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Keto Acidosis

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What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin. Depending on the severity, insulin may be given intravenously or by injection under the skin. Usually potassium is also needed to prevent the development of low blood potassium. Throughout treatment blood sugar and potassium levels should be regularly checked. Antibiotics may be required in those with an underlying infection. In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended. Rates of DKA vary around the world. About 4% of people with type 1 diabetes in United Kingdom develop DKA a year, while in Malaysia the condition affects about 25% a year. DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost universally fatal. The risk of death with adequate and timely treatment is currently around 1–4%. Up to 1% of children with DKA develop a complication known as cerebral edema. The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. Those who measure their glucose levels themselves may notice hyperglycemia (high blood sugar levels). In severe DKA, breathing becomes labored and of a deep, gasping character (a state referred to as "Kussmaul respiration"). The abdomen may be tender to the point that an acute abdomen may be suspected, such as acute pancreatitis, appendicitis or gastrointestinal perforation. Coffee ground vomiting (vomiting of altered blood) occurs in a minority of people; this tends to originate from erosion of the esophagus. In severe DKA, there may be confusion, lethargy, stupor or even coma (a marked decrease in the level of consciousness). On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, tachycardia (a fast heart rate) and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity", often compared to the smell of pear drops whose scent is a ketone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.....

Ketoacidosis At First Presentation Of Type 1 Diabetes Mellitus Among Children: A Study From Kuwait

We examined the frequency and severity of diabetic ketoacidosis (DKA) in 679 children and adolescents (0–14 years) at diagnosis of Type 1 Diabetes Mellitus (T1DM) in Kuwait. Between 1st January 2011 and 31st December 2013, all newly diagnosed children with diabetes were registered prospectively in a population-based electronic register. DKA was diagnosed using standard criteria based on the levels of venous pH and serum bicarbonate. At the time of diagnosis, mild/moderate DKA was present in 24.8% of the children, while severe DKA was present in 8.8%. Incidence of ketoacidosis was significantly higher in young children less than 2 (60.7% vs 32.4% p = <0.005) compared to children 2–14 years old, and a higher proportion presented with severe DKA (21.4% vs 8.3% p = <0.05). No association was seen with gender. Significant differences were found in the incidence of DKA between Kuwaiti and non-Kuwaiti children (31.1% vs 39.8%; p < 0.05). Family history of diabetes had a protective effect on the occurrence of DKA (OR = 0.44; 95% CI = 0.27–0.71). Incidence of DKA in children at presentation of T1DM remains high at 33.6%. Prevention campaigns are needed to increase public awareness amo Continue reading >>

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  1. Athena Walker

    At seventeen you are in a prime spot to decide what you are going to do. Your brain will finish growing at twenty-five. That probably seems like pointless information, but it isn’t. Until that time your behavior can look exactly like ASPD, sociopathy, psychopathy, or narcissism, but until that age, it’s a red herring.
    Your brain matures from the back to the front. Meaning that the last parts to finish growing and maturing are the ones that have to with emotional reasoning, understanding consequences for action, and empathy. Until these come fully online, and the brain finishes growing you can behave in a way that is dramatically like a psychopathy, a sociopath, or a narcissist.
    The secret here is, most people are not like us. We make up very low portions of the population. For psychopaths it’s .75%-1%, so low enough that it shouldn’t be too much a concern.
    Now, let’s say you are like me, and that you are psychopathic. What could that mean for your future? Whatever you decide. ASPD, psychopathy, sociopathy does not have the power to make choices. You do that. No part of these conditions give you permission or an excuse for poor behavior. It might be very easy to allow to happen, but it is behavior that you would be allowing. I have been accused of not understanding the draw, the difficulty of saying no, but really I didn’t say no. I paid the consequences. They were mine to pay. I earned them. If I didn’t want to pay them, I should have been smarter about when I did. I wasn’t, and I earned the reward of jail. Such is life. It was a choice.
    Everything is. Chances are you will be normal. When you age up a bit you will find all of the emotional reasoning center to be firing, and you will not have to think too much about this again. However, there is a low chance that won’t happen. If that is the case, you decide for yourself what you will accept from yourself as acceptable action. Then, you stick to it. It’s hard. I won’t say that it’s not. It’s worth it though. Prison sucks. It’s so boring. You don’t want that, trust me.

