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What You Should Know About Diabetic Ketoacidosis

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious condition that can occur in diabetes. DKA happens when acidic substances, called ketones, build up in your body. Ketones are formed when your body burns fat for fuel instead of sugar, or glucose. That can happen if you don’t have enough insulin in your body to help you process sugars. Learn more: Ketosis vs. ketoacidosis: What you should know » Left untreated, ketones can build up to dangerous levels. DKA can occur in people who have type 1 or type 2 diabetes, but it’s rare in people with type 2 diabetes. DKA can also develop if you are at risk for diabetes, but have not received a formal diagnosis. It can be the first sign of type 1 diabetes. DKA is a medical emergency. Call your local emergency services immediately if you think you are experiencing DKA. Symptoms of DKA can appear quickly and may include: frequent urination extreme thirst high blood sugar levels high levels of ketones in the urine nausea or vomiting abdominal pain confusion fruity-smelling breath a flushed face fatigue rapid breathing dry mouth and skin It is important to make sure you consult with your doctor if you experience any of these symptoms. If left untreated, DKA can lead to a coma or death. All people who use insulin should discuss the risk of DKA with their healthcare team, to make sure a plan is in place. If you think you are experiencing DKA, seek immediate medical help. Learn more: Blood glucose management: Checking for ketones » If you have type 1 diabetes, you should maintain a supply of home urine ketone tests. You can use these to test your ketone levels. A high ketone test result is a symptom of DKA. If you have type 1 diabetes and have a glucometer reading of over 250 milligrams per deciliter twice, you should test your urine for keton Continue reading >>

Ketoacidosis

Ketoacidosis

Ketoacidosis Diabetic Ketoacidosis (DK) occurs when a person with diabetes becomes dehydrated during a state of relative insulin deficiency, associated with high blood levels of sugar and organic acids called ketones. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. DK is a serious condition that can lead to diabetic coma or even death if left untreated. DK is associated with significant disturbances of the body’s chemistry, which can resolve with proper therapy. In Diabetic Ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). As the body produces stress response hormones unopposed by insulin due to the insulin deficiency, the body begins to consume its own muscle, fat and liver cells into glucose 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. Ketones are acids that build up in the blood and appear in the urine when your body doesn’t have enough insulin. They are a warning sign that your diabetes is out of control or that you are getting sick. High levels of ketones can poison the body. Ketoacidosis may happen to anyone with diabetes and individuals with Type I need to take extra precautionary measures. But you can help prevent DK by learning the warning signs and checking your urine and blood regularly. Ketoacidosis usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours. Early symptoms include the following: Thirst or a very dry mouth Frequent urination High blood glucose (sugar) levels High levels of ket Continue reading >>

How Dka Happens And What To Do About It

How Dka Happens And What To Do About It

Certified Diabetes Educator Gary Scheiner offers an overview of diabetic ketoacidosis. (excerpted from Think Like A Pancreas: A Practical Guide to Managing Diabetes With Insulin by Gary Scheiner MS, CDE, DaCapo Press, 2011) Diabetic Ketoacidosis (DKA) is a condition in which the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production. When bodily fluids become acidic, some of the body’s systems stop functioning properly. It is a serious condition that will make you violently ill and it can kill you. The primary cause of DKA is a lack of working insulin in the body. Most of the body’s cells burn primarily sugar (glucose) for energy. Many cells also burn fat, but in much smaller amounts. Glucose happens to be a very “clean” form of energy—there are virtually no waste products left over when you burn it up. Fat, on the other hand, is a “dirty” source of energy. When fat is burned, there are waste products produced. These waste products are called “ketones.” Ketones are acid molecules that can pollute the bloodstream and affect the body’s delicate pH balance if produced in large quantities. Luckily, we don’t tend to burn huge amounts of fat at one time, and the ketones that are produced can be broken down during the process of glucose metabolism. Glucose and ketones can “jump into the fire” together. It is important to have an ample supply of glucose in the body’s cells. That requires two things: sugar (glucose) in the bloodstream, and insulin to shuttle the sugar into the cells. A number of things would start to go wrong if you have no insulin in the bloodstream: Without insulin, glucose cannot get into the body’s cells. As a result, the cells begin burning large amounts of fat for energy. This, of course, Continue reading >>

