diabetestalk.net

Ketones In Urine Dehydration

Diabetes And Dehydration: A Dangerous Combination

Diabetes And Dehydration: A Dangerous Combination

When you experience vomiting, nausea, fever, diarrhea, or any form of infection, you should immediately contact your physician. I can’t really emphasize enough the importance of getting treatment and getting it fast. To drive home this point, I’ll share the following experience. Some years ago, I got a call from a woman at about four o’clock on a Sunday afternoon. She wasn’t my patient, but her diabetologist was out of town for the weekend with no backup for emergencies. He had never taught her what I teach my patients — the contents of this chapter. She found my Diabetes Center in the white pages of the phone book. She was alone with her toddler son and had been vomiting continuously since 9:00 a.m. She asked me what she could do. I told her that she must be so dehydrated that her only choice was to get to a hospital emergency room as fast as possible for intravenous fluid replacement. While she dropped off her son with her mother, I called the hospital and told them to expect her. I got a call 5 hours later from an attending physician. He had admitted her to the hospital because the emergency room couldn’t help her. Why not? Her kidneys had failed from dehydration. Fortunately, the hospital had a dialysis center, so they put her on dialysis and gave her intravenous fluids. Had dialysis not been available, she would likely have died. As it turned out, she spent five days in the hospital. Clearly, a dehydrating illness is not something to take lightly, not a reason to assume your doctor is going to think you’re a hypochondriac if you call every time you have one of the problems discussed in this chapter. This is something that could kill you, and you need prompt treatment. Why is it, then, that diabetics have a more serious time with dehydrating illness th Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

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 >>

Dangers Of Dehydration & Ketones In Pregnancy

Dangers Of Dehydration & Ketones In Pregnancy

I just spent the last weekend in the hospital getting a lesson from my doctor on the dangers of dehydration and ketones. It's common enough in pregnancy that I felt I would share with all of you. I was not even aware I was dehydrated, as I didn't feel any of the symptoms I will describe below. What is dehydration? Simply put, it's where your body eliminates more water than is being replaced. In your first trimester this is usually brought on my vomiting caused by "morning" sickness. Other culprits can be airplane travel and humidity. It is vitally important that you are drinking plenty of water throughout the entire day. A good rule of thumb is one glass for you; one glass for baby once per hour. Later in pregnancy, 2nd and 3rd trimester, dehydration can cause preterm labor. Actually, dehydration is the third most common reason that women experience preterm labor. When your doctor has you pee in a cup, they are checking for many things, one of them being dehydration and the other being ketones. Dehydration Symptoms: Signs and symptoms of dehydration include: Thirst. This is the first sign, and probably the most ignored. Listen to your body – if you’re thirsty, your body is trying to tell you something. You should try to maintain a schedule of drinking at least one glass of water an hour (more if needed). Dizziness. Dehydration may lead to feelings of dizziness, lightheadedness or vertigo, especially when standing up, bending over, or kneeling. This dizziness symptom is due to low blood pressure caused by dehydration. Headaches. Dehydration is a major cause of headaches, particularly migraines, in pregnant moms and non-pregnant folks alike. Don’t dismiss your headaches as hormonal (although, those can be a contributor). Make sure you’re drinking at least 10 pints Continue reading >>

What You Should Know About Dehydration

What You Should Know About Dehydration

Dehydration occurs when more water and fluids leave the body than enter it. Even low levels of dehydration can cause headaches, lethargy, and constipation. The human body is roughly 75 percent water. Without this water, it cannot survive. Water is found inside cells, within blood vessels, and between cells. A sophisticated water management system keeps our water levels balanced, and our thirst mechanism tells us when we need to increase fluid intake. Although water is constantly lost throughout the day as we breathe, sweat, urinate, and defecate, we can replenish the water in our body by drinking fluids. The body can also move water around to areas where it is needed most if dehydration begins to occur. Most occurrences of dehydration can be easily reversed by increasing fluid intake, but severe cases of dehydration require immediate medical attention. Around three-quarters of the human body is water. Individuals more at risk of dehydration include athletes, people at higher altitudes, and older adults. Symptoms The first symptoms of dehydration include thirst, darker urine, and decreased urine production. In fact, urine color is one of the best indicators of a person's hydration level - clear urine means you are well hydrated and darker urine means you are dehydrated. However, it is important to note that, particularly in older adults, dehydration can occur without thirst. This is why it is important to drink more water when ill, or during hotter weather. As the condition progresses to moderate dehydration, symptoms include: Severe dehydration (loss of 10-15 percent of the body's water) may be characterized by extreme versions of the symptoms above as well as: lack of sweating sunken eyes shriveled and dry skin increased heart rate delirium unconsciousness Symptoms in Continue reading >>

