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Ketoacidosis Word Breakdown

Diabetic Ketoacidosis

Diabetic Ketoacidosis

What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening condition caused by a build-up of waste products called ketones in the blood. It occurs in people with diabetes mellitus when they have no, or very low levels of, insulin. DKA mostly occurs in people with type 1 diabetes, but it can also occur in some people with type 2 diabetes and pregnant women with gestational diabetes. Causes Glucose is an essential energy source for the body's cells. When food containing carbohydrates is eaten, it is broken down into glucose that travels around the body in the blood, to be absorbed by cells that use it for energy. Insulin works to help glucose pass into cells. Without insulin, the cells cannot absorb glucose to use for energy. This leads to a series of changes in metabolism that can affect the whole body. The liver attempts to compensate for the lack of energy in the cells by producing more glucose, leading to increased levels of glucose in the blood, also known as hyperglycaemia. The body switches to burning its stores of fat instead of glucose to produce energy. This leads to a build-up of acidic waste products called ketones in the blood and urine. This is known as ketoacidosis, and it can cause heart rhythm abnormalities, breathing changes and abdominal pain. The kidneys try to remove some of the excess glucose and ketones. However, this requires taking large amounts of fluid from the body, which leads to dehydration. This can cause: Increased concentration of ketones in the blood, worsening the ketoacidosis; Loss of electrolytes such as potassium and salt that are vital for the normal function of the body's cells, and; Signs and symptoms Symptoms of DKA can develop over the course of hours. They can include: Increased thirst; Increased frequency Continue reading >>

Diabetes Glossary

Diabetes Glossary

Antibodies Antibodies are specialized proteins that are part of the immune system. They are created when an antigen (such as a virus or bacteria) is detected in the body. The antibodies bond with the specific antigen that triggered their production, and that action neutralizes the antigen, which is a threat to the body. Antibodies are created to fight off whatever has invaded the body. See also autoantibodies. Antigens An antigen is a foreign substance (such as a virus or bacteria) that invades the body. When the body detects it, it produces specific antibodies to fight off the antigen. Autoantibodies Autoantibodies are a group of antibodies that “go bad” and mistakenly attack and damage the body’s tissues and organs. In the case of type 1 diabetes, autoantibodies attack the insulin producing beta cells in the pancreas. Autoimmune disorder If you have an autoimmune disorder (also called an autoimmune disease), your body’s immune system turns against itself and starts to attack its own tissues. Basal secretion (basal insulin) We all should have a small amount of insulin that’s constantly present in the blood; that is the basal secretion. People with type 1 diabetes must take a form of insulin that replicates the basal secretion throughout the day; that’s basal insulin. Beta cells Beta cells are located in the islets of Langerhans in the pancreas. They are responsible for making insulin. Blood glucose level The blood glucose level is how much glucose is in your blood at a given time. This level is very important for people with diabetes, and they must monitor their blood glucose level throughout the day. If the blood glucose level is too high (hyperglycemia), that means that there isn’t enough insulin in the blood. If it’s too low (hypoglycemia), that mean Continue reading >>

Sodium Glucose Transporter 2 Inhibitors And Diabetic Ketoacidosis In Three Patients With Diabetes: Underlying Causation

Sodium Glucose Transporter 2 Inhibitors And Diabetic Ketoacidosis In Three Patients With Diabetes: Underlying Causation