Ketoacidosis In Cats – Causes, Symptoms & Treatment

Ketoacidosis In Cats – Causes, Symptoms & Treatment

Ketoacidosis in cats at a glance Ketoacidosis is a serious complication of diabetes in which ketones and blood sugar levels build up in the body due to insufficient levels of insulin which is required to move glucose into the cells for energy. As a result, the body uses fat as an alternate energy source which produces ketones causing the blood to become too acidic. Common causes include uncontrolled diabetes, missed or insufficient insulin, surgery, infection, stress and obesity. Symptoms of ketoacidosis include increased urination and thirst, dehydration, nausea, diarrhea, confusion, rapid breathing which may later change to laboured breathing. What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes characterised by metabolic acidosis (increased acids in the blood), hyperglycemia (high blood glucose) and ketonuria (ketones in the urine). It is caused by a lack of or insufficient amounts of insulin which is required to move glucose from the bloodstream and into the cells to be used for energy. When this occurs, the body begins to search for alternate sources of energy and begins to break down fat. When fat is broken down (metabolised) into fatty acids, waste products known as ketones (acetoacetate, beta-hydroxybutyrate, acetone) are released from the liver and accumulate in the bloodstream (known as ketonemia). This causes the blood to become too acidic (metabolic acidosis). As well as metabolic acidosis, ketones also cause central nervous depression.The body will try to get rid of the ketones by excreting them out of the body via the urine, increased urine output leads to dehydration, making the problem worse. Meanwhile, the unused glucose remains in the bloodstream, resulting in hyperglycemia (high blood sugar).Insulin Continue reading >>

How To Treat Ketoacidosis

How To Treat Ketoacidosis

Immediately drink a large amount of non-caloric or low caloric fluid. Continue to drink 8 to 12 oz. every 30 minutes. Diluted Gatorade, water with Nu-Salt™ and similar fluids are good because they help restore potassium lost because of high blood sugars. Take larger-than-normal correction boluses every 3 hours until the blood sugar is below 200 mg/dl (11 mmol) and ketones are negative. It will take much more rapid insulin than normal to bring blood sugars down when ketones are present in the urine or blood. Often, one and a half to two times the normal insulin dose for a high blood sugar will be necessary. Higher insulin doses than these will be needed if there is an infection or other major stress. If nausea becomes severe or last 4 hours or more, call your physician. If vomiting starts or you can no longer drink fluids, have a friend or family member call your physician immediately, then go directly to an emergency room for treatment. Never omit your insulin, even if you cannot eat. A reduced insulin dose might be needed, but only if your blood sugar is currently low. When high blood sugars or ketoacidosis happen, it is critical that you drink lots of fluid to prevent dehydration. Take extra amounts of Humalog, Novolog or Regular insulin to bring the blood sugars down. Children with severe ketoacidosis lose 10-15 % of their previous body weight (i.e., a 60 lb. child can lose 6 to 9 lbs. of weight) due to severe dehydration. Replacement of fluids should be monitored carefully. The dehydration is caused by excess urination due to high blood sugars and is quickly worsened when vomiting starts due to the ketoacidosis. The start of vomiting requires immediate attention at an ER or hospital where IV fluid replacement can begin. If only nausea is present and it is possible Continue reading >>

Diabetic Ketoacidosis Treatment & Management

Diabetic Ketoacidosis Treatment & Management

Approach Considerations Managing diabetic ketoacidosis (DKA) in an intensive care unit during the first 24-48 hours always is advisable. When treating patients with DKA, the following points must be considered and closely monitored: It is essential to maintain extreme vigilance for any concomitant process, such as infection, cerebrovascular accident, myocardial infarction, sepsis, or deep venous thrombosis. It is important to pay close attention to the correction of fluid and electrolyte loss during the first hour of treatment. This always should be followed by gradual correction of hyperglycemia and acidosis. Correction of fluid loss makes the clinical picture clearer and may be sufficient to correct acidosis. The presence of even mild signs of dehydration indicates that at least 3 L of fluid has already been lost. Patients usually are not discharged from the hospital unless they have been able to switch back to their daily insulin regimen without a recurrence of ketosis. When the condition is stable, pH exceeds 7.3, and bicarbonate is greater than 18 mEq/L, the patient is allowed to eat a meal preceded by a subcutaneous (SC) dose of regular insulin. Insulin infusion can be discontinued 30 minutes later. If the patient is still nauseated and cannot eat, dextrose infusion should be continued and regular or ultra–short-acting insulin should be administered SC every 4 hours, according to blood glucose level, while trying to maintain blood glucose values at 100-180 mg/dL. The 2011 JBDS guideline recommends the intravenous infusion of insulin at a weight-based fixed rate until ketosis has subsided. Should blood glucose fall below 14 mmol/L (250 mg/dL), 10% glucose should be added to allow for the continuation of fixed-rate insulin infusion. [19, 20] In established patient Continue reading >>