Department Of Emergency Medicine | Dehydration

Department Of Emergency Medicine | Dehydration

In young children, mild to moderate dehydration can happen very easily, particularly if the child has been in hot weather without drinking a sufficient amount of fluids, or if she has been experiencing diarrhea and/or vomiting. Timely and appropriate care is crucial in the assessment and management of dehydration in children because inadequate treatment can lead to serious, but preventable, complications. Although prevention is ideal, in some cases—like with excessive vomiting and diarrhea brought on by a bad “stomach flu”—dehydration is challenging to prevent. Making an accurate assessment that the child is dehydrated, or at serious risk of becoming dehydrated, is the single most important factor in making and carrying out the proper treatment decisions. Assessing dehydration If you suspect a child may be dehydrated, performing a thorough history and physical examination should be enough to confirm the diagnosis, help determine its cause and establish its severity. Factors like sunken eyes, crying without tears, lethargy, decreased frequency and/or volume of urination and fussiness are some of the signs of dehydration in children. Depending on the situation, a provider may perform the following tests to determine whether there is an underlying cause to the child's dehydration: blood count to determine the presence of a serious infection blood cultures to identify the type of bacterial infection blood chemistry to identify any electrolyte abnormality urinalysis to identify bladder infection, give evidence of severity of dehydration and/or identify sugar and ketones in urine (indicating inadequately treated diabetes) Managing dehydration in children Children who are dehydrated should begin treatment with oral re-hydration solutions (ORS), which help replace not j Continue reading >>

Ketones In Urine During Pregnancy

Ketones In Urine During Pregnancy

Ketones in the urine during pregnancy is a health concern which some women experience during those crucial nine months. Although, it is not a high-risk pregnancy complication, studies reveal that it can be a cause of worry. Ketones are substances derived from fat breakdown. They are used by the body as a source of energy under emergency circumstances, like starvation or glucose deficiency, in order to survive. In other words, ketones in the urine are formed when the body's fat reserves are used to generate energy. Ketones in the blood further leads to ketosis. Weakness, nausea, lethargy, and excess sweating are signs of ketosis. Occurrence Our body gets its energy from the food we eat, which gets converted into glucose or blood sugar. It is insulin which provides an easy access to this blood sugar. During pregnancy, the placental hormones make the body resistant to insulin, which subsequently restricts the glucose in the blood from entering the cells. Hence, though the blood will be enriched with blood sugar, the cells will be deprived of the required energy. As a result, the cells start accessing other energy sources, like the fat stores, resulting in ketones as the byproduct of this entire process. Causes There can be various factors that may contribute to large ketones in the urine during pregnancy; dehydration and bad diet, to name a few. Others are enlisted below: ➤ Not getting enough calories from the food you are eating ➤ Long time intervals between meals ➤ Skipping meals or snacks ➤ Gestational diabetes ➤ Diets which include low intake of carbohydrates ➤ Dehydration - not drinking enough water ➤ Metabolic disorders ➤ Nausea, poor eating habits or throwing up ➤ Insulin resistance from hormones as a result of which the body is unable to access bl Continue reading >>

High Ketones In Urine

High Ketones In Urine

The presence of ketones in urine indicates that the body is making use of fat as energy source instead of glucose. Ketonuria, as this condition is referred to, is characterized by the high quantity of ketone bodies in the urine. This arises when the body has to metabolize stored fat rather than glucose for fuel. Various factors could bring forth ketonuria including starvation, severe physical activity, prolonged exposure to cold, constant vomiting and diabetes. Sponsored link What are the causes of ketones in urine? Normally, the body gets energy from glucose. If, for some reason, there is not enough glucose that the body can use, it will switch to using stored fats. As fatty acids are metabolized, ketones will be produced by the liver. In a normal state, the amount of ketone that gets into the urine is minimal or nothing at all. But when the primary source of energy is stored fat, the quantity of unmetabolized ketones become significant it can be detected in the urine. This condition is known as ketonuria. Ketonuria could be caused by a number of things. Some of these are: Starvation When the body isn’t sufficiently nourished, there will be a shortage of carbohydrates to supply the body’s energy requirements. And so, stored fat will be processed in its place. Starvation could be a result of not eating for a long time, alcoholism, bulimia and anorexia. Fasting, high protein-low carbohydrate diets, severe vomiting and frequent diarrhea could likewise lead to starvation. Diabetes Uncontrolled diabetes milletus can cause high ketones in urine. In diabetes, the body is not able to break down glucose due to the lack of insulin. And so fat is metabolized to serve as fuel, instead. Other causes Some other conditions could factor in the appearance of ketone bodies in the ur Continue reading >>