Byline: Jordan. Kelley, Matthew. Strum, Daniel. Riche, Andrew. Chandler Sodium glucose transporter 2 inhibitors (SGLT2i) inhibit the reabsorption of glucose in the renal tubules reducing glycemia and increasing glucosuria. The increased glucosuria causes a shift in normal flora and colonization of pathogenic microorganisms leading to an increase in mycotic genital infections. Recent Food and Drug Administration reported cases of diabetic ketoacidosis (DKA) after initiation of SGLT2i probes the question of safety with such agents. The mechanisms of ketoacidosis and the breakdown of lipids are often misunderstood, and blame is placed on lack of insulin or on medications used to treat diabetes. However, many patients living with diabetes do not experience DKA if the proper treatment and management of concomitant comorbidities are addressed. After a retrospective chart review of 250 patients, three patients were identified with DKA while on SGLT2i, but for three distinct contrasting reasons. Assessment of the pharmacodynamics of SGLT2i and the pathophysiology of DKA infers that emphasis for prevention of SGLT2i-associated DKA should be placed on appropriate diagnosis, infection, and electrolyte abnormalities. The sodium glucose transporter 2 inhibitors (SGLT2i), such as canagliflozin, empagliflozin, and dapagliflozin, promote the renal excretion of glucose, and A1C is modified by the osmotic diuresis effect of the medication.[sup][1] SGLT2i are commonly prescribed due to their ability to reduce weight and blood pressure, and lower the risk of hypoglycemia compared to sulfonylureas. Although SGLT2i use has become increasingly common (including advancing in therapy preference on the AACE/ACE algorithm), SGLT2i are not without limitation, particularly increased risk of infecti Continue reading >>

How Too Much Protein Is Bad For Ketosis

How Too Much Protein Is Bad For Ketosis

One of the well-known mantras of the ketogenic diet is very low carb intake and high fat intake. But there’s another nutrient that’s important to monitor when going keto—and a lot of people make the mistake of not considering its importance. That would be protein. Although protein is a critical element in the diet we need for optimal health, it’s important to not eat TOO much protein on the ketogenic diet. Why? Well, there are a couple reasons that we’ll be discussing below. How Too Much Protein is Bad for Ketosis The biggest energy source on the ketogenic diet is fat. In fact, around 75% of your diet should come from healthy fat sources. The key here is that, unlike the traditional idea of low-carb diets where protein is higher, protein intake should bemoderate, not high, on keto. Not following this advice will never allow your body to enter ketosis, which is the main point of going keto and reaping all of the amazing benefits. The reason too much protein is bad for ketosis is because our bodies have a fundamental energy process called gluconeogenesis. For a deeper dive into the topic, see our post on fixing the biggest ketosis mistakes. For now we shoud know the basics. Let’s break it down this mouthful of a term. The word gluconeogenesis has three parts to it, Gluco – coming from the greek root glukos – literally meaning “sweet wine.” Neo – “new” Genesis – “creation” So a great way to think about it is this is how your body creates new sweet wine for your body. Some people tout that “you don’t need carbohydrates to survive,” which is only partially true. To clarify, you don’t need to eat any carbs to survive, but make no mistake, your body needs carbs in the form of glucose and glycogen, and it will get this via survival mechan Continue reading >>

Fighting Ketoacidosis (prediabetes)

Fighting Ketoacidosis (prediabetes)

I introduce this dangerous complication of diabetes in topic 3, but I offer more detail here. Ketoacidosis occurs most often in patients with type 1 diabetes. Ketoacidosis is rare if you have type 2 diabetes, but it can occur, especially if you have another illness like an infection or a trauma that puts you under great stress. The rate of developing ketoacidosis among the diabetic population seems to be increasing, but I don’t have a clear explanation for that fact. Since 1999, the rate has increased from less than 3 percent per 10,000 people to more than 4 percent per 10,000 people. One explanation is the rising incidence of ketoacidosis in ethnic minority groups, especially African Americans and Hispanics. Although a precipitating cause (like infection or trauma) is usually present in these groups as well, ketoacidosis sometimes occurs without it. Ketoacidosis is a severe complication, and some people die of this illness. The word ketoacidosis refers to the fact that your blood becomes very acidic as fat is broken down by your body for energy. Keto refers to the breakdown products of fat, which are called ketone bodies. Looking out for symptoms A number of symptoms can alert your loved ones that you have developed ketoacidosis. You may not be aware enough to recognize the problems yourself because you are so sick that your mental abilities are significantly reduced. The main signs and symptoms are Nausea and vomiting: These symptoms result from the acidic condition of your blood and the loss of many important body substances. You can’t eat or drink, and you rapidly become dehydrated. Rapid breathing: Also called Kussmaul breathing, it occurs because your blood is so acidic that your body tries to get rid of the acid by blowing it out through your lungs. Your brea Continue reading >>

