Sglt2 Inhibitors And Dka

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SGLT2 inhibitors show no significant risk of DKA, study reports Follow this link: http://tinyurl.com/6irc9o5ia89 SGLT2 inhibitors show no significant risk of DKA, study reports click here full resolution --- for more information go to-http://tinyurl.com/pvwe7iu879/ Adults with type 2 diabetes who take SGLT2 inhibitors are less likely to experience diabetic ketoacidosis (DKA) than those on insulin treatment, a study suggests.These findings existed for those with type 2 diabetes either prescribed SGLT2 inhibitors as a single treatment or in combination with another drug.Scientists from the Steno Diabetes Center, Copenhagen, Denmark examined 415,670 people with type 2 diabetes during 1995-2017, all of whom were treated with medication, including insulin.They sought to evaluate the rates of DKA within patients to assess if any association could be made between DKA, a dangerous short-term complication, and SGLT2 inhibitors.SGLT2 inhibitors work by helping the kidneys to lower blood glucose levels, with excess blood glucose removed through urine. for more information go to-http://tinyurl.com/82d95inail/ type 2 diabetes, SGLT2 inhibitors, dka

Sglt2 Inhibitors And Dka In People With Type 1 Diabetes

SGLT2 Inhibitors and DKA in People With Type 1 Diabetes Treating type 1 diabetes with insulin alone can be a challenge. One fairly new class of drugs, SGLT2 inhibitors, appears to be an effective add-on treatment. It reduces blood glucose levels, body weight, and the amount of insulin patients need. Also, it does not increase the frequency ofhypoglycemia(low blood glucose levels) in people with either type 1 or type 2 diabetes. However, the drug may increase the risk of diabetic ketoacidosis (DKA), a dangerous form of extremehyperglycemia(high blood glucose levels) that can lead tocomaor even death. How real is that risk? A total 351 people with poorly controlled type 1 diabetes signed up for the study. All either took multiple daily injections of insulin or used an insulin pump, which continuously delivers insulin under the skin. The participants were randomly assigned to one of two groups for the 18-week study. One group took the study drug canagliflozin, an SGLT2 inhibitor, at 100 or 300 mg once a day. The other group was given a placebo, which resembled the treatment pill but had no active ingredients. The goal: to determine which group had a higher number of participants who Continue reading >>

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  1. FJoker09

    Keto doesn't work for everyone.

    Keto only worked for the first couple of weeks and did not lose anymore fat for the next 6 weeks even after reducing my calorie and fat count. I am going back to a low fat, low carb diet.
    Has anybody else experienced this? Photo attached.
    Height: 5'8"
    Weight: 170
    bf% about 14%
    Waist: 33"
    Age: 38
    20 min. HIIT 5XWeek
    Weights: 5XWeek.

    Attached Images
    IMG_0014.JPG‎ (41.6 KB, 462 views)

  2. kdhoward83

    Originally Posted by FJoker09
    20 min. HIIT 5XWeek
    Weights: 5XWeek.

    Theres such a thing as too much exercise. What kind of calorie intake were you doing?

  3. FJoker09

    Originally Posted by kdhoward83
    Theres such a thing as too much exercise. What kind of calorie intake were you doing?

    2,000 calories in 5 meals and a PWO drink (25g Protein) not included in the calorie count.

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Susan Cornell, PharmD, CDE, FAPhA, FAADE, describes the risks for ketoacidosis and serious urinary tract infection associated with use of SGLT2 inhibitors. This video was recorded at APhA's 2016 Annual Meeting and Exposition in Baltimore, Maryland.