What Are Ketones And Their Tests?

What Are Ketones And Their Tests?

A ketone test can warn you of a serious diabetes complication called diabetic ketoacidosis, or DKA. An elevated level of this substance in your blood can mean you have very high blood sugar. Too many ketones can trigger DKA, which is a medical emergency. Regular tests you take at home can spot when your ketone levels run too high. Then you can take insulin to lower your blood sugar level or get other treatments to prevent complications. What Exactly Are Ketones? Everyone has them, whether you have diabetes or not. Ketones are chemicals made in your liver. You produce them when you don't have enough of the hormone insulin in your body to turn sugar (or “glucose”) into energy. You need another source, so your body uses fat instead. Your liver turns this fat into ketones, a type of acid, and sends them into your bloodstream. Your muscles and other tissues can then use them for fuel. For a person without diabetes, this process doesn’t become an issue. But when you have diabetes, things can run out of control and you build up too many ketones in your blood. If the level goes too high, it can become life-threatening. Who Needs a Ketone Test? You might need one if you have type 1 diabetes. In this type, your immune system attacks and destroys cells in your pancreas that make insulin. Without it, your blood sugar rises. People with type 2 diabetes can also get high ketones, but it isn't as common as it is with type 1. Tests can show you when your level gets high so you can treat it before you get sick. When Should You Test? Your doctor will probably tell you to test your ketones when: Your blood sugar is higher than 250 milligrams/deciliter (mg/dl) for two days in a row You're sick or you've been injured You want to exercise and your blood sugar level is over 250 mg/dl Continue reading >>

Why Do Ketones Produce Dehydration?

Why Do Ketones Produce Dehydration?

I assume you are referring to the high ketones associated with people who have Type I diabetes. These individuals cannot process carbohydrates properly, so they metabolize fatty acids and produce ketones for energy as an alternative to using glucose or carbs for energy. The ketones can build to dangerously high levels if the process is uncontrolled, even resulting in death. The ketones do not cause dehydration. The dehydration is caused by high glucose levels in the blood due to diabetics not being able to metabolize it for energy. This effect then causes fats to be metabolized to ketones for energy, and at the same time the high glucose in the blood causes the dehydration. So, the ketones and dehydration both are the result of the lack of metabolism of glucose, but ketones do not cause the dehydration. Ketones have a carbon-oxygen double bond in them called a carbonyl group. These groups are very prone to something called keto-enol tautomerization, meaning that the ketone form of the compound easily shifts in the right conditions (with water around usually) to its enol (has an “ene” double bond in the carbon backbone and an “ol” alcohol group) form. When a ketone is in the presence of water, it tends to “like” to balance itself out because carbonyls have a partial dipole. The dipole becomes attracted to the hydrogens in the water, and a redox style reaction occurs in the manner of a Bronsted-Lowry type acid-base interaction. The result is a net loss of water - dehydration - and also an enol. Continue reading >>

