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Diabetic Ketoacidosis (dka) - Topic Overview

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 >>

Ketosis Vs. Ketoacidosis: What You Should Know

Ketosis Vs. Ketoacidosis: What You Should Know

Despite the similarity in name, ketosis and ketoacidosis are two different things. Ketoacidosis refers to diabetic ketoacidosis (DKA) and is a complication of type 1 diabetes mellitus. It’s a life-threatening condition resulting from dangerously high levels of ketones and blood sugar. This combination makes your blood too acidic, which can change the normal functioning of internal organs like your liver and kidneys. It’s critical that you get prompt treatment. DKA can occur very quickly. It may develop in less than 24 hours. It mostly occurs in people with type 1 diabetes whose bodies do not produce any insulin. Several things can lead to DKA, including illness, improper diet, or not taking an adequate dose of insulin. DKA can also occur in individuals with type 2 diabetes who have little or no insulin production. Ketosis is the presence of ketones. It’s not harmful. You can be in ketosis if you’re on a low-carbohydrate diet or fasting, or if you’ve consumed too much alcohol. If you have ketosis, you have a higher than usual level of ketones in your blood or urine, but not high enough to cause acidosis. Ketones are a chemical your body produces when it burns stored fat. Some people choose a low-carb diet to help with weight loss. While there is some controversy over their safety, low-carb diets are generally fine. Talk to your doctor before beginning any extreme diet plan. DKA is the leading cause of death in people under 24 years old who have diabetes. The overall death rate for ketoacidosis is 2 to 5 percent. People under the age of 30 make up 36 percent of DKA cases. Twenty-seven percent of people with DKA are between the ages of 30 and 50, 23 percent are between the ages of 51 and 70, and 14 percent are over the age of 70. Ketosis may cause bad breath. Ket Continue reading >>

What Was A Choice You Made That Completely Changed Your Life?

What Was A Choice You Made That Completely Changed Your Life?

I gave up pitching myself to everyone out there. When I graduated from the university, I had no clue what to do next. As well as thousands of young graduates who have to move to the next stage of their lives, I had to decide where to live, how to make money, and ultimately what direction to move in… I had no idea what decisions would let me not screw up my life. I was still looking for the passion and was still trying to understand what excites me the most. The only thing I felt passionate about was blogging. However, I realized that it wasn’t likely to let me make a living within the first year or two. Another thing I knew is that I have always wanted to be self-employed and run my own business. I had a decent amount of ideas that seemed great to me… however, I had no dedicated team and not enough savings to sustain a startup… Unfortunately, it didn’t seem feasible to launch a business. I had too many questions and no answers at all. I faced a few dilemmas and appeared to be not ready to solve them. Eventually, I kept blogging on a regular basis and as most people out there I decided to look for a job. The next month was all about pitching - every single day I sent resumes to dozens of different companies and tried to convince the editors of the authoritative outlets that my writing is worth sharing. No success. Neither companies were sending me job offers, nor anyone found my articles interesting enough. Over that month I received 37 job rejections and sent 78 unanswered emails asking to feature my articles on different publications and websites. At that point, I realized that my strong unwillingness to work in the corporate sector and my overall uncertainty about the field I want to work at were not likely to help me land a nice job. Moreover, frankly speak Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (DKA) is a dangerous and potentially life threatening complication of diabetes, with thousands of preventable cases each year. DKA most commonly happens in people with Type 1 Diabetes although it occasionally occurs in people with insulin-treated Type 2 Diabetes. DKA occurs when there is persistently high glucose and a severe lack of insulin. 10,434 people with Type 1 diabetes hospitalised at least once during 2011-12 ¹ 9% of children experienced DKA in 1 year ² Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period, with the first sign often being hyperglycemia. Typical symptoms of diabetic ketoacidosis include: Vomiting Dehydration Deep laboured breathing (called kussmaul breathing) Confusion and sometimes even coma Click here to download the full DKA Information Brochure What are Ketones? Ketones are the by-product of fat metabolism. Ketones can provide the body with energy when glucose is not available. As you know, in order to derive energy from the carbohydrates in the foods that we eat, the body needs insulin. Insulin is the key that unlocks the body’s cells in order to allow glucose to enter to provide energy. In the absence of sufficient insulin, glucose cannot enter the cells and the glucose levels build up in the blood. Without insulin, the body begins to metabolize fat and produces ketones. Ketones can be very dangerous when the blood glucose level is high. If the blood glucose and ketones levels continue to rise, one can get very sick very quickly. The person begins to get dehydrated and acidotic, meaning that the body loses water and salts and the pH falls with a build up of acids, the ketones, developing DKA. What are blood ketones versus urine ketones You may have heard about or learned how to check urine ketones 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 >>

Will Ketoacidosis Or Hypoglycemia Skew The Results Of A Blood Alcohol Test?

