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Metabolic Acidosis Pathophysiology Pdf

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Diabetic Ketoacidosis (dka)

Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. DKA occurs mostly in type 1 diabetes mellitus (DM). It causes nausea, vomiting, and abdominal pain and can progress to cerebral edema, coma, and death. DKA is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia. Treatment involves volume expansion, insulin replacement, and prevention of hypokalemia. Diabetic ketoacidosis (DKA) is most common among patients with type 1 diabetes mellitus and develops when insulin levels are insufficient to meet the body’s basic metabolic requirements. DKA is the first manifestation of type 1 DM in a minority of patients. Insulin deficiency can be absolute (eg, during lapses in the administration of exogenous insulin) or relative (eg, when usual insulin doses do not meet metabolic needs during physiologic stress). Common physiologic stresses that can trigger DKA include Some drugs implicated in causing DKA include DKA is less common in type 2 diabetes mellitus, but it may Continue reading >>

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Popular Questions

  1. easygreen

    Hi,
    I started on the Adkins diet 10 days ago. I've
    been testing my urine with Ketone test strips I
    purchased at GNC. The manufacturer is
    LW Scientific from Tucker, Georgia, USA. For ten
    days I've kept my daily carb intake below 20
    grams. Each night I've tested my urine and each
    night its come out negative. Two days I had
    zero carbs because I was getting frustrated. I
    also exercise 60 minutes on a NordicTrak each day.
    Tonight, I went to Walgreens and bought Ketone
    test strips manufactured by Bayer. These are used by diabetics to test for Ketones. It showed I
    had a "Large" amount of Ketones! Registered 80!
    At the same time I dipped the GNC test strips in
    the same Urine. Came up negative again.
    I don't know if I just got a bad batch or this
    brand is generically defective. They have an
    expiration date of Feb, 2002, so they should be
    good.
    Anyway, if you aren't registering any Ketones
    in your urine and you think you've followed the
    rules, go to a drug store and ask the pharmacist
    for the Ketone test strips. Walgreens keeps them
    behind the counter.
    Mark

  2. Natrushka

    Hi Mark. Welcome to the forum and wtg on those 20+ lbs You must feel wonderful!
    Good advice about the test strips, I'd just like to add that if you're registering "heavy" it would be a good idea to drink more water. Darker on those things usually means dehydrated which is not good. Optimal fat burning happens when you're properly hydrated Also, remember that if you're not showing it could that you've used up all the ketone bodies produced as fuel (I hardly ever get above trace as I drink lots of water and use the nordictrack as well, for about 45 minutes every morning - arent they wonderful machines?)
    Best of luck to you in your LC Journey
    Nat

  3. doreen T

    Yes, welcome, and thanks for the tip.
    Other possible reasons for the strips giving negative results (when they "should" be positive) are discussed in the article Ketosis and Ketone Test Strips, from Low Carb Tips on the orange menu bar at the top of every page.
    I'd also like to remind folks of the importance of TIMING when reading the strips. Read the label, and follow the directions exactly. If it says to take the reading at 15 seconds, then that is when you take the reading. Not at 30 seconds, not at 2 minutes. The chemical in the little pad on the end of the stick will continue to darken after the peak ketone reading, but this is due to the decompostion of other non-ketone products in the urine. Some folks who think they're testing "dark" all the time are actually waiting for the strips to turn as dark as possible before taking the reading. Don't.
    There is yet another reason for faulty readings ... some folks have found they get more accurate results if they collect the urine in a small container, and then dip the test strip to take the reading. It seems that holding the strip directly in the urine flow may cause the chemical reagent to be washed out of the little pad ...
    Just a few more reasons to NOT get hung up on those strips....
    Doreen

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