Causes Of Protein In Urine During Pregnancy

Causes Of Protein In Urine During Pregnancy

Protein in Urine During Pregnancy Routine urine tests are part of prenatal visits to screen for infection or other conditions. Testing for the presence of protein in the urine (proteinuria) is necessary to determine if your kidney function is normal. Although proteins are normally absent in the urine, having a small amount of it during pregnancy is common. It can indicate kidney dysfunction, but it can also be related to infection, stress, or other conditions that need to be evaluated further. 1. Preeclampsia Women with this condition have high blood pressure during pregnancy, accompanied by water retention and protein in their urine. It can lead to complications, including babies with low birth weight. However, if diagnosed and treated early, affected women can deliver normal babies. Treatment includes consuming a healthy, low salt diet and engaging in regular exercise as recommended. Watch a video for more on Preeclampsia: 2. Kidney Infection or Urinary Tract Infection (UTI) UTI during pregnancy can cause protein to appear in the urine. If you feel the urge to urinate more frequently and suffer some discomfort during urination, you may have a UTI. If not treated promptly, this condition can cause kidney infection, which manifests as fever and chills, nausea, vomiting, and back pains. UTI may not adversely affect your baby, but a kidney infection can lead to premature labor and low birth weight babies. 3. Other Causes Factors that can cause transient increases in urinary protein include emotional stress, fever, exposure to extreme temperatures, dehydration, medications and strenuous exercise. Some medical conditions, however, can cause proteinuria that needs further investigation, such as heart disease, diabetes, leukemia, rheumatoid arthritis, lupus, sickle cell anemi Continue reading >>

Urine Ketones

Urine Ketones

Ketones are produced when the body burns fat for fuel. Normally these ketones will be completely broken down (metabolised) so that there are very few ketones in the urine. If for any reason the body cannot get enough glucose for energy it will switch to using body fats, causing an increase in ketones in the body. This results in more ketones present in the urine. What are ketones? Ketones are produced when the body burns fat for energy. Normally, your body gets the energy it needs from carbohydrate in your diet. But stored fat is broken down and ketones are made if your diet does not contain enough carbohydrate to supply the body with sugar (glucose) for energy or if your body can't use blood sugar (glucose) properly. Ketones are usually formed in the liver and are broken down so that very small amounts of ketones appear in the urine. However, when carbohydrates are unavailable (for example, in starvation) or can't to be used as an energy source (for example, in diabetes), fat becomes the main source of energy and large amounts of ketones are made. Therefore, higher levels of ketones in the urine indicate that the body is using fat as the major source of energy. High levels of ketones in your body can cause tummy (abdominal) pain, feeling sick (nausea), being sick (vomiting) and diarrhoea. The ketones that most often appear in the urine when fats are burned for energy are called acetoacetate and beta-hydroxybutyric acid. What are the causes of ketones in the urine? The causes of high levels of ketones and therefore ketones in your urine include: Diabetic ketoacidosis (DKA). Starvation: not eating for prolonged periods (for example, 12 to 18 hours). Ketogenic diet (high-fat, low-carbohydrate diet). This can cause an increase in body ketones but much less than DKA and not Continue reading >>

Dehydration In Children

Dehydration In Children

Dehydration means not enough fluid in a child's body. This can result from vomiting, diarrhoea, not drinking, or any combination of these three. Sweating or urinating too much can also cause dehydration, although this is far less common. Infants and small children are much more likely to become dehydrated than older children or adults. Causes of dehydration in children Dehydration is most often caused by a viral infection that causes fever, diarrhoea, vomiting and a decreased ability to drink or eat. Common viral infections causing vomiting and diarrhoea include rotavirus and winter vomiting disease (norovirus). Sometimes sores in a child's mouth caused by a virus make it painful to eat or drink, helping to cause or worsen dehydration. More serious bacterial infections can make a child less likely to eat and may cause vomiting and diarrhoea. Common bacterial infections include Salmonella, E coli, Campylobacter, and C.difficile. Parasitic infections such as Giardia lamblia cause the condition known as giardiasis. Increased sweating due to a very hot environment can cause dehydration. Excessive urination caused by unrecognised or poorly treated diabetes (not taking insulin) is another cause. Symptoms of dehydration in children You should be concerned if your child has an excessive loss of fluid from vomiting or diarrhoea, or if the child refuses to eat or drink. Signs of dehydration: Sunken eyes Decreased frequency of urination or dry nappies Sunken soft spot on the top of the head in babies (called the fontanelle) No tears when the child cries Dry or sticky mucous membranes (the lining of the mouth or tongue) Lethargy (less activity than normal) Irritability (more crying, fussiness) When to seek medical care: Seek urgent medical advice if your child has any of the follow Continue reading >>