    So, try to act the part of empathetic. It might feel unnatural, but you are feeding neurons at this stage. What you feed is reinforced. If you are psychopathic and find out later that is the case, you are establishing for yourself a good level groundwork to work from. Always remember, you decide. No one else does. It might be hard to say no, but if you do and do something different you are only serving your own self interests. That alone should appeal to you.

  2. Kellen Von Houser

    ??? Psychiatric hospitals are usually for stabilizing disorders which require medication, like a thought disorder or a mood disorder. Were they thinking of a residential treatment center perhaps? Also, you’re not old enough to be diagnosed with APD.

  3. Linda Porter

    people as young as you are not diagnosed with conditions like this. And from what i am hearing you have not been diagnosed. It is just an opinion of a therapist

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What is KETOACIDOSIS? What does KETOACIDOSIS mean? KETOACIDOSIS meaning - KETOACIDOSIS definition - KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and ß-hydroxybutyrate. Ketoacidosis is a pathological metabolic state marked by extreme and uncontrolled ketosis. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased. In extreme cases ketoacidosis can be fatal. Ketoacidosis is most common in untreated type 1 diabetes mellitus, when the liver breaks down fat and proteins in response to a perceived need for respiratory substrate. Prolonged alcoholism may lead to alcoholic ketoacidosis. Ketoacidosis can be smelled on a person's breath. This is due to acetone, a direct by-product of the spontaneous decomposition of acetoacetic acid. It is often described as smelling like fruit or nail polish remover. Ketosis may also smell, but the odor is usually more subtle due to lower concentrations of acetone. Treatment consists most simply of correcting blood sugar and insulin levels, which will halt ketone production. If the severity of the case warrants more aggressive measures, intravenous sodium bicarbonate infusion can be given to raise blood pH back to an acceptable range. However, serious caution must be exercised with IV sodium bicarbonate to avoid the risk of equally life-threatening hypernatremia. Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively. In diabetic ketoacidosis, a high concentration of ketone bodies is usually accompanied by insulin deficiency, hyperglycemia, and dehydration. Particularly in type 1 diabetics the lack of insulin in the bloodstream prevents glucose absorption, thereby inhibiting the production of oxaloacetate (a crucial molecule for processing Acetyl-CoA, the product of beta-oxidation of fatty acids, in the Krebs cycle) through reduced levels of pyruvate (a byproduct of glycolysis), and can cause unchecked ketone body production (through fatty acid metabolism) potentially leading to dangerous glucose and ketone levels in the blood. Hyperglycemia results in glucose overloading the kidneys and spilling into the urine (transport maximum for glucose is exceeded). Dehydration results following the osmotic movement of water into urine (Osmotic diuresis), exacerbating the acidosis. In alcoholic ketoacidosis, alcohol causes dehydration and blocks the first step of gluconeogenesis by depleting oxaloacetate. The body is unable to synthesize enough glucose to meet its needs, thus creating an energy crisis resulting in fatty acid metabolism, and ketone body formation.

What Is Diabetic Ketoacidosis?

Diabetic ketoacidosis is a buildup of acids in the blood. It is a life-threatening complication of diabetes resulting from not having enough insulin. It may happen with type 1 diabetes. (It rarely happens with type 2 diabetes.) It’s an emergency that must be treated right away. If ketoacidosis is not treated right away, it can cause coma or death. What is the cause? Diabetic ketoacidosis happens when the body does not have enough insulin. Without insulin, sugars in the blood cannot move out of the blood and into the body’s cells, so the cells burn fats instead of sugar for energy. The burning of fats makes byproducts called ketones. The ketones build up to poisonous and dangerous levels in the blood. Usually the blood sugar is also very high. Ketoacidosis can happen if you skip doses of insulin. Or it may happen if there is a change in your life, such as: Infection Injury Heart attack Surgery Pregnancy Other types of physical or emotional stress If you are using an insulin pump, it may happen if you stop getting insulin because there is a kink in the tube or the tube comes out. Sometimes you may not know you have diabetes until ketoacidosis occurs. When the pancreas stops makin Continue reading >>

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Popular Questions

  1. Saraleesaralee

    Is it possible to stay on ketogenic diet for life-long?

