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Starvation Ketoacidosis Pathophysiology

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Fasting Ketosis And Alcoholic Ketoacidosis

INTRODUCTION Ketoacidosis is the term used for metabolic acidoses associated with an accumulation of ketone bodies. The most common cause of ketoacidosis is diabetic ketoacidosis. Two other causes are fasting ketosis and alcoholic ketoacidosis. Fasting ketosis and alcoholic ketoacidosis will be reviewed here. Issues related to diabetic ketoacidosis are discussed in detail elsewhere. (See "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis" and "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis" and "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment".) PHYSIOLOGY OF KETONE BODIES There are three major ketone bodies, with the interrelationships shown in the figure (figure 1): Acetoacetic acid is the only true ketoacid. The more dominant acid in patients with ketoacidosis is beta-hydroxybutyric acid, which results from the reduction of acetoacetic acid by NADH. Beta-hydroxybutyric acid is a hydroxyacid, not a true ketoacid. Continue reading >>

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  1. uglyduck2

    i take mct oil with my coffee in the morning. interested in taking exogenous ketones for long hikes and the such

  2. carbaholic

    Yes

  3. [deleted]

    Yes
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Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis

Starvation Ketoacidosis: A Cause Of Severe Anion Gap Metabolic Acidosis In Pregnancy

Copyright © 2014 Nupur Sinha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pregnancy is a diabetogenic state characterized by relative insulin resistance, enhanced lipolysis, elevated free fatty acids and increased ketogenesis. In this setting, short period of starvation can precipitate ketoacidosis. This sequence of events is recognized as “accelerated starvation.” Metabolic acidosis during pregnancy may have adverse impact on fetal neural development including impaired intelligence and fetal demise. Short periods of starvation during pregnancy may present as severe anion gap metabolic acidosis (AGMA). We present a 41-year-old female in her 32nd week of pregnancy, admitted with severe AGMA with pH 7.16, anion gap 31, and bicarbonate of 5 mg/dL with normal lactate levels. She was intubated and accepted to medical intensive care unit. Urine and serum acetone were positive. Evaluation for all causes of AGMA was negative. The diagnosis of starvation ketoacidosis was established in absence of other causes of Continue reading >>

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  1. SWEETJAS

    HEY ALL!!
    I AM SOOOOO CONFUSED! I know some people don't think that the strips are accurate (their are many things that can effect the out come, how much water are you drinking, yadda, yadda, yadda) I had to try them !. I bought some last night and according to the color I am in Moderate ketosis. This morning I used one and it is the same. The strips go from Zero, Trace, Low, Moderate, to Large. So does the moderate mean that I AM buring fat as fuel or that I am ALMOST buring fat for fuel? The box and directions don't give and explanation for some odd reason.
    HEEEEELP!! Thanks!

  2. Cherimee

    On the side of the bottle, you should see a like a chart to compare it to.... if you are in moderate ketosis then that's good! The more purple the stick, the more fat you are burning for fuel, which is what you want to do on Atkins. You'll notice that with Atkins, the keto strips are like the scale, you wanna see PURPLE when you test becasue the more ketones in your urine, of course the more fat you burn! Sounds like you are doing good...good luck
    P.S. I'm told that with Atkins even a 'trace' of ketones is good... trying going to www dot lowcarbnexus dot com, that site gives you good info... here's what they say about ketosis:
    Ketosis? - As long as we are on the topic, what about ketosis? Ketosis is the state that your body enters into when you are eating mainly protein and fats, and drastically curtailing your consumption of carbohydrates. As Dr. Atkins says, "There is no lipolysis without ketosis, no ketosis without lipolysis." Lipolysis is, essentially, "fat burning." In other words, this is just what we want! We want to force our bodies to consume stored fat for fuel rather than burn primarily our food. This occurs because protein and fat do not "give up" their stored energy as easily as do carbohydrates. As long as you are eating mainly carbs, especially refined sugars, you will find that your body will burn that as opposed to your fat stores. Testing with LTS, as we have mentioned above, scientifically tests for the process of your body burning it's own fat as fuel. When the sticks turn purple (or a shade thereof), you are burning fat! It is a good feeling! It is especially comforting to see that purple when your scales don't agree that you are losing! Keep in mind that fat loss doesn't always equal weight loss on the scales... immediately. Body weight can be related to water retention, and many other temporary conditions. However, FAT loss is what we want, and you will see measurements change even if your scale does not show it immediately! That WILL follow, of course... just stick with it!
    Some have asked, "Do I have to be in ketosis?" Well, it is perfectly safe to be in what Dr. Atkins calls "Benign Dietary Ketosis" for extended periods. In fact, if you are burning fat, you will be in some amount of ketosis...sometimes just not a measurable amount (with LTS). If you are out of ketosis for extended periods, you won't be burning fat, and therefore, you won't be losing weight! And that's what we are doing the diet to do! Don't confuse ketosis, a safe metabolic state that you enter when you loss weight, with ketoacidosis, a dangerous state that diabetics, in particular, can enter if they get out of proper balance in their insulin / glycogen balance. Many health care professionals and nutritionists are apparently confused by the distinction between these two different states... ketone test strips are used to test both states, but they are quite different!