Sglt2 Inhibitors And Diabetic Ketoacidosis: What's Behind The Fda Warning

With commentary by Yehuda Handelsman, MD, FACP, FACE, FNLA, an endocrinologist in private practice in Tarzana, CA, Medical Director and Principal Investigator of the Metabolic Institute of America and President of the American College of Endocrinology People with diabetes who take blood sugar-lowering drugs called SGLT2 inhibitors were recently warned by the U.S. Food and Drug Administration (FDA) that they should watch for signs of a life-threatening condition called diabetic ketoacidosis. canagliflozin (Invokana) dapagliflozin (Farxiga) empagliflozin (Jardiance) as well as the combination pills: canagliflozin plus metformin (Invokamet) dapagliflozin plus metformin extended-release (Xigduo XR) empagliflozin plus linagliptin (Glyxambi). “Diabetic ketoacidosis (DKA) can be deadly,” says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE, an advanced practice dietitian at the University of Chicago Kovler Diabetes Center and a member of EndocrineWeb’s advisory board. “DKA is usually more of a concern for people with type 1 diabetes, but this warning is for people with type 2 diabetes who are taking the SGLT2 inhibitors, as well as people with type 1 diabetes who take these medications Continue reading >>

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    I find that testing at night my sticks are much darker. I also read in ATkins to test later in the day. Often in the AM the sticks are the lightest for me.
    However, I dont understand how my sticks are turning, butI dont seem to be losing very fast. It might be just water retention.. I hope!

    Pounds lost: 14.0







    Gigi, thanks for the valuable info on Ketosis.
    Everyone should consider several things before giving up drinking the water. First, test first thing in the morning before eating or drinking anything. Second, give up all artificial sweetners or things with them it it. If you are still not in ketosis after a few days, then look at what carbs you have been consuming. Maybe you are one of those people who are very carb sensitive. Try a couple of day with meat, eggs and green veggies.
    As the article says make sure your sticks are fresh.
    The Waist Management Team
    Low Carbing with Atkins Team! www.sparkpeople.com/myspark/groups_i
    Doxie Lovers www.sparkpeople.com/myspark/groups_i

