance, they believe it is closely related to being overweight, having excess fat around the waist and physical inactivity. Genetics and heredity also appear to influence who develops insulin resistance. Insulin resistance risk increases with age; affecting 10% of people between the ages of 20 and 40, but nearly 40% of people over the age of Continue reading >>

Treatment And Complications Of Diabetic Ketoacidosis In Children And Adolescents

Treatment And Complications Of Diabetic Ketoacidosis In Children And Adolescents

INTRODUCTION Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM), with a case fatality rate ranging from 0.15 percent to 0.31 percent [1-3]. DKA also can occur in children with type 2 DM (T2DM); this presentation is most common among youth of African-American descent [4-8]. (See "Classification of diabetes mellitus and genetic diabetic syndromes".) The management of DKA in children will be reviewed here (table 1). There is limited experience in the management and outcomes of DKA in children with T2DM, although the same principles should apply. The clinical manifestations and diagnosis of DKA in children and the pathogenesis of DKA are discussed elsewhere. (See "Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents" and "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis".) DEFINITION Diabetic ketoacidosis – A consensus statement from the International Society for Pediatric and Adolescent Diabetes (ISPAD) in 2014 defined the following biochemical criteria for the diagnosis of diabetic ketoacidosis (DKA) [9]: Hyperglycemia – Blood glucose of >200 mg/dL (11 mmol/L) AND Metabolic acidosis – Venous pH <7.3 or a plasma bicarbonate <15 mEq/L (15 mmol/L) AND Continue reading >>

What Are The Types Of Diabetes And What Causes Diabetes?

What Are The Types Of Diabetes And What Causes Diabetes?

Types of Diabetes Type 1 Diabetes Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy. The far more common type 2 diabetes occurs when the body becomes resistant to insulin or doesn't make enough insulin. Various factors may contribute to type 1 diabetes, including genetics and exposure to certain viruses. Although type 1 diabetes usually appears during childhood or adolescence, it also can begin in adults. Despite active research, type 1 diabetes has no cure. But it can be managed. With proper treatment, people with type 1 diabetes can expect to live longer, healthier lives than did people with type 1 diabetes in the past. The exact cause of type 1 diabetes is unknown. In most people with type 1 diabetes, the body's own immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet) cells in the pancreas. Genetics may play a role in this process, and exposure to certain environmental factors, such as viruses, may trigger the disease. Type 2 diabetes is the most common type of diabetes, with around 3 million people in the UK diagnosed with the condition. A person with type 2 diabetes has insulin resistance, meaning their pancreas doesn’t produce enough insulin or the body doesn't react properly to insulin. Insulin is used by the body to manage glucose, or sugar, levels in the blood and to convert glucose into energy. For some people, type 2 diabetes may be managed through diet and exercise. Other people may also need medication to manage blood sugar. Risk factors for type 2 diabetes include being over 40, having a family history of di Continue reading >>

Hereditary And Acquired Abnormalities In Erythrocyte Phosphofructokinase Activity: The Close Association With Altered 2,3-diphosphoglycerate Levels

Hereditary And Acquired Abnormalities In Erythrocyte Phosphofructokinase Activity: The Close Association With Altered 2,3-diphosphoglycerate Levels

Specific deficiency of erythrocyte phosphofructokinase (PFK) activity in Type VII glycogenosis presents a good model for the analysis of the relationship between 2,3 diphosphoglycerate (2,3 DPG) level and glycolysis in erythrocytes since glycolytic flow is partially blocked at the regulatory step. Enzymatic analyses of glycolytic intermediates of erythrocytes from a patient with Type VII glycogenosis demonstrated that 2,3 DPG is markedly decreased in parallel with fructose-1,6-phosphate (FDP). In acidosis including diabetic ketoacidosis and uremic acidosis a fall in 2,3 DPG is also associated with a marked reduction in FDP. On the other hand, in respiratory alkalosis glycolytic intermediates shift to the opposite direction and forward crossover at PFK step appears, being associated with an elevation of 2,3 DPG. These data indicate a close relationship between 2,3 DPG level and PFK activity in erythrocytes. At least in acidosis and alkalosis the alteration in 2,3 DPG level may well be explained by changes in PFK activity caused mainly through allosteric mechanism. Continue reading >>

New Insights Into The Management Of Diabetic Ketoacidosis - Wsava2009 - Vin

New Insights Into The Management Of Diabetic Ketoacidosis - Wsava2009 - Vin

The diagnosis of diabetic ketoacidosis (DKA) in the ill-appearing diabetic dog is usually straightforward. Dogs with DKA usually present with dramatic clinical manifestations, such as anorexia, vomiting, and lethargy. Within such a setting, detection of ketonuria can rapidly confirm the suspicion of DKA, but it has few implications in the subsequent approach. One can estimate ketonemia by applying a drop of serum or plasma on the appropriate reagent of the urine test strip, but this test only detects acetoacetate and is a semiquantitative test. The measurement of plasma beta-hydroxybutyrate (β-OHB) on admission can provide additional information. Based on a previous study, dogs with plasma β-OHB >2.0 mmol/L should receive ambulatory monitoring and treatment, until the results of additional tests. If plasma β-OHB is >3.8 mmol/L the diagnosis of DKA is confirmed and intensive care is warranted.1 Coincidentally, a recent study in human beings with DKA, suggested that the same cutoff value of plasma β-OHB should be used for the diagnosis of DKA, using a portable meter (MediSense Optium, Abbott Laboratories).2 This device has been validated for the use in dogs.3 Evaluation of blood gases and pH is still needed. In a study of our group (unpublished data), mixed acid-base disorders were common, chiefly high anion gap acidosis and concurrent respiratory alkalosis, and hyperchloremic acidosis with moderated to marked increases in serum B-OHB. The implications of these findings are unknown, but in human patients with DKA, both conditions can possibly slower the recovery from metabolic acidosis. Because respiratory alkalosis is the expected physiologic response to metabolic acidosis, this mixed acid-base disorder may be difficult to recognize clinically, and the diagnosis can 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 >>