Diabetic Ketoacidosis (causes, Symptoms, Treatment, Complications) Center

Diabetic Ketoacidosis (causes, Symptoms, Treatment, Complications) Center

Diabetic ketoacidosis (DKA) is a complication of type 1 diabetes that is life threatening. If a person thinks they may have diabetic ketoacidosis they should seek medical care immediately. Diabetic ketoacidosis happens when a person's insulin levels in the blood become dangerously low. Symptoms of diabetic ketoacidosis include dehydration, abdominal pain, confusion, and nausea and vomiting. Diabetic ketoacidosis needs medical treatment. It cannot be treated at home. Read more: Diabetic Ketoacidosis (Causes, Symptoms, Treatment, Complications) Article Multimedia: Slideshows, Images & Quizzes Continue reading >>

Alcoholic Ketoacidosis Treatment & Management

Alcoholic Ketoacidosis Treatment & Management

Approach Considerations Treatment of alcoholic ketoacidosis (AKA) is directed toward reversing the 3 major pathophysiologic causes of the syndrome, which are: This goal can usually be achieved through the administration of dextrose and saline solutions. [4] Carbohydrate and fluid replacement reverse the pathophysiologic derangements that lead to AKA by increasing serum insulin levels and suppressing the release of glucagon and other counterregulatory hormones. Dextrose stimulates the oxidation of NADH and aids in normalizing the NADH/NAD+ ratio. Fluids alone do not correct AKA as quickly as do fluids and carbohydrates together. Indeed, evidence-based guidelines by Flannery et al, on the management of intensive care unit patients with a chronic alcohol disorder, including symptoms that mimic or mask Wernicke encephalopathy, recommend that in cases of suspected AKA, dextrose-containing fluids be used in place of normal saline during the first day of admission. [23] In alcoholics, thiamine (100 mg IV or IM) should be administered prior to any glucose-containing solutions. This will decrease the risk of precipitating Wernicke encephalopathy or Korsakoff syndrome. [13] Phosphate depletion is also common in alcoholics. The plasma phosphate concentration may be normal on admission; however, it typically falls to low levels with therapy as insulin drives phosphate into the cells. When present, severe hypophosphatemia may be associated with marked and possibly life-threatening complications, such as myocardial dysfunction, in these patients. Institute appropriate treatment for serious, coexisting, acute illnesses. These may include pancreatitis, hepatitis, heart failure, or infection. Prevention of AKA involves the treatment of chronic alcohol abuse. Transfer considerations Pati Continue reading >>

Alcoholic Ketoacidosis

Alcoholic Ketoacidosis

Increased production of ketone bodies due to: Dehydration (nausea/vomiting, ADH inhibition) leads to increased stress hormone production leading to ketone formation Depleted glycogen stores in the liver (malnutrition/decrease carbohydrate intake) Elevated ratio of NADH/NAD due to ethanol metabolism Increased free fatty acid production Elevated NADH/NAD ratio leads to the predominate production of β–hydroxybutyrate (BHB) over acetoacetate (AcAc) Dehydration Fever absent unless there is an underlying infection Tachycardia (common) due to: Dehydration with associated orthostatic changes Concurrent alcohol withdrawal Tachypnea: Common Deep, rapid, Kussmaul respirations frequently present Nausea and vomiting Abdominal pain (nausea, vomiting, and abdominal pain are the most common symptoms): Usually diffuse with nonspecific tenderness Epigastric pain common Rebound tenderness, abdominal distension, hypoactive bowel sounds uncommon Mandates a search for an alternative, coexistent illness Decreased urinary output from hypovolemia Mental status: Minimally altered as a result of hypovolemia and possibly intoxication Altered mental status mandates a search for other associated conditions such as: Head injury, cerebrovascular accident (CVA), or intracranial hemorrhage Hypoglycemia Alcohol withdrawal Encephalopathy Toxins Visual disturbances: Reports of isolated visual disturbances with AKA common History Chronic alcohol use: Recent binge Abrupt cessation Physical Exam Findings of dehydration most common May have ketotic odor Kussmaul respirations Palmar erythema (alcoholism) Lab Acid–base disturbance: Increased anion gap metabolic acidosis hallmark Mixed acid–base disturbance common: Respiratory alkalosis Metabolic alkalosis secondary to vomiting and dehydration Hyperchlorem Continue reading >>

