Is Type 1 Diabetes More Dangerous Than Type 2?
Type 1 diabetes results from a rheumatoid-like autoimmune reaction in which one’s own body attacks and destroys the beta cells of the pancreas. These are the cells that normally produce insulin. Type 1 is a disease in which the patient in a relatively short time has no insulin production. All patients with type 1 diabetes can also develop a serious metabolic disorder called ketoacidosis when their blood sugars are high and there is not enough insulin in their body. Ketoacidosis can be fatal unless treated as an emergency with hydration and insulin. Type 2 diabetes rates are growing dramatically in the United States and Western Europe. Type 2 is the result of the muscles and other tissues of the body developing a resistance to insulin produced by the beta cells of the pancreas. The pancreas first tries to overcome this resistance to insulin by making more insulin. The blood sugar goes up as a patient’s body is no longer able to make enough insulin. Most patients with type 2 diabetes mellitus are overweight or obese. For most, but not all, maintenance of a normal weight and a good diet will prevent development of type 2 diabetes. Most type 2 diabetes is diagnosed after age 40. For this reason, many have referred to type 2 as adult-onset diabetes mellitus. This latter name has lost favor as the obesity epidemic has caused a number of people to be diagnosed with type 2 as early as 10 or 11. Type 2 can often be treated with diet modification and can improve significantly with weight loss and exercise. Some patients will be effectively treated with medications such as metformin that increase peripheral sensitivity of organs to insulin. Still more severe disease will require oral medications that encourage the pancreas to make more insulin such as glyburide or glipizide So Continue reading >>
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Diabetic Ketoacidosis And Brain Function
Diabetic Ketoacidosis (DKA) is a life-threatening consequence of diabetes. DKA occurs when there is a lack of insulin in the body causing hyperglycemia. As a result of the inability of glucose to enter the cells, the body must find other means to obtain energy. As such, fat breakdown occurs resulting in the accumulation of fatty acids. The fatty acids are metabolized to ketones that cause the blood to become acidotic (pH less than7.3). Because glucose remains in the blood, there is an increase in thirst and drinking to eliminate the solute load of glucose, which also results in increased urination (polyuria and polydipsia). Thus, the combination of increased serum acidity, weight loss, polyuria, and polydipsia may lead to extreme dehydration, coma, or brain damage. Without a doubt, the most severe acute complication of DKA is cerebral edema. Many cases of new onset type 1 diabetes present DKA (15-70 percent depending on age and geographic region, according to multiple studies), hence the importance of an early diagnosis of diabetes in order to avoid potential consequences. Much research is being conducted to predict the development of severe complications of DKA, most notably on brain herniation, the swelling of the brain that causes it to push towards the spinal cord, as well as other neurological consequences. Fulminant cerebral edema, or swelling of the brain, is relatively rare and has an incidence rate of 0.5-0.9 percent. However, what about the subtler, less severe alterations in brain functions that occur after DKA? Indeed, a recent paper published in Diabetes Care 2014; 37: 1554-1562by Cameron, Scratch, Nadebaum, Northum, Koves, Jennings, Finney, Neil, Wellard, Mackay, and Inder on behalf of the DKA Brain Injury Study Group entitled "Neurological Consequences of Continue reading >>
Tweet Ketosis is a state the body may find itself in either as a result of raised blood glucose levels or as a part of low carb dieting. Low levels of ketosis is perfectly normal. However, high levels of ketosis in the short term can be serious and the long term effects of regular moderate ketosis are only partially known at the moment. What is ketosis? Ketosis is a state the body goes into if it needs to break down body fat for energy. The state is marked by raised levels of ketones in the blood which can be used by the body as fuel. Ketones which are not used for fuel are excreted out of the body via the kidneys and the urine. Is ketosis the same as ketoacidosis? There is often confusion as to the difference between ketosis and ketoacidosis. Ketosis is the state whereby the body is producing ketones. In ketosis, the level of ketones in the blood can be anything between normal to very high. Diabetic ketoacidosis, also known as DKA, only describes the state in which the level of ketones is either high or very high. In ketoacidosis, the amount of ketones in the blood is sufficient to turn the blood acidic, which is a dangerous medical state. When does ketosis occur? Ketosis will take place when the body needs energy and there is not sufficient glucose available for the body. This can typically happen when the body is lacking insulin and blood glucose levels become high. Other causes can be the result of being on a low carb diet. A low level of carbohydrate will lead to low levels of insulin, and therefore the body will produce ketones which do not rely on insulin to get into and fuel the body’s cells. A further cause of ketosis, less relevant to people with diabetes, is a result of excessive alcohol consumption. Is ketosis dangerous? The NHS describes ketosis as a pote Continue reading >>
What Is It Like To Go On A Ketogenic Diet?