    I have been on ketogenic diet for 2 weeks. It controls my blood sugar level really well. However I am not over weight. And I am worried about potential long term side effects of the diet. For example, high LDL level, steoporosis, auto immune disease, too much weight loss, vesicular stiffness. I was wondering if there is anyone in this forum has been on ketogenic diet for years? And do you experience any side effects from the diet?

  2. Aaron1963

    I've been on a strict ketogenic diet for 6 months, and was doing LCHF for much of the 5 months prior to that but didn't make any attempts at it being ketogenic so I may have been in and out of ketosis some during that period. I now have a blood ketone meter and remain in ketosis according to it.
    I did suffer excessive weight loss initially. I lost about 40kg (about 90 lbs.), and it ended up sending me from being very obese to being underweight. But I've always eaten very little protein, which I continued to do, plus I was doing intermittent fasting, sometimes not eating anything for days at a time. Once I stopped the intermittent fasting and concentrated on getting adequate protein, my weight went back up to my ideal weight and stabilized there. I've heard from several people that you really need to watch your protein when doing a ketogenic diet being it's easy for excess to hinder weight loss and/or increase your BG.
    I have had a few issues while doing a ketogenic diet, but not 100% sure which if any can be attributed to ketosis vs. some other factor. First off, as winter was approaching I got extremely cold all the time, especially my fingers and toes, but even my whole body was cold. I thought it might have been the caffeine I was getting as part of my ketogenic diet involves drinking lots of coffee with HWC, coconut oil, and butter. I switched to decaf and the problem pretty much went away, but I don't know if it was the caffeine, the ketosis, the massive weight loss (lack of body fat), something else, or a combination of factors.
    I've also had excessive itching and a rash. That's normal for me during the winter months, but this year it started a bit early, went longer, and was much worse than normal. I think it may very well have been my usual sensitivity to the cold dry weather, aggravated by toxins released during my rapid weight loss, and perhaps ketones being emitted through the skin. It's just recently started to clear up and the rash is gone and most of the itching.
    I got keto-breath for a week or two when I first concentrated on going keto. It was very noticeable, but disappeared after that and no issues anymore with my breath.
    This diet is very sustainable for me. I tried my whole adult life to diet to lose weight and was never successful. This time I wanted to lose weight, but my primary focus was controlling my BG, meaning reducing carbs down to a low-carb level, which caused me to gravitate naturally to a LCHF diet. For the first time I have no desire to go back to my old way of eating. I love this diet and it's completely satisfying. So I killed two birds with one stone - got my BG under control, down to non-diabetic levels, and got my weight down to ideal. Plus with the huge benefits (IMHO) of having my body use ketones rather than glucose, I'm totally sold on this way of eating for the rest of my life and have absolutely no worries about not being able to stick to my diet. I really have no strong urges for carbs anymore, and only end up going off the plan rarely due to social pressures or inadvertently eating hidden/unknown carbs.
    My LDL has gone up, but I've heard from others that usually it's benign large fluffy LDL that typically goes up when on a ketogenic diet. And my body is still adjusting. Also I've heard that LDL by itself is not a good measure of risk. So I'm not worried about it, but will keep an eye on things. I also have taken my ketogenic diet to an extreme, hitting a KR of 3.0 or higher almost everyday, and sometimes up to 4.0 or more. Not sure if eating much more fat than necessary for ketosis affected my LDL any or not. Initially my LDL dropped significantly as well as my trigs, but both increased at my last doctor's visit. I may try a more normal KR in the future while monitoring my blood ketones to verify I stay in ketosis and see if there's any difference in my BG, cholesterol, or other tests.
    I did also suffer from other typical symptoms during my keto adaptation phase. Most went away within about two weeks. But it's just been here at the 6-month mark where my BG numbers suddenly stabilized with very little change, and quite low, and overall I just feel absolutely fantastic. I feel like I'm bursting with energy and joined a gym and suddenly love running and working out whereas I hated them all my life.
    Well, I don't have years of experience with ketosis to report anything to you about that. Other than I've heard lots of other people with years of experience and not heard of anyone having any real side effects other than the things I've mentioned. However some people do find ketosis isn't for them and give up very soon. For those that feel it is working for them and stick with it, seems there's no significant side effects. But I'll let the others who've been in ketosis for longer than me speak for themselves.