Diabetic Ketoacidosis - Symptoms

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 >>

Complications Of Relatively Rapid Onset Include Diabetic

Complications Of Relatively Rapid Onset Include Diabetic

Popular Wikipedia articles that use the word ketoacidosis: There are two major causes of ketoacidosis: —Ketosis In early 2010, Casey died of diabetic ketoacidosis. —Woody Johnson There are some case reports of olanzapine-induced diabetic ketoacidosis. —Olanzapine In type I diabetics, ketoacidosis can be associated with sinusitis due to mucormycosis. —Sinusitis Acute complications can include diabetic ketoacidosis, nonketotic hyperosmolar coma, or death. —Diabetes mellitus Another example of increased production of acids occurs in starvation and diabetic ketoacidosis. —Acidosis The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon. —Diabetes mellitus type 2 Some medical conditions, such as kidney failure and diabetic ketoacidosis, can also affect sweat odor. —Perspiration Complications of relatively rapid onset include diabetic ketoacidosis and nonketotic hyperosmolar coma. —Diabetes mellitus type 1 Classical diabetic ketoacidosis (DKA) presents with abdominal pain, nausea, and vomiting, but without diarrhea. —Gastroenteritis Ketoacidosis can occur in individuals who chronically abuse alcohol and have a recent history of binge drinking. —Binge drinking Diabetic ketoacidosis Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. —Diabetic ketoacidosis Alcoholic ketoacidosis can occur in individuals who chronically abuse alcohol and have a recent history of binge drinking. —Alcoholism Ketosis should not be confused with ketoacidosis, a dangerous and extreme ketotic condition associated with type I diabetes. —Low-carbohydrate diet Signs and symptoms of diabetic ketoacidosis may include: Hyperglycemia can be a serious problem if not treated in time. —Hyperglyce Continue reading >>

The Catabolism Of Fats And Proteins For Energy

The Catabolism Of Fats And Proteins For Energy

Before we get into anything, what does the word catabolism mean? When we went over catabolic and anabolic reactions, we said that catabolic reactions are the ones that break apart molecules. To remember what catabolic means, think of a CATastrophe where things are falling apart and breaking apart. You could also remember cats that tear apart your furniture. In order to make ATP for energy, the body breaks down mostly carbs, some fats and very small amounts of protein. Carbs are the go-to food, the favorite food that cells use to make ATP but now we’re going to see how our cells use fats and proteins for energy. What we’re going to find is that they are ALL going to be turned into sugars (acetyl) as this picture below shows. First let’s do a quick review of things you already know because it is assumed you learned cell respiration already and how glucose levels are regulated in your blood! Glucose can be stored as glycogen through a process known as glycogenesis. The hormone that promotes this process is insulin. Then when glycogen needs to be broken down, the hormone glucagon, promotes glycogenolysis (Glycogen-o-lysis) to break apart the glycogen and increase the blood sugar level. Glucose breaks down to form phosphoglycerate (PGAL) and then pyruvic acid. What do we call this process of splitting glucose into two pyruvic sugars? That’s glycolysis (glyco=glucose, and -lysis is to break down). When there’s not enough oxygen, pyruvic acid is converted into lactic acid. When oxygen becomes available, lactic acid is converted back to pyruvic acid. Remember that this all occurs in the cytoplasm. The pyruvates are then, aerobically, broken apart in the mitochondria into Acetyl-CoA. The acetyl sugars are put into the Krebs citric acid cycle and they are totally broken Continue reading >>