It's do-able. Some people love it and some people hate it. Personally, I find that nutritional ketosis is almost ideal for me, whereas "normal" eating with lots of carbs in my diet leads to feelings of non-satiety, drowsiness, mood swings, insulin spikes, bloating, and sometimes nausea. A ketogenic diet consists of 70-80% calories from fat, 15-25% calories from protein, and 0-5% calories from net carbohydrates (carbs). You must restrict your daily net carbs to 20-40g daily. (total grams carbs) - (grams fiber) = (net grams carbs) Your transition period depends on a few factors: how strictly you limit your carbohydrate intake, how much energy you expend day-to-day, and how much energy in the form of glucose and glycogen you have stored in your body currently. My transition period takes 3 days. Day 1: This is an easy day. Your blood is still filled with circulating glucose, and any deficit will be taken from the glycogen in your liver to be converted to glucose. You may feel hunger pangs by the afternoon, and a small dip in insulin, which will feel normal to you because this is what happens every day on a normal diet and you are used to it. Day 2: This is an easy day, too. Your body is happily pulling glycogen from your liver, converting it to glucose, and all is well. Any small amount of carbs that you consume are burned away, nothing is being stored. You may feel the typical afternoon slowdown and hunger, as on day 1. Day 3: Hard day. Your body has been (or is nearly) depleted of glucose and glycogen. The small amount of carbs that you consume are not enough to fuel your brain. You have a feeling of satiety from all the fat you are consuming, but you may feel achy, have headaches, and feel sluggish. Your body is alerting you to the lack of glucose and glycogen. It will t Continue reading >>
Diabetic Ketoacidosis: A Serious Complication
A balanced body chemistry is crucial for a healthy human body. A sudden drop in pH can cause significant damage to organ systems and even death. This lesson takes a closer look at a condition in which the pH of the body is severely compromised called diabetic ketoacidosis. Definition Diabetic ketoacidosis, sometimes abbreviated as DKA, is a condition in which a high amount of acid in the body is caused by a high concentration of ketone bodies. That definition might sound complicated, but it's really not. Acidosis itself is the state of too many hydrogen ions, and therefore too much acid, in the blood. A pH in the blood leaving the heart of 7.35 or less indicates acidosis. Ketones are the biochemicals produced when fat is broken down and used for energy. While a healthy body makes a very low level of ketones and is able to use them for energy, when ketone levels become too high, they make the body's fluids very acidic. Let's talk about the three Ws of ketoacidosis: who, when, and why. Type one diabetics are the group at the greatest risk for ketoacidosis, although the condition can occur in other groups of people, such as alcoholics. Ketoacidosis usually occurs in type one diabetics either before diagnosis or when they are subjected to a metabolic stress, such as a severe infection. Although it is possible for type two diabetics to develop ketoacidosis, it doesn't happen as frequently. To understand why diabetic ketoacidosis occurs, let's quickly review what causes diabetes. Diabetics suffer from a lack of insulin, the protein hormone responsible for enabling glucose to get into cells. This inability to get glucose into cells means that the body is forced to turn elsewhere to get energy, and that source is fat. As anyone who exercises or eats a low-calorie diet knows, fa Continue reading >>
What Are The Side Effects Of High Blood Sugar Levels?