  3. furball64801

    Hi and welcome to DD I know of a guy called no more carbs that was on it over 2 yrs. It is possible he is still on it, that chat site closed down but he was going strong on it.

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Home > Our Services > Health Info Library > Helping Hands > Diabetes: Ketoacidosis (dka)

Diabetic Ketoacidosis (KEY toe as i DOE sis), also known as DKA, is a serious complication of diabetes. When the cells in the body cannot use glucose for energy, there is a buildup of acids called “ketones” in the blood. For the cells to use glucose for energy both glucose and insulin need to be in the blood. Insulin acts like a key to unlock the cell door. It allows glucose in to be used for energy. When cells do not have glucose to use for energy: The body starts to use fat for energy. Ketones are made when fat is used for energy. Ketones are present in the blood and in the urine. Ketones cause the blood to become more acidic. If untreated, this leads to DKA and life-threatening problems. Cause Not enough insulin: Missing doses of insulin Infection, illness or injury (which causes the body to need more insulin) Insulin doses too small If using insulin pump, interruption in delivery of insulin Signs of DKA and When to Test for Ketones You may or may not feel any different when you begin to have ketones. The only way to know is by checking the urine or blood for the presence of ketones. Check for ketones if blood glucose is higher than 300 mg/dl. Check for ketones when ill (fev Continue reading >>

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  1. kaazoom

    I recently had my Hba1c tests and it was over 9 . The doctor increased my metformin from 1 tablet twice a day to 2 tablets twice a day. I was told to start by increasing the morning dose and after 2 weeks increase my evening dose. I have had a lot of stomach discomfort, and terrible indigestion since increasing the does. I work up the other morning in extreme pain like I was having a heart attack. The pain went after taking antacids. Indigestion is something I get every now and then, but it is usually due to eating something I should avoid. This day I don't think I had eaten anything that would cause it. But I had increased my evening dose of metformin, so I was and am on 4 tablets a day. I have had more general discomfort than usual, muscle pains and more breathlessness.The difficult is I have other health problems so knowing which one is caused by which is a nightmare.
    I also tend to let myself get dehydrated at night as I have bladder problems which I having investigations for at the moment. If I don't stop drinking about at about 7pm I end up waking numerous times to go to the loo. The only drink I have after 7pm is a few sips of water to help swallow my medications.
    Sorry for being so long winded. My main question is does lactic acidosis come on suddenly, or does it build up over days or weeks?
    Paul

  2. destiny0321

    Hi. If you find your metformin could be causing problems which it did with me runs,breathing problems and generally really poorly go back to your gp I did and I was put on me form in slow release which is much gentler on the stomach hope this helps you destiny
    Sent from the Diabetes Forum App

  3. kaazoom

    Thanks.
    I've got to see my GP next week about something else so I will talk to him about it. I don't think I have lactic acidosis, I was curious about whether it was sudden or gradual onset. I saw something on the TV yesterday that said patients are risking their health because they don't read the information sheets that come with their medication. So I had a look at mine. It gave a number of symptoms to watch out for including severe indigestion,muscle spasms etc it said if you have any of these symptoms when taking Metformin to go immediately to the nearest hospital A&E because these symptoms can be signs of lactic acidosis. I don't think what I'm experiencing is severe enough for A&E.
    I had muscle spasms, pains and a number of the other symptoms list prior to my diabetes diagnose due to other illnesses, and they can vary in severity. They seem to have got somewhat worse since my metformin was increased, but it could just be coincidence. The indigestion and stomach problems are particularly bad. My feeling is my body is taking time to adapt to them. i will ask my doctor if I can change to a slow release version.
    Paul

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