Pediatric Dka Guidelines 2016

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What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high b

Pediatric Office Emergencies Diabetic Ketoacidosis Treatment Protocol

Update 1/22/2016: Soonafter I initially postedthis entry I found an even more helpful podcast resource on pediatric diabetic ketoacidosis from Emergency Medicine Cases : Episode 63 Pediatric DKA . It turns out that in the pediatric office, the biggest challenge is diagnosing diabetic ketoacidosis in the child without a history of known Diabetes.What follows is from Reference (1) Episode 63 Pediatric DKA . In a child without a known history of diabetes, making the diagnosis of DKA can be difficult, especially in the mild cases where symptoms can be quite vague. If we dont have a high level of suspicion we can easily miss cases of early DKA. Thus, the diagnosis should be considered or ruled out if any of the following are present: Specific high risk groups (ie. Teenagers, children on insulin pumps and those from lower socio-economic status). Remember that glucose should be consideredthe sixth vital sign and any sick appearingchild should have a point of care glucose done! Once DKA is suspected, elements on history should focus on screening for symptoms of diabetes (polyuria, polydipsia, enuresis ,weight loss) as well as symptoms of DKA (nausea, vomiting, abdominal pain, decreased al Continue reading >>

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  1. Chantruese

    Hi! So based on the excellent advice of everyone here, I'm on a daily limit of 25g total carbs each day, and I've held to that the last three days. I was thinking about testing my ketones again this weekend (after about 5 days of super strict restriction), but I'm wondering - what is the best time of day to test?

    I don't have T2DM, but am I still impacted by the dawn phenomenon? Should I plan for afternoon? Before or after food? Does any of that matter? I just don't want to waste the little blood strips, cause crap they're expensive!

  2. permabuddy

    I don't know the answer, cos I'm new also, but following the thread for this interesting question. Someone in Dudeland knows and will tell us!!

  3. Shortstuff

    The levels are up and down naturally throughout the day. I test at random times just out of curiosity.
    Most people apparently have higher levels later in the day.

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Paediatric Dka Guideline 2015 Whats New?

Paediatric DKA Guideline 2015 Whats new? I put up the link to the revised BSPED DKA guideline recently, so I thought Id follow up with this post to explain exactly what all the changes are. Most of them relate to fluid management and seem to be geared towards making sure we dont end up overshooting with rehydration and putting kids in danger of cerebral oedema seems pretty reasonable In DKA, there is a hypertonicstate due to the massively elevated plasma glucose concentration. The theory is, that in order to avoid osmotic losses, brain cellsproduce osmotically active substances to counter the extra osmolality of the hypertonicplasma. If the plasma glucose concentration is corrected TOO FAST, not giving time for the osmotically active substances in the brain to dissipate, fluid gets drawn into the cells causing cerebral oedema. BSPED highlighted seven major updates mostly about fluid management that Ill explain briefly. The full guideline runs to 92 pages so probably not one to sit down to unless you have insomnia. 1. Change in degree of dehydration used to calculate fluids (5% deficit for moderate, 10% deficit for severe DKA, based on pH) According tothe 2015 guideline, pH below 7 Continue reading >>

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  1. AMeyer05

    I'm somewhat confused by your doctors reasoning? I had a stillborn at 22w in February. We are currently 14w pregnant again and my high risk doctor told me that at 16w I will start progesterone shots and that I have to do them every week until 36w. He said they are not recommended until week 16? It was always my understanding that early miscarriages were due to issues in the pregnancy and that nothing could be done if you were having one? They even told me this when they deemed my first pregnancy a "threatened miscarriage" at 17w. I would seek a second opinion personally. I would be concerned about being taken off of progesterone as well! Best of luck momma :)

  2. sesame16

    Thanks for getting back to me. I'm sorry to hear about your loss.
    My understanding from my doctor is that at 12 weeks the placenta takes over as it should be producing enough progesterone that the suppositories are redundant...

    I have heard of other moms starting progesterone later on for other reasons (much like you) so I find it very confusing.

  3. petrap14

    I have had 2 miscarriages because of low progesterone. I will be 12 wks this coming Thursday and last Friday my dr said I could stop taking the progesterone at 12 wks bc the placenta has taken over. She also said I could have some spotting. Hope this helps.

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What is KETOACIDOSIS? What does KETOACIDOSIS mean? KETOACIDOSIS meaning - KETOACIDOSIS definition - KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and ß-hydroxybutyrate. Ketoacidosis is a pathological metabolic state marked by extreme and uncontrolled ketosis. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased. In extreme cases ketoacidosis can be fatal. Ketoacidosis is most common in untreated type 1 diabetes mellitus, when the liver breaks down fat and proteins in response to a perceived need for respiratory substrate. Prolonged alcoholism may lead to alcoholic ketoacidosis. Ketoacidosis can be smelled on a person's breath. This is due to acetone, a direct by-product of the sp

Diabetic Ketoacidosis In Children: Management

Diabetic Ketoacidosis in Children: Management CEREBRAL OEDEMA: DO WE REALLY KNOW THE CAUSE? We recently had a child with (diabetic ketoacidosis)DKA in our department and the subject of fluid resuscitation came up. Also the Queensland Government guidelines on the Emergency Management of children with DKA has recently been produced. I thought it was timely to revisit a blog I wrote in 2014 on the evidence on this topic, as well as set up a teaching module on DKA ( more on this at the end) Cerebral oedema is the most feared complication in children presenting with DKA. It occurs in about 1% of cases but has a mortality rate of up to 90% (Waldorf J et al Diabetes Care 2006; 29:1150-9). Patients will have a decreased conscious state and may also have cranial nerve palsies, headache and/or bradycardia and hypertension. Its incidence has remained the same since it was described in 1936 and although we have clues as to what may contribute to it, and we know that some patients have subclinical cerebral oedema even at presentation(Krane et al NEJM 1985;312:1147-51), we still cant predict who will get it, nor greatly affect its high rate of mortality. There are theories of causative factors, Continue reading >>

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  1. SuppFiend

    sorbitol and sugar alcohols

    does sorbitol and sugar alcohols count towards your carbs.... and what should the marco breakdown be for a typical keto diet im currently only taking in 100 grms. or less of carbs a day (and this is including fiber just becasue im to lazy to count up and subtract it)

  2. Eileen

    Short answer: avoid them. And if you do eat them, count them.
    They can cause all sorts of problems, tummy upsets, smelly farts, the runs. If they don't, then you are digesting them and they should definitely be counted.
    Read my sig.

  3. Mouzer

    Originally Posted by Eileen
    Short answer: avoid them. And if you do eat them, count them.
    They can cause all sorts of problems, tummy upsets, smelly farts, the runs. If they don't, then you are digesting them and they should definitely be counted.
    Read my sig.

    x2. Avoid that stuff. You will feel bloated, gassy, and regret eating anytthing with it afterwards.

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