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Starvation Ketoacidosis Pathophysiology

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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

Alcoholic Ketoacidosis

Alcoholic ketoacidosis is a metabolic complication of alcohol use and starvation characterized by hyperketonemia and anion gap metabolic acidosis without significant hyperglycemia. Alcoholic ketoacidosis causes nausea, vomiting, and abdominal pain. Diagnosis is by history and findings of ketoacidosis without hyperglycemia. Treatment is IV saline solution and dextrose infusion. Alcoholic ketoacidosis is attributed to the combined effects of alcohol and starvation on glucose metabolism. Alcohol diminishes hepatic gluconeogenesis and leads to decreased insulin secretion, increased lipolysis, impaired fatty acid oxidation, and subsequent ketogenesis, causing an elevated anion gap metabolic acidosis. Counter-regulatory hormones are increased and may further inhibit insulin secretion. Plasma glucose levels are usually low or normal, but mild hyperglycemia sometimes occurs. Diagnosis requires a high index of suspicion; similar symptoms in an alcoholic patient may result from acute pancreatitis, methanol or ethylene glycol poisoning, or diabetic ketoacidosis (DKA). In patients suspected of having alcoholic ketoacidosis, serum electrolytes (including magnesium), BUN and creatinine, glucose, Continue reading >>

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  1. timothyw

    Ketosis & BG

    Has anyone ever made a correlation between their blood sugar numbers and Ketosis? I imagine it would be different for everyone. seems to me that if the BG went down to x then you would switch into ketosis for fuel needs. Too high a BG and you wouldn't be in ketosis. Or am I off track here and it is purely the carb count that matters? I have read how atkins suggested increasing carbs each week to find the right level of carbs to maintain weight on his diet.
    Any ideas or thoughts?

  2. MarkM

    You can be in ketosis and have high blood sugar levels but low insulin levels. This what happens to T1s at onset, but it gets worse and there can be ketoacidosis. T2s, if they are insulin resistant and/or insulin deficient, can also be in ketosis and have above normal blood glucose levels.
    Normal people go in and out of ketosis every day. But for someone who has normal insulin production and insulin sensitivity, sustained ketosis would only occur if carb consumption dropped below what is needed to satisfy the normal daily glucose requirement. Some say this is 130 grams of carb a day. Low carbers will tell you it is a lot lower, based on their observations of ketone test results and eating patterns.
    That is my take on it anyway. And in answer to your question, no, I don't think there is a clear correlation there.

  3. Nicoletti

    I never gave it a thought. My concern is keeping blood sugar down.

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Journal Of The Intensive Care Society

We read with interest the recent case report by Yeow et al.1 of a 65-year-old female who developed starvation ketoacidosis perioperatively following an extended period of poor oral intake. The authors noted that euglycaemic ketoacidosis in non-diabetic patients is very rarely reported and that it is important to be aware of the condition. Perhaps the most common factor that predisposes to starvation ketoacidosis in otherwise healthy individuals is pregnancy, which the authors do not mention. It has long been known that accelerated ketone production following fasting is seen in normal pregnancy.2 We have recently reported a number of cases of starvation ketoacidosis in pregnant women without hyperglycaemia.3 It typically occurs in the third trimester following a short history of reduced oral intake. We have also described this condition in pregnant women with pancreatitis and in one woman after commencement of olanzapine during pregnancy.4,5 Many of these women were admitted to intensive care units and several had emergency deliveries in the absence of a clear diagnosis. On the other hand, in those in whom the diagnosis was recognised, treatment with dextrose alone often appeared to Continue reading >>

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  1. Heather

    I've been on the diet now for 7 days. Day 1 and 2 I dropped 2 kilos, and since that I haven't budged.
    I check my pee twice a day and am always in the top or second top keto reading...
    Is it possible to be in ketosis, but still doing something wrong ?

  2. Helen

    Ketosis just means that you are burning fat instead of carbs/glucose for energy. If you are having too many calories (or even not enough), you may find that you do not lose weight.
    Also, if you only have a few kgs to lose, then your weight loss will be slower than someone who has a lot of weight to lose. What is your BMI?
    Are you doing a lot of intensive exercise? Sometimes you may be losing fat, but building muscle, so the scales appear to not move.
    Regardless of what diet you follow, you will not lose weight each and every day. 2 kgs in 1 week is a pretty good loss, especially if you don't have a lot of weight to lose.
    Chances are that if you continue to follow the program properly and keep avoiding carbs, you will lose more weight in the next few days. Some call it the "whoosh" effect, lol. Some people lose weight slowly and steadily. Many more of us, lose it in stops and starts. We lose a bit, then a few days of nothing and then another "whoosh".
    Keep at, and you should get results.
    Cheers
    Helen
    [ed. note: Helen (1169825) last edited this post 3 years, 7 months ago.]