Diabetic Ketoacidosis: Evaluation And Treatment

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, gastroenteritis, starvation ketosis, and other metabolic syndromes, and can assist in diagnosing comorbid conditions. Appropriate treatment includes administering intravenous fluids and insulin, and monitoring glucose and electrolyte levels. Cerebral edema is a rare but severe complication that occurs predominantly in children. Physicians should recognize the signs of diabetic ketoacidosis for prompt diagnosis, and identify early symptoms to prevent it. Patient education should include information on how to adjust insulin during times of illness and how to monitor glucose and ketone levels, as well as i Continue reading >>

Can Diabetes Kill You?

Can Diabetes Kill You?

Here’s what you need to know about the life-threatening diabetes complication called diabetic ketoacidosis. Diabetic ketoacidosis is one of the most serious complications of diabetes. Symptoms can take you by surprise, coming on in just 24 hours or less. Without diabetic ketoacidosis treatment, you will fall into a coma and die. “Every minute that the person is not treated is [another] minute closer to death,” says Joel Zonszein, MD, professor of medicine at Albert Einstein College of Medicine in New York City. Diabetic ketoacidosis occurs when your body doesn’t produce enough insulin. (Diabetic ketoacidosis most often affects people with type 1 diabetes, but there is also type 2 diabetes ketoacidosis.) Without insulin, sugar can’t be stored in your cells to be used as energy and builds up in your blood instead. Your body has to go to a back-up energy system: fat. In the process of breaking down fat for energy, your body releases fatty acids and acids called ketones. Ketones are an alternative form of energy for the body, and just having them in your blood isn’t necessarily harmful. That’s called ketosis, and it can happen when you go on a low-carb diet or even after fasting overnight. “When I put people on a restricted diet, I can get an estimate of how vigorously they’re pursuing it by the presence of ketones in the urine,” says Gerald Bernstein, MD, an endocrinologist and coordinator of the Friedman Diabetes Program at Lenox Hill Hospital in New York City. RELATED: The Ketogenic Diet Might Be the Next Big Weight Loss Trend, But Should You Try It? But too many ketones are a problem. “In individuals with diabetes who have no or low insulin production, there is an overproduction of ketones, and the kidneys can’t get rid of them fast enough,” sa Continue reading >>

What Are The Treatments For Ketoacidosis In Dogs?

What Are The Treatments For Ketoacidosis In Dogs?

If your dog has diabetes mellitus, a common ailment in the canine realm, then diabetic ketoacidosis is a hazardous possibility. Ketoacidosis is a metabolic disorder that's related to extreme hyperglycemia. When diabetic dogs develop ketoacidosis, ketones, a type of acid, accumulate in their blood. Veterinary care is vital for dogs with this condition. Diabetic Ketoacidosis Background When insufficient amounts of insulin bring upon the liver's inordinate manufacturing of ketoacids, ketoacidosis arises. Numerous factors can cause diabetic ketoacidosis in canines. The primary cause of the condition is reliance on insulin, although ketoacidosis is also linked to things such as urinary tract infections and skin infections. Dogs frequently experience diabetic ketoacidosis when their diabetes mellitus hasn't yet been identified or managed. Key Diabetic Ketoacidosis Symptoms If you notice any unusual symptoms in your diabetic pet, get him to the veterinarian for treatment immediately. Diabetic ketoacidosis is an urgent condition. Common symptoms of the ailment are throwing up, nausea, appetite loss, dandruff, fatigue, feebleness, dehydration, fast breathing, depression, decreased body temperature, frequent urination, inordinate thirst, weight loss and unusual-smelling breath: If your dog's breath has an odor that's reminiscent of nail polish remover, diabetic ketoacidosis could be the culprit. Since diabetic ketoacidosis is a medical emergency in dogs, immediate care is of the essence, no matter the time of day or night. If you notice these symptoms in your pet overnight, take him to a 24-hour veterinary hospital. Female dogs are particularly susceptible to the condition, as are elderly dogs. Treatment Options Some dogs with diabetic ketoacidosis need hospitalization, others do Continue reading >>