Ketoacidosis

Ketoacidosis

ketoacidosis [ke″to-as″ĭ-do´sis] the accumulation of ketone bodies in the blood, which results in metabolic acidosis; it is often associated with uncontrolled diabetes mellitus. See also ketosis. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. ke·to·ac·i·do·sis (kē'tō-as'i-dō'sis), Acidosis, as in diabetes or starvation, caused by the enhanced production of ketone bodies. ketoacidosis /ke·to·ac·i·do·sis/ (ke″to-as″ĭ-do´sis) acidosis accompanied by the accumulation of ketone bodies in the body tissues and fluids. ketoacidosis (kē′tō-ăs′ĭ-dō′sĭs) n. pl. ketoaci·doses (-dō′sēz) 1. Metabolic acidosis caused by an abnormally high concentration of ketone bodies in the blood and body tissues. 2. This condition occurring as a complication of untreated or improperly controlled diabetes mellitus, especially type 1 diabetes, characterized by thirst, fatigue, a fruity odor on the breath, and other symptoms, and having the potential to progress to coma or death. Also called diabetic ketoacidosis. ketoacidosis [kē′tōas′idō′sis] acidosis accompanied by an accumulation of ketones in the body, resulting from extensive breakdown of fats because of faulty carbohydrate metabolism. It occurs primarily as a complication of diabetes mellitus and is characterized by a fruity odor of acetone on the breath, mental confusion, dyspnea, nausea, vomiting, dehydration, weight loss, and, if untreated, coma. Emergency treatment includes the administration of insulin and IV fluids and the evaluation and correction of electrolyte imbalance. Nasogastric intubation and bladder catheterization may be required if the patient is comatose. Continue reading >>

Caution: Don’t Get Caught With Ketones

Caution: Don’t Get Caught With Ketones

Ketoacidosis is an extremely serious diabetic complication that can lead to coma and even death. Unfortunately it is also fairly common. The good news, however, is that with proper care and an eye towards prevention, this costly and dangerous complication can be avoided. What Is Ketoacidosis? When there isn't enough insulin present for the metabolism of glucose, or when insufficient food has been eaten to satisfy energy requirements, the body burns fat for energy. Ketones are toxic, acidic byproducts of this process. Ketones are normally processed by the kidneys and excreted in the urine. But when more ketones are produced than the kidneys can handle, they can build up in the blood and lead to a dangerous condition known as diabetic ketoacidosis (DKA). Ketoacidosis raises the acidity of the body, which leads to "a cascade of problems throwing off a number a parameters in the body," says Cindy Onufer, RN, MA, CDE, the diabetes research and clinical care coordinator at Oregon Health Sciences University. Ketoacidosis rarely occurs in people with type 2 diabetes, who usually do not suffer from insufficiency of insulin, but is of great concern to those with type 1 diabetes. In fact, ketoacidosis is the number one cause of hospitalization for children with known diabetes in the United States. However, these hospitalizations are completely preventable if a urine ketone test is done and a care provider is called when indicated, says H. Peter Chase, MD, with the Barbara Davis Center for Childhood Diabetes in Denver, Colorado. Timely testing and prevention are of utmost importance as the condition can cause coma and death if proper treatment is not administered quickly. Higher ketone levels are a warning sign that your diabetes is out of control or that you may be in danger of ke Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis is a very serious condition in which chemicals known as ‘ketones’ are build up in the blood of a patient with diabetes. It can happen to individuals who have either type 1 diabetes or type 2 diabetes but it is more common in people having type 1 diabetes. In people, who have type 1 diabetes, a chemical or hormone called ‘insulin’ is either deficient or completely absent and insulin is necessary for the breakdown of sugars in the human body to get energy. Without insulin, the body starts burning fats to produce energy and as a result of that ‘ketones’ are produced and start building up in blood and can cause diabetic ketoacidosis. There are a number of reasons which can eventually lead to diabetic ketoacidosis: If a patient is not being treated for diabetes and it is possible that patient doesn’t even know that he/she has diabetes and patient’s body is burning fats to produce ketones. Patient has some serious illness, for example, blood infection The patient is not using insulin as directed by the doctor. The patient is skipping insulin doses intentionally or unintentionally. Patient’s sugar levels mostly remain higher than required. In other words, the patient has poor control of diabetes. The patient is dehydrated (decreased amount of total body water). The patient is losing more water and taking less. Patient belongs to poor family and couldn’t afford treatment for diabetes. Diabetic ketoacidosis is more common in young children. The patient is taking certain medications for some other ailment that could cause ketoacidosis. Patient is drinking alcohol and taking illicit drugs e.g. amphetamines The Following symptoms can be present in a patient with diabetic ketoacidosis: Patient might feel thirsty and drink lot of water The pa Continue reading >>