Ketonuria

Ketonuria

Ketonuria is a medical condition in which ketone bodies are present in the urine. It is seen in conditions in which the body produces excess ketones as an indication that it is using an alternative source of energy. It is seen during starvation or more commonly in type I diabetes mellitus. Production of ketone bodies is a normal response to a shortage of glucose, meant to provide an alternate source of fuel from fatty acids. Pathophysiology[edit] Ketones are metabolic end-products of fatty acid metabolism. In healthy individuals, ketones are formed in the liver and are completely metabolized so that only negligible amounts appear in the urine. However, when carbohydrates are unavailable or unable to be used as an energy source, fat becomes the predominant body fuel instead of carbohydrates and excessive amounts of ketones are formed as a metabolic byproduct. Higher levels of ketones in the urine indicate that the body is using fat as the major source of energy. Ketone bodies that commonly appear in the urine when fats are burned for energy are acetoacetate and beta-hydroxybutyric acid. Acetone is also produced and is expired by the lungs.[1] Normally, the urine should not contain a noticeable concentration of ketones to give a positive reading. As with tests for glucose, acetoacetate can be tested by a dipstick or by a lab. The results are reported as small, moderate, or large amounts of acetoacetate. A small amount of acetoacetate is a value under 20 mg/dl; a moderate amount is a value of 30–40 mg/dl, and a finding of 80 mg/dl or greater is reported as a large amount. One 2010 study admits that though ketonuria's relation to general metabolic health is ill-understood, there is a positive relationship between the presence of ketonuria after fasting and positive metabo Continue reading >>

Are Ketones In Urine During Pregnancy A Problem

Are Ketones In Urine During Pregnancy A Problem

Most women are flustered by frequent urine and blood tests for monitoring healthy pregnancy. Routine checkups paired with dietary restrictions are not a pleasant experience for any women. However, any condition should not be overlooked during those laborious nine months of gestation. If your urine report indicates presence of ketones, then stop and read below! Although ketones in urine during pregnancy may not lead to complications in pregnancy, here’s some food for thought: What are ketones? Ketones are acid bodies which are produced when fat is broken down by the body instead of carbohydrates to keep the body working. Causes This usually happens, when there is shortage of carbohydrates in body, probably when one has not eaten for a long time. Secondly, if the body is unable to obtain glucose from blood, then the liver breaks down fats which produces ketones. The lower rate of insulin in blood, like when suffering from diabetes or pancreatic disorders may not be producing sufficient quantities of insulin to break down sugar/glucose from the food we eat in usable form. Starvation: If carbohydrates are not provided to the body and the fat is continuously broken down to obtain energy, then resulting ketones keep accumulating which then become detectable in blood and urine. Dehydration Low-carbohydrate diet: When pregnant, one needs approx 300 calories more per baby. If enough calories are not being provided to body, then liver breaks down fat or protein to obtain energy. Eating disorders: Anorexia Nervosa, Bulimia Nervosa Metabolic disorders Stress Symptoms vomiting or nausea excessive sweating weakness fatigue headache dizziness bad breath abdominal pain feeling thirsty all the time If you experience any of the above symptoms during pregnancy, its sensible to inform yo Continue reading >>

Urine Ketones - Meanings And False Positives

Urine Ketones - Meanings And False Positives

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Urine Ketones article more useful, or one of our other health articles. Description Ketones are produced normally by the liver as part of fatty acid metabolism. In normal states these ketones will be completely metabolised so that very few, if any at all, will appear in the urine. If for any reason the body cannot get enough glucose for energy it will switch to using body fats, resulting in an increase in ketone production making them detectable in the blood and urine. How to test for ketones The urine test for ketones is performed using test strips available on prescription. Strips dedicated to ketone testing in the UK include[1]: GlucoRx KetoRx Sticks 2GK® Ketostix® Mission® Ketone Testing should be performed according to manufacturers' instructions. The sample should be fresh and uncontaminated. Usually the result will be expressed as negative or positive (graded 1 to 4)[2]. Ketonuria is different from ketonaemia (ie presence of ketones in the blood) and often ketonuria does not indicate clinically significant ketonaemia. Depending on the testing strips used, urine testing for ketones either has an excellent sensitivity with a low specificity, or a poor sensitivity with a good specificity. However, this should be viewed in the context of uncertainty of the biochemical level of significant ketosis[3]. Interpretation of results Normally only small amounts of ketones are excreted daily in the urine (3-15 mg). High or increased values may be found in: Poorly controlled diabetes. Starvation: Prolonged vomiting. Rapid weight loss. Frequent strenuous exercise. Poisoning (eg, with isop Continue reading >>

More in ketosis