  3. SWEETJAS

    Cherimee, BIG THANKS!!!! The info you gave me is sooooo relieving!!! I was so worried! I know that must have takin a while for you to find and type, thank you so much for helping me!

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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 blood sugar, low blood pH, and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin. Depending on the severity, insulin may be given intravenously or by injection under the skin. Usually potassium is also needed to prevent the development of low blood potassium. Throughout treatment blood sugar and potassium levels should be regularly checked. Antibiotics may be required in those with an underlying infection. In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended. Rates of DKA vary around the world. About 4% of people with type 1 diabetes in United Kingdom develop DKA a year, while in Malaysia the condition affects about 25% a year. DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost universally fatal. The risk of death with adequate and timely treatment is currently around 1–4%. Up to 1% of children with DKA develop a complication known as cerebral edema. The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. Those who measure their glucose levels themselves may notice hyperglycemia (high blood sugar levels). In severe DKA, breathing becomes labored and of a deep, gasping character (a state referred to as "Kussmaul respiration"). The abdomen may be tender to the point that an acute abdomen may be suspected, such as acute pancreatitis, appendicitis or gastrointestinal perforation. Coffee ground vomiting (vomiting of altered blood) occurs in a minority of people; this tends to originate from erosion of the esophagus. In severe DKA, there may be confusion, lethargy, stupor or even coma (a marked decrease in the level of consciousness). On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, tachycardia (a fast heart rate) and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity", often compared to the smell of pear drops whose scent is a ketone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.....

Diabetic Ketoacidosis: Evaluation And Treatment

Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis can occur in persons of all ages, with 14 percent of cases occurring in persons older than 70 years, 23 percent in persons 51 to 70 years of age, 27 percent in persons 30 to 50 years of age, and 36 percent in persons younger than 30 years. The case fatality rate is 1 to 5 percent. About one-third of all cases are in persons without a history of diabetes mellitus. Common symptoms include polyuria with polydipsia (98 percent), weight loss (81 percent), fatigue (62 percent), dyspnea (57 percent), vomiting (46 percent), preceding febrile illness (40 percent), abdominal pain (32 percent), and polyphagia (23 percent). Measurement of A1C, blood urea nitrogen, creatinine, serum glucose, electrolytes, pH, and serum ketones; complete blood count; urinalysis; electrocardiography; and calculation of anion gap and osmolar gap can differentiate diabetic ketoacidosis from hyperosmolar hyperglycemic state, gastroente Continue reading >>

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Popular Questions

  1. tiger_lily5

    Hey ladies, this question is for you. Have any of you noticed a change in your cycle since being on keto? ie heavier or lighter periods, early or late on timing? Just curious if its affected you at all and if it was just a change in the beginning or it kept fluctuating.

  2. strawmama

    My cycle cam early...like 2.5 weeks early my first month, but it has since leveled out to once a month. I have less cramping and stomach problems...big bonus.

  3. LilMamaBear125

    I'm still like a clock on a timer here...

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