Questions To Ask The Hospitalist If Admitted With Diagnosis Of Dka Aka Diabetic Ketoacidosis

Questions To Ask The Hospitalist If Admitted With Diagnosis Of Dka Aka 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 >>

Case Report Severe Allergic Reaction To Human Insulin In The Patient With Diabetic Ketoacidosis

Case Report Severe Allergic Reaction To Human Insulin In The Patient With Diabetic Ketoacidosis

1. Introduction Diabetic ketoacidosis (DKA) is a potentially fatal crisis of diabetes mellitus (DM). In the treatment of DKA, fluid resuscitation, insulin therapy, and electrolyte replacement are important. Rarely, insulin allergies can be developed in the patient treated with insulin. The most common symptoms of insulin allergies are localized and limited. Life-threatening allergic reactions are rarely reported. Insulin allergies can be managed safely and successfully by desensitization treatment.1,2 We present treatment of a patient with DKA who developed an insulin allergy. In this case report, we aimed to discuss DKA treatment options in patient with insulin allergies. 2. Case report A 45-year-old male was brought to our emergency department with chest pain and hyperglycemia. He had a history of type 2 DM and had been using an oral antidiabetic drug for two years, but he had been stopped using for a month. HIs past medical history did not show any drug allergies. His vitals were measured: 1.) blood pressure of 166/98 mmHg; 2.) pulse 100/min; 3.) respiration number 24/min; 4.) O2 saturation 98%; and 5.) temperature 36.0 °C. His electrocardiograms (ECG's) were normal. His blood glucose level was 405 mg/dL, urinary ketones 15 mmol/L, pH was 6.8, HCO3 4.7 mmol/L, and lactate 3.6 mmol/L. Regular insulin (0.1unit/kg IV bolus) was initiated in addition to 2000 mL of intravenous saline, and a 0.1 unit/kg/hour infusion was started. He developed a generalized skin rash, hoarseness, and uvular edema at the 30th minute of treatment, which then expanded to the soft palate. The vital findings were normal except for the presence of tachycardia. At that moment his vitals were measured: 1.) blood pressure 126/75 mmHg; 2.) pulse 104/min; 3.) respiration number 24/min; 4.) O2 saturat Continue reading >>

Severe Diabetic Ketoacidosis In A Newly Diagnosed Child With Type 2 Diabetes Mellitus: A Case Report

Severe Diabetic Ketoacidosis In A Newly Diagnosed Child With Type 2 Diabetes Mellitus: A Case Report

Abdulmoein E Al-Agha1* and Mohammed A Al-Agha2 1Department of Pediatric Endocrinology, King Abdul-Aziz University Hospital, Saudi Arabia 2Faculty of Medicine, King Abdul-Aziz University, Saudi Arabia Citation: Abdulmoein E Al-Agha1, Mohammed A Al-Agha (2017) Severe Diabetic ketoacidosis in a Newly Diagnosed Child with Type 2 Diabetes Mellitus: A Case Report. J Diabetes Metab 8:724. doi:10.4172/2155-6156.1000724 Copyright: © 2017 Al-Agha AE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Background: Diabetes ketoacidosis (DKA) is an acute complication of both type 1 and type 2 diabetes mellitus (DM). DKA is characterized by the presence of hyperglycemia, ketosis, ketonuria, and metabolic acidosis. Cerebral edema is a rare but rather a serious complication of DKA. Case presentation: An obese 12-year-old, Egyptian boy, previously medically free, presented to the emergency room (ER) of King Abdulaziz university hospital, with two weeks' histories of dizziness, shortness of breath, polyuria, polydipsia & nocturia. His symptoms were deteriorating with a change in sensorial and cognitive functions at the time of presentation. He was diagnosed with type 2 DM based upon clinical background, namely the presence of obesity (weight+7.57 Standard Deviation Score (SDS), height+1.4 SDS, and body mass index (BMI) of 34.77 kg/m2 (+3.97SDS) together with the presence of Acanthosis nigricans and biochemically based on, normal level of serum insulin, normal serum level of connecting peptide and negative autoantibodies. H Continue reading >>

How To Identify And Manage Diabetic Ketoacidosis In Adults

How To Identify And Manage Diabetic Ketoacidosis In Adults

By Natasha Jacques, BSc, MRPharmS, and Sally James, MSc, MRPharmS In short Diabetic ketoacidosis (DKA) is a condition in which a lack of insulin leads to hyperglycaemia, ketosis and metabolic acidosis. The symptoms of DKA include thirst, polyuria, confusion, fatigue and nausea. Treatment of DKA centres around the administration of intravenous fluids (including potassium) and infusions of soluble insulin. Natasha Jacques is principal pharmacist for diabetes at Heart of England NHS Foundation Trust and Sally James is divisional pharmacist for medicine at Royal Liverpool and Broadgreen University Hospital NHS Trust. Both authors are committee members of the United Kingdom Clinical Pharmacy Association diabetes group. Call for Practice tools Useful clinical skills are described in this Clinical Pharmacist series. Comments on this or other articles are welcomed in the form of personal feedback to the editor or correspondence to Clinical Pharmacist. Pharmacists who have ideas for the series or wish to write an article are invited to contact the editor. Email: [email protected] Telephone: +44 (0)20 7572 2425 Continue reading >>

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