    current weight: 148.0






  3. GIGIX068

    I was under the understanding that the ketostix will not measure accurately when we drink a lot of water. Your urine is too diluted to get a good result. I test in the morning.
    Here is a copy and paste with a lot more information than you asked for--but it might be helpful. After I read it I understood that because of the volume of water I drink that it is not registering but I am still in ketosis.
    What are ketones?
    Ketones are a normal and efficient source of fuel and energy for the human body. They are produced by the liver from fatty acids, which result from the breakdown of body fat in response to the absence of glucose/sugar. In a ketogenic diet, such as Atkins ... or diets used for treating epilepsy in children, the tiny amounts of glucose required for some select functions can be met by consuming a minimum amount of carbs - or can be manufactured in the liver from PROTEIN. When your body is producing ketones, and using them for fuel, this is called "ketosis".
    How will ketosis help me to lose weight?
    Most reducing diets restrict calorie intake, so you lose weight but some of that is fat and some of it is lean muscle tissue as well. Less muscle means slowed metabolism, which makes losing weight more difficult and gaining it back all too easy. Ketosis will help you to lose FAT.
    Being in ketosis means that your body's primary source of energy is fat (in the form of ketones). When you consume adequate protein as well, there's no need for the body to break down its muscle tissue. Ketosis also tends to accelerate fat loss --- once the liver converts fat to ketones, it can't be converted back to fat, and so is excreted.
    But, isn't ketosis dangerous?
    Being in ketosis by following a low carbohydrate diet is NOT dangerous. The human body was designed to use ketones very efficiently as fuel in the absence of glucose. However, the word ketosis is often confused with a similar word, ketoacidosis.
    Ketoacidosis is a dangerous condition for diabetics, and the main element is ACID not ketones. The blood pH becomes dangerously acidic because of an extremely high blood SUGAR level (the diabetic has no insulin, or doesn't respond to insulin .... so blood sugar rises ... ketones are produced by the body to provide the fuel necessary for life, since the cells can't use the sugar). It's the high blood sugar, and the acid condition that is so dangerous. Ketones just happen to be a part of the picture, and are a RESULT of the condition, not the CAUSE. Diabetics can safely follow a ketogenic diet to lose fat weight ... but they must be closely monitored by their health care provider, and blood sugars need to be kept low, and stable.
    How do the ketone test strips work, and where can I get them?
    Ketone urine-testing strips, also called Ketostix or just ketone sticks ... are small plastic strips that have a little absorptive pad on the end. This contains a special chemical that will change colour in the presence of ketones in the urine. The strips may change varying shades of pink to purple, or may not change colour at all. The container will have a scale on the label, with blocks of colour for you to compare the strip after a certain time lapse, usually 15 seconds. Most folks simply hold a strip in the flow of urine. Other folks argue that the force of the flow can "wash" some of the chemical away, and advise that a sample of urine be obtained in a cup or other container, then the strip dipped into it.
    The chemical reagent is very sensitive to moisture, including what's in the air. It's important to keep the lid of the container tightly closed at all times, except for when you're getting a strip to take a reading. Make sure your fingers are dry before you go digging in! They also have an expiry date, so make note of this when you purchase the strips ... that's for the UNopened package. Once opened, they have a shelf-life of about 6 months -- you may wish to write the date you opened on the label for future reference.
    Ketone test strips can be purchased at any pharmacy, and are usually kept with the diabetic supplies. In some stores they're kept behind the counter, so if you don't see them on the shelf, just ask the pharmacist; you don't need a prescription to buy them.
    I'm following Induction strictly; why won't my strips turn purple?
    Ketones will spill into the urine ONLY when there is more in the blood than is being used as fuel by the body at that particular moment.
    You may have exercised or worked a few hours previously, so your muscles would have used up the ketones as fuel, thus there will be no excess. You may have had a lot of liquids to drink, so the urine is more diluted. Perhaps the strips are not fresh, or the lid was not on tight and some moisture from the atmosphere got in.
    Some low carbers NEVER show above trace or negative even ... yet they burn fat and lose weight just fine. If you're losing weight, and your clothes are getting looser, you're feeling well and not hungry all the time .. then you are successfully in ketosis. Don't get hung up on the strips; they're just a guide, nothing more.
    Will I lose weight faster if the strips show dark purple all the time?
    No. Testing in the darkest purple range all the time is usually a sign of dehydration -- the urine is too concentrated. You need to drink more water to dilute it, and keep the kidneys flushed.
    The liver will make ketones from body fat, the fat you EAT, and from alcohol --- the ketone strips have no way of distinguishing the source of the ketones. So, if you test every day after dinner, and dinner usually contains a lot of fat, then you may very well test for large amounts of ketones all the time. However this does not indicate that any BODY fat was burned.
    The strips only indicate what's happening in the urine. Ketosis happens in the blood and body tissues. If you're showing even a small amount, then you are in ketosis, and fat-burning is taking place. Don't get hung up on the ketone sticks.
    Does caffeine affect ketosis?
    This is questionable. There ARE a few studies that suggest caffeine may cause blood sugar to rise, with consequent effect on insulin ... The studies involve consuming 50 gm glucose orally, followed by a dose of caffeine. This is quite different from a low carber, who is consuming only 20 gm carbs, in the form of high-fiber vegetables, spread throughout the day.
    Many low carbers continue to enjoy caffeine-containing beverages with no serious impact on their weight-loss efforts. However, there are some sensitive individuals ... and persons who are extremely insulin resistant may need to restrict or even eliminate all caffeine. If you have been losing successfully then find your weight loss stalled for a month or two, and you are following your program to the letter, you might consider stopping all caffeine for a while, to see if that will get things started again.
    Will drinking alcohol affect ketosis?
    No and yes. The liver can make ketones out of alcohol, so technically, when you drink you'll continue to produce ketones and so will remain in ketosis. The problem is ... alcohol converts more easily to ketones than fatty acids, so your liver will use the alchol first, in preference to fat. Thus, when you drink, basically your FAT burning is put on hold until all the alcohol is out of your system.
    This rapid breakdown of alcohol into ketones and acetaldehyde (the intoxicating by-product) ... tends to put low carbers at risk for quicker intoxication ... especially if no other food is consumed to slow absorption.
    Atkinscenter Official Website ... FAQ page, (select Ketosis)
    Ketosis ... from the Low Carb Diet and Exercise List
    Ketosis and Lipolysis ... from Low Carb Retreat
    I believe Gary Taubes!
    Week 1-8 pounds
    Week 2-5 pounds