Will Ketoacidosis Or Hypoglycemia Skew The Results Of A Blood Alcohol Test?

Elevated blood ketones (as with diabetic ketoacidosis) can cause false elevation of blood test results. Alcohols others than ethanol (e.g., isopropyl [rubbing alcohol] or methanol [grain alcohol]) will also cause testing to be positive. Ask New Question Continue reading >>

With What Diet Can I Lose A Lot Of Weight Fast?

With What Diet Can I Lose A Lot Of Weight Fast?

Look, almost any diet will make you lose weight. But what are you going to do when you’re finished with them? If you’re like most people, you’ll fall back on your old habits—the same ones that made you fat in the first place. That’s why most diets end in failure. It’s not that they’re ineffective—although some are complete rubbish; it’s that they’re a temporary answer to a semi-permanent problem. Here’s what you need to find out: what’s the healthiest form of food consumption you can enjoy for the rest of your life? Maybe you like veganism? Or paleo, or keto, or whatever. Perhaps you don’t end up in any diet camp and instead create your own habits. That’s great too. But here’s what matters for right now: if you want to lose weight, then you must consume food at a caloric deficit. This means eating less calories than you burn. I lost eighty pounds a number of years ago. About fifty to sixty pounds of that came without any exercise; I simply ate at a caloric deficit and tracked everything on MyFitnessPal—an online food journal with a mobile app. Similar stories can be found daily on forums like Reddit’s /r/loseit. You can literally achieve this eating junk food. (although I don’t recommend it!) A professor at Kansas State University lost 27lbs in 2 months eating Twinkies, chips, Oreos, and other junk. More recently, I lost 6lbs after eating exclusively at gas stations for 30 days. I traveled across 9 states and visited more than 200 stores—all in an effort to prove that you can “eat out” and still be healthy. But to be fair, the convenience store industry is working hard to make healthful food available on-the-go. Finding fruit, veggies, and good made-to-order options was easier than I thought it would be. So here’s the point: d Continue reading >>

Lab Values And Dka

Lab Values And Dka

Changes in laboratory values often give us clues to what is happening with our patients. I came across the following resource this morning and thought it was worth sharing. Here’s a handy table to help you identify diabetic ketoacidosis (DKA). The following equation can be used to calculate an anion gap: Anion gap = Na+(mEq/L) – [Cl-(mEq/L) + HCO3-(mEq/L)] You have an important role when caring for a patient with DKA. Thorough physical assessments, careful monitoring of laboratory values, and critical thinking are essential to avoid complications of this complex disorder. Have you cared for a patient with DKA? What are the common presenting signs and symptoms? Reference Donahey, E., Folse, S., Weant, K. (2012). Management of Diabetic Ketoacidosis. Advanced Emergency Nursing Journal, 34(3). Continue reading >>

A Breath Test For Ketoacidosis

A Breath Test For Ketoacidosis

British investigators are researching a non-invasive breath test to quickly diagnose diabetic ketoacidosis. Diabetic ketoacidosis is a preventable acute complication of type 1 diabetes (DM). It develops rapidly upon interruption of insulin therapy, or when conditions develop that do not allow insulin to work (for example, acute illness). When someone with diabetes doesn't have enough insulin to burn glucose as fuel, their body can start breaking down fat instead. Ketones start building up in the bloodstream. Ketones are acid, and their accumulation in the blood may lead to diabetic ketoacidosis. Diabetic ketoacidosis may be lethal even in this day and age. Children, who depend on parental management of diabetes, are especially susceptible to diabetic ketoacidosis, but anyone with type 1 DM may get it. Home testing for ketones is available, however they currently require either a blood or urine sample. These tests differ from the standard blood sugar tests (fingerstick glucose test for A1c levels). Every patient with type 1 DM (or caregiver) is instructed to check for ketones whenever: • The child does not feel well • They become dehydrated • They have an interruption of insulin therapy • Their blood glucose testing reads high. For more information on how to avoid diabetic ketoacidosis. Researchers in England have developed a potentially easier way to monitor these ketone levels, and curiously enough, the trick may lie in a person's breath. Breath Test Detects Acetone In a recent study at Oxford Children's Hospital,1 researchers tested more than 100 patients with type 1 diabetes between the ages of 7 to 18 years old, measuring gases in their breath and ketone levels in their blood. Researchers found that one gas in particular—acetone— seemed to predict ketone Continue reading >>