Ads – Diabetic Ketoacidosis

Ads – Diabetic Ketoacidosis

Diabetic ketoacidosis or DKA is an interesting topic that has briefly come up for me in my clinical orientation. I was interested in learning more about this, especially prior to my PICU rotation. During the ADS each pair of residents had critically appraised a paper and discussed it. This allowed us all to have a greater understanding of the primary literature by discussing it with one another. Pearls about DKA: DKA is defined as: Plasma glucose > 11.1 mmol/L + pH < 7.3 and/or HCO3 < 15 mmol/L + ketonuria or ketonemia + sx of diabetic complications e.g. polyuria, polydypsia, weight loss and fatigue Ketoacidosis of DKA is as a result of having increased fat usage for energy due to inability to appropriately utilize sugar sources for energy. Ketones are a breakdown product of fats, and are acidic and thus when there are too many of them it results in ketoacidosis. Causes of DKA: Undiagnosed type 1 diabetes, unmanaged type 2 diabetes, insulin omission or manipulation, inadequate insulin dosing/monitoring (inappropriate sick day management), pump misuse or infusion site disconnection. The reason we are concerned with DKA is the morbidity of DKA-related cerebral edema. This is more common in those who are younger, more “sick”, new-onset diabetes, longer duration of symptoms, inc dehydration (sunken eyes, dec skin turgor, anuria) and high degree of acidosis. Tx variables associated with DKA-related cerebral edema Too-rapid fall (>2 mmol/L/h) in corrected sodium Failure to correct or uncorrected sodium rise Too-rapid fall (>4 mOsm/kg/h) in active osmolarity Use of bicarbonate to treat acidosis Early insulin treatment of large insulin boluses Use of fluids: > 4 L/m2/24h or > 50 mL/kg in the first 4 hours Treatment guidelines: 1st step: correct dehydration Typically done wi Continue reading >>

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

Ketosis

Not to be confused with Ketoacidosis. Ketosis is a metabolic state in which some of the body's energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis in which blood glucose provides energy. Ketosis is a result of metabolizing fat to provide energy. Ketosis is a nutritional process characterised by serum concentrations of ketone bodies over 0.5 mM, with low and stable levels of insulin and blood glucose.[1][2] It is almost always generalized with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted (or from metabolising medium-chain triglycerides[3]). The main ketone bodies used for energy are acetoacetate and β-hydroxybutyrate,[4] and the levels of ketone bodies are regulated mainly by insulin and glucagon.[5] Most cells in the body can use both glucose and ketone bodies for fuel, and during ketosis, free fatty acids and glucose synthesis (gluconeogenesis) fuel the remainder. Longer-term ketosis may result from fasting or staying on a low-carbohydrate diet (ketogenic diet), and deliberately induced ketosis serves as a medical intervention for various conditions, such as intractable epilepsy, and the various types of diabetes.[6] In glycolysis, higher levels of insulin promote storage of body fat and block release of fat from adipose tissues, while in ketosis, fat reserves are readily released and consumed.[5][7] For this reason, ketosis is sometimes referred to as the body's "fat burning" mode.[8] Ketosis and ketoacidosis are similar, but ketoacidosis is an acute life-threatening state requiring prompt medical intervention while ketosis can be physiological. However, there are situations (such as treatment-resistant Continue reading >>

Diabetes

Diabetes

When a person has the medical condition called diabetes, the body can’t produce enough insulin to process the glucose in the blood. Diabetes has been known since the first century B.C.E., when a Greek physician, Aretus the Cappadocian, named it diabainein, meaning "a siphon," referring to the excessive urination associated with the disease. The word diabetes was first recorded in 1425, and in 1675, the Greek mellitus, “like honey,” was added, to reflect the sweet smell and taste of the patient’s urine. An unrelated and rare disorder, diabetes insipidus, is usually caused by a hormone deficiency. Continue reading >>

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