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Diabetic Ketoacidosis: Evaluation And Treatment

Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis can occur in persons of all ages, with 14 percent of cases occurring in persons older than 70 years, 23 percent in persons 51 to 70 years of age, 27 percent in persons 30 to 50 years of age, and 36 percent in persons younger than 30 years. The case fatality rate is 1 to 5 percent. About one-third of all cases are in persons without a history of diabetes mellitus. Common symptoms include polyuria with polydipsia (98 percent), weight loss (81 percent), fatigue (62 percent), dyspnea (57 percent), vomiting (46 percent), preceding febrile illness (40 percent), abdominal pain (32 percent), and polyphagia (23 percent). Measurement of A1C, blood urea nitrogen, creatinine, serum glucose, electrolytes, pH, and serum ketones; complete blood count; urinalysis; electrocardiography; and calculation of anion gap and osmolar gap can differentiate diabetic ketoacidosis from hyperosmolar hyperglycemic state, gastroente Continue reading >>

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Popular Questions

  1. javajo91

    I know this has been brought up in prior posts but it appears to be an older thread....so just to get a fresh answer ...
    I'm a runner...46 years old. Been on a healthy track for 6 years since my 40th bday.
    I was Vegan for 5 of those years and after eating animal products again my wife and I swore to never follow such an extreme diet again...and to just enjoy life and the wonderful food out there.
    With that being said...as a a runner...the idea of fat burning is extremely alluring... Plus the fact that ketosis improves ” brain fog" is another very compelling positive effect. Ever since I turned 40 I swear my mind is total garbage at remembering​ anything!
    I also enjoy the occasional beer and glass of wine....and good New Jersey pizza.
    I can do 8 weeks to get Keto adapted and keep my carbs under 50 grams per day....doing an 80, 15, 5 ratio....fat, protein carb respectively.
    After adaptation..If I want an occasional night out with the wife enjoying beer and pizza, I've read from this post it takes about 48 hours to get back into the ketosis groove again. Is this still accurate? Once again this is after being fully Keto adapted.
    I'm assuming that if you overdue carbs during your initial adaptation.. you're just not going to move forward.
    Thanks guys

  2. about_some_stuff

    I'll give you my experience. Been keto for about 4 months. I was extremely militant during the adaptation, which for me was between 3 and 4 weeks.
    Since then I've been pretty strict, but not militant. I track my food a lot of the time, but not always. I have a pretty good sense on a day to day basis how much to eat, and of what. My body fat % has gone down every single week since I started - from 18%+ to around 11-12%.
    Now for the unpopular part: you can safely ignore all of the people saying that it has to be a 100% lifestyle, that you can't ever have a "cheat" day, etc. You can throw out your worry about "getting back into keto", etc.
    I've pigged out on pizza every Friday night since I was keto adapted. Sometimes I have a little soda. Hell, one time I even had a donut the next morning. And guess what? I feel just fine. I don't get sick. I don't feel horrible. And I don't feel horrible about myself either. I really like pizza, it's part of my family's weekly routine, and I don't really care that for one night a week my body gets to process 100g of carbs within a few hours.
    I'm 100% certain that our bodies evolved to be totally fine when our ancestors stumbled across a grove of fruit trees and pigged out on 100s of grams of pure sugar for a few days.
    Your mileage may vary: test it out yourself. But I'd go with how you feel vs how people say you need to run your life.
    Having said all of that, I think it's important (and maybe what some people are trying to say) to think of your "diet" as a way of life. I'm 100% convinced that a ketogenic diet has a long list of health benefits and that I'll be eating this way for a very long time. As such, I don't view NOT eating stuff as a "restriction". I just view it as how I eat because I know it's great for me. And I view occasionally deviating from ideal eating exactly the same way as any other adult decision in life.

  3. javajo91

    Great write up and advice. I appreciate your input Thank you

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