The Stanbio Chemistry Beta-hydroxybutyrate Liquicolor® Reagent

The Stanbio Chemistry Beta-hydroxybutyrate Liquicolor® Reagent

Diabetic ketoacidosis is a problem that occurs in people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin, and fat is used for fuel instead. Other symptoms include: Abdominal pain Breathing difficulty while lying down Decreased appetite Decreased consciousness Dulled senses that may worsen to a coma Fatigue Frequent urination or thirst that lasts for a day or more Headache Muscle stiffness or aches Shortness of breath People with type 1 diabetes may be at risk when they do not have enough insulin, a hormone the body uses to break down sugar (glucose) in the blood for energy. When the body senses glucose is not available, fat is broken down instead. As fats are broken down, acids called ketones build up in the blood and urine. Ketones are poisonous in high levels and this condition is called ketoacidosis. Blood glucose levels rise (usually higher than 300 mg/dL) because the liver makes glucose to try to combat the problem. However the cells cannot pull in that glucose without insulin. Diabetic ketoacidosis may be the first sign of type 1 diabetes in people who do not yet have other symptoms. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, or surgery can lead to diabetic ketoacidosis in people with type 1 diabetes. Ketoacidosis can also occur in people with diabetes when they miss their insulin treatments. People with type 2 diabetes can develop ketoacidosis, but it is rare. It is usually triggered by a severe illness. Hispanic and African-American people are more likely to have ketoacidosis as a complication of type 2 diabetes. During ketosis, Beta-Hydroxybutyrate (BHB) levels may increase more than levels of acetone Continue reading >>

What Are The Indicators To Check Up The Blood Sugar Of Type 1 Diabetics? How Often Should A Diabetic Check Their Blood Glucose Level Within A Day?

What Are The Indicators To Check Up The Blood Sugar Of Type 1 Diabetics? How Often Should A Diabetic Check Their Blood Glucose Level Within A Day?

Blood glucose monitoring can help keep diabetes under control. The following symptoms may be the first signs of type 1 diabetes. They may also occur when blood sugar is high. Excessive thirst and hunger Fatigue, feeling tired all the time Blurry eyesight Feeling numbness or tingling in your feet Losing weight even without trying Frequent urination Methods of Monitoring Glucose Blood glucose monitoring using a glucometer gives a direct measure of the glucose concentration at the time of the test. After washing your hands, insert a test strip into your meter. Use your lancing device on the side of your fingertip to get a drop of blood. Touch and hold the edge of the test strip to the drop of blood, and wait for the result. Your blood glucose level will appear on the meter's display. All meters are slightly different, so always refer to your user's manual for specific instructions. Keep a record of your blood sugar for yourself and your health care team. These numbers will help if you have problems managing your diabetes. You and your doctor should set a target goal for your blood sugar level at different times during the day. You can also ask a doctor to test your blood sugar. Your results with glucose meter may not be as accurate as a lab-drawn test would be. Urine glucose testing is not as accurate as blood glucose checks and should only be used when blood testing is impossible. Urine checks for ketones, however, is important when your diabetes is out of control. How Often Should You Check Your Blood Sugar Level? If you have type 1 diabetes, check your blood sugar at least 4 times a day. Usually, you will test your blood sugar before meals and at bedtime. You may also check your blood sugar: After you eat out, especially if you have eaten foods you do not normally eat I 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 >>