High blood sugar, also known as hyperglycemia, occurs when the body has too little insulin, or cannot use it properly. Common causes of high blood sugar include overeating, under-exercising and emotional stress. According to the American Diabetes Association (ADA), hyperglycemia is a major cause of complications for people diabetes. If you experience frequent or extreme symptoms of high blood sugar, seek guidance from your doctor. Video of the Day Frequent urination is a common symptom of high blood sugar. Urinating more frequently or producing greater urine volume than usual, regardless of how much fluid you've consumed, is often a first recognized symptom of diabetes. When blood sugar increases, compounds known as ketones may develop in the body. Urine test strips provide a means of testing ketone levels at home. According to the ADA, exercise can lower blood sugar. However, if you know that your blood sugar is high and your ketone level is high, exercise may further elevate blood sugar. Reducing your food intake may also help manage your blood sugar. If you have not been tested for, or diagnosed with, diabetes and experience on-going frequent urination, discuss your symptoms with your doctor. Unexplained increases in thirst and hunger may indicate high blood sugar. According to the University of Iowa Hospitals and Clinics (UIHC), dry mouth and increased thirst are common first symptoms of ketoacidosis, a condition also known as diabetic coma. Ketoacidosis occurs when the body lacks insulin and cannot utilize glucose as fuel. The body breaks down fats to use as energy, which causes ketone production. Too many ketones cause build-up, the precursor to ketoacidosis. People with diabetes often recognize the symptoms of high blood sugar, such as thirst, before ketoacidosis Continue reading >>
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How Does A Ketogenic Diet Change Your Life?
The ketogenic diet has changed many people’s lives in different ways: from weight loss to reversing diabetes to improving multiple health factors. Eating a diet high in fat, moderate in protein, and very low in carbohydrates, such as the ketogenic diet (or commonly known as “keto”), puts your body into a state of ketosis, a natural metabolic state in which your body is no longer using glucose as its main source of fuel, and instead it begins using ketones to get its energy. Ketones are produced when your body is burning fat because no glucose is available. It is important not to confuse ketosis, a completely harmless and normal metabolic state, with ketoacidosis, a dangerous condition that occurs mostly in type 1 diabetics when they create high levels of both glucose and ketones at the same time. On the ketogenic plan, blood glucose usually drops, so this is not a danger for most people. However, if you are a type 1 diabetic, check with your doctor before switching to the ketogenic way of eating. So being in ketosis simply means that you have switched from being a sugar-burner to a fat-burner. Ketones are created when you are metabolizing fat, whether it is from the fat in the foods you eat or from the fat around your belly. The ketogenic diet also is an anti-inflammatory way of eating. Chronic inflammation has been shown to be a significant contributor to metabolic syndrome, which includes obesity, insulin resistance, high blood pressure, and high cholesterol levels. Keto avoids foods that can cause inflammation, notably grains, sugar, and starchy carbohydrates such as potatoes and rice. Reducing inflammation may also improve leptin function in the body. Leptin is a hormone that sends signals to the brain that you have enough energy stored and that you are satiat Continue reading >>
What Is It? Diabetic ketoacidosis is a potentially fatal complication of diabetes that occurs when you have much less insulin than your body needs. This problem causes the blood to become acidic and the body to become dangerously dehydrated. Diabetic ketoacidosis can occur when diabetes is not treated adequately, or it can occur during times of serious sickness. To understand this illness, you need to understand the way your body powers itself with sugar and other fuels. Foods we eat are broken down by the body, and much of what we eat becomes glucose (a type of sugar), which enters the bloodstream. Insulin helps glucose to pass from the bloodstream into body cells, where it is used for energy. Insulin normally is made by the pancreas, but people with type 1 diabetes (insulin-dependent diabetes) don't produce enough insulin and must inject it daily. Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School. Continue reading >>
Is A Ketogenic Diet Effective?