Diabetic (diabetes) Ketoacidosis Treatment And Home Remedies

Diabetic (diabetes) Ketoacidosis Treatment And Home Remedies

One of the symptoms of diabetes is the so-called diabetic ketoacidosis or DKA. This condition occurs as a result of the body’s dehydration at the state of insulin deficiency. This is also connected with the rise in blood sugar levels and organic acids known as ketones. Diabetic ketoacidosis normally happens to patients with type 1 diabetes mellitus. Diabetic ketoacidosis is common to younger age group than that of type 2 diabetes. This condition can happen to both men and women. However, diabetic ketoacidosis treatment is available whether through home treatment or clinic medication. Causes of Diabetic Ketoacidosis Diabetic ketoacidosis occurs when a diabetic patient becomes dehydrated. Events that trigger the attack of diabetic ketoacidosis include the following: Infection related to diarrhea, vomiting, and high fever Inadequate amount of insulin Newly diagnosed with diabetes Heart attack, stroke, trauma, stress, alcohol abuse, drug abuse Previous surgery Home Remedies and Treatment for Diabetic Ketoacidosis Diabetic ketoacidosis treatment guidelines can be conveniently done at home. Self-care is usually available along with frequent checkups with the doctor. However, self-care at home is oftentimes administered for the prevention of diabetic ketoacidosis in treating moderate to elevated blood sugar levels. If you are a patient with type 1 diabetes, it is important that you monitor your sugar levels in the blood as directed by your doctor. Regularly check on the levels of blood sugar if you feel ill, having an infection, or have had an illness or injury. Doing the self-care diabetic ketoacidosis treatment at home would mean having additional injections of insulin. This treatment should of course be coupled with arranging extra insulin regimen and frequent blood gluco Continue reading >>

Natural Cures And Home Remedies For Acidosis

Natural Cures And Home Remedies For Acidosis

Acidosis is a biochemical condition, caused by acid-alkaline imbalance in the body's pH levels, where the acidity of the body fluid is very high. The kidneys and lungs maintain the balance of chemicals (acids and bases) in the body. All foods are digested in the body leaving ash as the result of the digestion. This food ash can be neutral, acid or alkaline, depending largely on the mineral composition of the foods. Some foods leave an acid residue, some alkaline. The acid ash results when there is a depletion of the alkali reserve in the blood and the tissues of the body. When the alkalinity of the blood is reduced, the ability to transport carbon dioxide is reduced. As a result, acid accumalates in the tissues. Acidosis can be classified into respiratory acidosis and metabolic acidosis. When the body is unable to remove carbon dioxide through breathing, it results in respiratory acidosis. Metabolic acidosis occurs when the kidney is not able to remove enough acid from the body. Metabolic acidosis has several types. Diabetic acidosis (Diabetic ketoacidosis) develops when ketone bodies which are acidic build up in the body. Hyperchloremic acidosis is caused when too much sodium bicarbonate is lost from the body. Lactic acidosis occurs when there is a build up of lactic acid. Symptoms of Acidosis The general symptoms of acidosis are constant hunger, pain in the pharynx, nausea and vomitting, headaches, various nervous disorders and drowsiness. Chronic acidosis can lead to inflammation of the kidneys, rheumatism, artericlerosis, high BP, skin disorders and other degenerative diseases. It lowers immunity and vitality and makes us prone to the danger of other infections. Causes of Acodosis The main cause of acidosis is wrong diet choices. It mainly occurs because of too many Continue reading >>

What You Should Know About Diabetic Ketoacidosis

What You Should Know About Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too. It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system. People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction. DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration. Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes. Call your doctor or go to the emergency room right away if that doesn't work, if you have any of the symptoms below and your ketones aren't normal, or if you have more than one symptom. You've been throwing up for more than 2 hours. You feel queasy or your belly hurts. Your breath smells fruity. You're tired, confused, or woozy. You're having a hard time breathing. Continue reading >>

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