Exams And Tests For Diabetic Ketoacidosis

Exams And Tests For Diabetic Ketoacidosis

A A A Diabetic Ketoacidosis (cont.) The diagnosis of diabetic ketoacidosis is typically made after the health care practitioner obtains a history, performs a physical examination, and reviews the laboratory tests. Blood tests will be ordered to document the levels of sugar, potassium, sodium, and other electrolytes. Ketone level and kidney function tests along with a blood gas sample (to assess the blood acid level, or pH) are also commonly performed. Other tests may be used to check for conditions that may have triggered the diabetic ketoacidosis, based on the history and physical examination findings. These may include chest X-ray, electrocardiogram (ECG), urine analysis, and possibly a CT scan of the brain. Home care is generally directed toward preventing diabetic ketoacidosis and treating moderately to elevated to high levels of blood sugar. If you have type 1 diabetes, you should monitor your blood sugars as instructed by your health care practitioner. Check these levels more often if you feel ill, if you are fighting an infection, or if you have had a recent illness or injury. Your health care practitioner may recommend treating moderate elevations in blood sugar with additional injections of a short-acting form of insulin. Working with their health care practitioner, people with diabetes should have previously arranged a regimen of extra insulin injections and more frequent blood glucose and urinary ketone monitoring for home treatment as blood sugar levels begin to rise. Be alert for signs of infection and keep yourself well hydrated by drinking sugar free fluids throughout the day. Continue Reading A A A Diabetic Ketoacidosis (cont.) Fluid replacement and insulin administration intravenously (IV) are the primary and most critical initial treatments for diabeti Continue reading >>

Diabetes Urine Tests

Diabetes Urine Tests

Urine tests may be done in people with diabetes to evaluate severe hyperglycemia (severe high blood sugar) by looking for ketones in the urine. Ketones are a metabolic product produced when fat is metabolized. Ketones increase when there is insufficient insulin to use glucose for energy. Urine tests are also done to look for the presence of protein in the urine, which is a sign of kidney damage. Urine glucose measurements are less reliable than blood glucose measurements and are not used to diagnose diabetes or evaluate treatment for diabetes. They may be used for screening purposes. Testing for ketones is most common in people with type 1 diabetes. Type 1 Diabetes: What Are The Symptoms? This test detects the presence of ketones, which are byproducts of metabolism that form in the presence of severe hyperglycemia (elevated blood sugar). Ketones are formed from fat that is burned by the body when there is insufficient insulin to allow glucose to be used for fuel. When ketones build up to high levels, ketoacidosis (a serious and life-threatening condition) may occur. Ketone testing can be performed both at home and in the clinical laboratory. Ketones can be detected by dipping a test strip into a sample of urine. A color change on the test strip signals the presence of ketones in the urine. Ketones occur most commonly in people with type 1 diabetes, but uncommonly, people with type 2 diabetes may test positive for ketones. The microalbumin test detects microalbumin, a type of protein, in the urine. Protein is present in the urine when there is damage to the kidneys. Since the damage to blood vessels that occurs as a complication of diabetes can lead to kidney problems, the microalbumin test is done to check for damage to the kidneys over time. Can urine tests be used to Continue reading >>

Urine Test Kits

Urine Test Kits

What is the difference between the urine test kits for people with diabetes? Three different kinds of urine testing kits are available for testing three different substances in the urine: glucose (sugar), ketones, and microscopic amounts of protein (microalbuminuria). Glucose test kits Before the development of blood glucose meters, urine testing was the only method for gauging a person's sugar levels. However, it has always been a very imprecise method for testing glucose levels for a variety of reasons: Urine test strips cannot detect glucose (sugar) until the blood glucose level is above 180 mg/dl. This means a person's blood sugar level could still be high (hyperglycemia) or even dangerously low (hypoglycemia) but still not be detected. Urine glucose testing is highly subject to user error because it requires color interpretation of the urine test strip via a color-scale comparison. This becomes an issue with people who are colorblind or have poor eyesight, and certain drugs and vitamin C can change the color of the urine and thus provide an invalid measurement. The reading reflects the level of blood glucose from a few hours earlier - not at the present moment - and often is misinterpreted. As a result of these shortcomings, healthcare professionals recommend that anyone needing to closely monitor blood glucose levels use a blood glucose meter. However, urine strips can be useful in certain populations who physically cannot or will not test themselves with a blood glucose meter. Ketone test kits Ketone bodies are the byproducts of the body burning fat, rather than glucose, to provide energy. When fat is used for energy instead of glucose, the preferred fuel source, the liver produces substances called ketones. If ketones build up, they can lead to a life-threatenin Continue reading >>

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