The short answer to your question, is yes, a ketogenic diet is safe and effective for most people. Of course, as with any major change in diet or exercise, you should consult with your doctor so that he or she can help you understand whether this diet is safe for YOU. And especially if you are a Type 1 diabetic, I would be concerned about you starting keto without being under close supervision by a doctor because you could go into ketoacidosis which is a dangerous condition. (Ketoacidosis is different than ketosis, which is a safe metabolic condition that your body enters when you cut carbs and raise your fat levels. It’s important not to confuse the two because while ketoacidosis is very dangerous, ketosis is healthy and is actually the goal for most people on the keto diet. Check out this research for the science behind ketosis vs. ketoacidosis.) Basically, a ketogenic diet is very low carb, moderate protein, and high fat. On keto, you should start out eating less than 20 net carbs per day - which is usually what everyone focuses on. But you also need to focus on your protein and fat levels. Women should eat between 50 and 75 grams of protein per day and men should stay between 100–125 grams of protein per day. And then for the fun part of keto - the FAT - your fat should be between a 1:1 and 1:2 ratio of protein to fat. Which means that if I eat 50 grams of protein a day, I should be eating between 50 and 100 grams of fat per day. And this is the yummy kind of fat - saturated fat is great on keto. So eat that bacon and slather on the butter because eating all that fat will help you lose weight and get healthy - as long as you have cut the carbs. And the fat helps you feel full so you won’t get hungry as often and you won’t feel deprived. And don’t worry tha Continue reading >>
Renal Function And Effects Of Partial Rehydration During Diabetic Ketoacidosis
Although diabetic ketoacidosis is characterized by increased renal excretion of glucose, ketone bodies, and nitrogenous compounds, there are few quantitative studies pertaining to renal function during this state. Therefore, renal function was studied in 10 adult patients in moderate to severe diabetic ketoacidosis before insulin administration. Admission plasma concentrations were: glucose 21.4 (9.2–39.4) mM or 386 (166–710) mg/dl, acetoacetate 3.0 (1.3–7.4) mM, beta-hydroxybutyrate 7.9 (2.9–15.2) mM, acetone 4.4 (1.3–8.9) mM, and HCO3 12.8 (9.5–17.8) mM. Arterial blood pH was 7.28 (7.21–7.38). Partial rehydration was achieved with 0.45% saline. Inulin was used to measure GFR. Renal clearance of acetoacetate, beta-hydroxybutyrate, acetone, glucose, and urinary excretion of nitrogenous compounds were determined. Partial rehydration reduced plasma glucose concentration, primarily because of renal excretion, amounting to 384 ± 73 μmol/min or 69 ± 13 mg/min. Partial rehydration had no effect on plasma ketone bodies, on bicarbonate or urea concentrations, or on arterial pH. Partial rehydration had no effect on ketone body or nitrogenous compound excretory rates. Reabsorptive rates of acetoacetate, beta-hydroxybutyrate, acetone, and glucose increased linearly with their filtered loads, and no maximal renal tubular transport rates were demonstrated for any ketone body or glucose. Because renal absorption of ketone bodies was less than 100%, ketonuria increased as filtered loads increase. Unlike ketone bodies, glucose reabsorptive rate was directly related to GFR. Total renal excretion of nitrogen in the forms of urea, ammonium, creatinine, and uric acid amounted to 16 ± 2 mg/min. This huge loss of body nitrogen reflected ongoing protein catabolism and not he Continue reading >>
Diabetic Ketoacidosis - Symptoms
A A A Diabetic Ketoacidosis Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected. Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel. In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common. The most common Continue reading >>
Diabetic Ketoacidosis Symptoms
What is diabetic ketoacidosis? Diabetic ketoacidosis, also referred to as simply ketoacidosis or DKA, is a serious and even life-threatening complication of type 1 diabetes. DKA is rare in people with type 2 diabetes. DKA is caused when insulin levels are low and not enough glucose can get into the body's cells. Without glucose for energy, the body starts to burn fat for energy. Ketones are products that are created when the body burns fat. The buildup of ketones causes the blood to become more acidic. The high levels of blood glucose in DKA cause the kidneys to excrete glucose and water, leading to dehydration and imbalances in body electrolyte levels. Diabetic ketoacidosis most commonly develops either due to an interruption in insulin treatment or a severe illness, including the flu. What are the symptoms and signs of diabetic ketoacidosis? The development of DKA is usually a slow process. However, if vomiting develops, the symptoms can progress more rapidly due to the more rapid loss of body fluid. Excessive urination, which occurs because the kidneys try to rid the body of excess glucose, and water is excreted along with the glucose High blood glucose (sugar) levels The presence of ketones in the urine Other signs and symptoms of ketoacidosis occur as the condition progresses: These include: Fatigue, which can be severe Flushing of the skin Fruity odor to the breath, caused by ketones Difficulty breathing Type 2 Diabetes Diagnosis, Treatment, Medication What should I do if I think I may have, or someone I know may diabetic ketoacidosis? You should test your urine for ketones if you suspect you have early symptoms or warning signs of ketoacidosis. Call your health-care professional if your urine shows high levels of ketones. High levels of ketones and high blood sug Continue reading >>