    Pounds lost: 13.0






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Euglycemic Dka Secondary To Sglt2 Inhibitors

Authors: Priyanka Kailash (MS-4, Campbell University School of Osteopathic Medicine), Kevin Weaver, DO (Program Director, Lehigh Valley Health Network), and Krystle Shafer, MD (Attending Physician, York Hospital) // Edited by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital) and Brit Long, MD (@long_brit) A 35-year-old male with a past medical history of type 2 diabetes arrives at the Emergency Department (ED) with altered mental status, nausea, vomiting, and diffuse abdominal pain that started 10 hours ago. The patient was recently started on an SGLT2 inhibitor. On examination, the patient is tachycardic (HR 126) and tachypneic (RR 25), with normal blood pressure (110/90). He is further noted to have dry mucous membranes and poor skin turgor. Blood glucose is noted to be 140 mg/dl, serum ketones 6.2 mmol/L, and arterial pH of 6.9. The patient is diagnosed with euglycemic DKA and quickly admitted to ICU for treatment. Pathogenesis of Typical DKA Two major complications from type 1 diabetes mellitus and type 2 diabetes mellitus are diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). DKA is typically Continue reading >>

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Popular Questions

  1. blankpenny

    I’ve been reading the information here for a while, although I haven’t commented until now. For a few weeks, I’ve been following some version of a keto diet combined with intermittent fasting (and have confirmed several times with ketostix that I’m in ketosis). I’ve lost weight pretty quickly and feel really good. I’m 5’2”, female, about 112 pounds now, but I still a little bit of fat left to lose.
    My problem is, I’ve basically been accused of having an eating disorder and agreed to see a doctor at my university health center this week for a medical evaluation. This will consist of a CBC, urinalysis, complete metabolic profile, thyroid screen, electrocardiogram, and serum magnesium test. I was wondering if anyone here could help me know where to expect “abnormal” results.
    If I stay in ketosis this week, how will my blood work look different from that of someone on a more typical diet? (Besides ketones in my urine.) I want my test results to look as normal as possible. I’m even considering eating carbs the day of my appointment to kick myself out of ketosis for the day. (Would that cause the urinalysis to look normal?) Anyway, I guess this is one way to ask my question: if I didn’t explain that I’ve been on a very low carb diet, would the doctor be able to detect that? With what evidence, exactly?
    Any information(/suggestions about how to make my labs look normal) would be appreciated!

  2. anbeav

    Not really because everyone is different, my labs on keto are completely within normal range except glucose
    I want my test results to look as normal as possible
    Shouldn't you want your labs to reflect how you actually eat? Who is making you get this test? Not to mention that many have abnormal labs when not eating keto
    Not sure what you're trying to prove and to who and if you're an adult maybe you shouldn't

  3. blankpenny

    Thanks for the comment. It’s a good point, I’m an adult. The backstory is that I’ve been seeing a counselor at my university’s health center for other issues (in the mild depression/anxiety category) and her perspective is that she can’t continue treating me in the same way if I have an undiagnosed eating disorder. (As you can probably imagine, it raises red flags at a college counseling center if a slightly neurotic college-aged woman loses a lot of weight quickly.) I want to continue seeing her without discussing my dietary choices, so I’m accepting being in the somewhat infantilizing position of having to prove that I don’t have an eating disorder.

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