The Facts Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, most often in those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a fatal coma. DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. It can also occur in people already diagnosed with type 1 diabetes that have missed an insulin dose, have an infection, or have suffered a traumatic event or injury. Although much less common, DKA can occasionally occur in people with type 2 diabetes under extreme physiologic stress. Causes With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take in glucose from the blood. In the case of type 2 diabetes, the pancreas is unable to make sufficient amounts of insulin in order to take in glucose from the blood. Glucose, a simple sugar we get from the foods we eat, is necessary for making the energy our cells need to function. People with diabetes can't get glucose into their cells, so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL) while insulin levels are very low. Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood, causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able Continue reading >>
Diabetic Ketoacidosis (dka) - Topic Overview
Diabetic ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are unable to get the sugar (glucose) they need for energy because there is not enough insulin. When the sugar cannot get into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood and remove it from the body through urine. Because the cells cannot receive sugar for energy, the body begins to break down fat and muscle for energy. When this happens, ketones, or fatty acids, are produced and enter the bloodstream, causing the chemical imbalance (metabolic acidosis) called diabetic ketoacidosis. Ketoacidosis can be caused by not getting enough insulin, having a severe infection or other illness, becoming severely dehydrated, or some combination of these things. It can occur in people who have little or no insulin in their bodies (mostly people with type 1 diabetes but it can happen with type 2 diabetes, especially children) when their blood sugar levels are high. Your blood sugar may be quite high before you notice symptoms, which include: Flushed, hot, dry skin. Feeling thirsty and urinating a lot. Drowsiness or difficulty waking up. Young children may lack interest in their normal activities. Rapid, deep breathing. A strong, fruity breath odor. Loss of appetite, belly pain, and vomiting. Confusion. Laboratory tests, including blood and urine tests, are used to confirm a diagnosis of diabetic ketoacidosis. Tests for ketones are available for home use. Keep some test strips nearby in case your blood sugar level becomes high. When ketoacidosis is severe, it must be treated in the hospital, often in an intensive care unit. Treatment involves giving insulin and fluids through your vein and closely watching certain chemicals in your blood (electrolyt Continue reading >>
Diabetic Ketoacidosis Or Dka
Diabetic ketoacidosis, often referred to as ketoacidosis or simply DKA, is a short term complication of high blood glucose levels in people with diabetes. It most commonly occurs in people with type 1 diabetes but it can also affect some people with type 2 diabetes who are also reliant on insulin (insulin-dependent). Ketoacidosis is a serious medical condition and can advance very quickly within a matter of hours, or sometimes as quickly as within one hour. It is therefore important to know whether you are at risk of ketoacidosis and, if so, to be able to spot the signs and react accordingly. What causes diabetic ketoacidosis? Ketoacidosis occurs when the body starts running out of insulin – the hormone responsible for regulating levels of blood sugar. Without enough insulin, the cells cannot access glucose from the blood and so the body responds by breaking down protein and fat to produce an alternative form of energy called ketones. Whilst the body can cope with lower levels of ketones, higher levels can turn the blood acidic and pose an immediate danger to health, often causing severe illness. Am I at risk of ketoacidosis? People with type 1 diabetes or LADA (Latent Autoimmune Diabetes of Adulthood) who require insulin injections are most at risk of developing ketoacidosis. Type 2 diabetics who need to take meal time insulin (short or rapid-acting insulin) in addition to long term (basal) insulin may also be at risk. What the signs of diabetic ketoacidosis? The symptoms of ketoacidosis include: Lethargy Nausea and/or stomach pains Vomiting Dehydration Laboured breathing Confusion If you have any of the symptoms of ketoacidosis contact your health care provider immediately. Early detection and treatment is vital in cases of DKA, as failure to treat the condition qui Continue reading >>