  3. Heather

    My Bmi is 30.51. I've got about 15 kilos to lose, but on a bazillion diets I never seem to get past 6 or 7kg.
    I'm not currently exercising because I'm just too tired. I'm hoping to get back to the gym soon though.
    I'll stick it out in hopes for this whoosh hehe. Thanks Helen.

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Subscribe for videos on becoming superhuman: https://goo.gl/TSDCuv Lowering your caloric intake and doing intermittent fasting has a ton of health benefits on both your body and your mind. Herman Hesse said in his novel, Siddhartha: Everyone can perform magic, everyone can reach his goals, if he is able to think, if he is able to wait, if he is able to fast. Numerous studies have shown that caloric restriction increases the lifespan and youthfulness of almost all species, starting with fruit flies and ending with rhesus monkeys. In humans, there is no definite anti-aging proof but fastings been shown to improve biomarkers, reduce inflammation, promote stem cell growth, boost the immune system and make you burn a ton of fat. However, the key to successfully gaining these health benefits comes from avoiding malnutrition and starvation. Theres a hugedifference between fasting, starvationand caloric restriction, but it doesn't mean you can't be starving while intermittent fasting or consuming fewer calories. This video tells you how to avoid starvation mode while fasting and gain the longevity benefits More In-Depth video on autophagy: https://www.youtube.com/watch?v=_2kW_... Read the

Extreme Gestational Starvation Ketoacidosis: Case Report And Review Of Pathophysiology

A case of severe starvation ketoacidosis developing during pregnancy is presented. The insulinopenic/insulinresistant state found during fasting in late gestation predisposes to ketosis. Superimposition of stress hormones, which further augment lipolysis, exacerbates the degree of ketoacidosis. In our patient, gestational diabetes, twin pregnancies, preterm labor, and occult infection were factors that contributed to severe starvation ketoacidosis. Diagnosis was delayed because starvation ketosis is not generally considered to be a cause of severe acidosis, and because the anion gap was not elevated. Improved understanding of the complex fuel metabolism during pregnancy should aid in prevention, early recognition, and appropriate therapy of this condition. Continue reading >>

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  1. Injecto

    I can't seem to find anything that backs this up. I know that high BG will damage them over time (duh!!), but what about ketones?

  2. fgummett

    Ketone bodies are water-soluble compounds that are produced as by-products when fatty acids are broken down for energy. They are a vital source of energy during fasting -- such as overnight.
    The brain gets its energy from ketone bodies when insufficient glucose is available. In the event of low blood glucose, most other tissues have additional energy sources besides ketone bodies (such as fatty acids), but the brain does not.
    Remember that when you are not fasting, the body can use Amino Acids (from dietary Protein) to synthesize Glucose (Gluconeogenesis).
    Any production of Ketones is called ketogenesis, and this is necessary in small amounts. When even larger amounts of ketone bodies accumulate such that the blood's pH is lowered to dangerously acidic levels, this state is called ketoacidosis. This happens in untreated Type I diabetes (DKA).
    In short, the human body has evolved over the millennia to burn either Glucose or Fatty Acids -- think of these as the short-term fuel and longer-term reserve, respectively.
    So if it is normal to burn Fatty Acids and produce Ketones why would they be harmful unless they accumulate to dangerous levels? Yes I know... we always get the "dangerous levels" lecture but consider that BG can be toxic at high enough levels... that does not mean it is bad for us at any level

  3. REDLAN

    can we get the production of ketones correct??
    The primary cause of ketogenesis in the body is.....
    gluconeogenesis from dietary protein, when there is insufficient dietary glucose to fill the body needs, aka the ketogenic diet.
    The process of gluconeogenesis utilises a key component of the citric acid cycle (oxaloacetate), which blocks the oxidation of Acetyl CoA. Fatty acid (and glucose oxidation) require their conversion to Acetyl CoA. It is Acetyl CoA which is converted to ketone bodies and this process occurs pretty exclusively in the liver (also happens in the kidney)
    Normally oxidation of fatty acids does NOT produce ketone bodies, even during fasting overnight, as usually there are more than sufficient stores of glycogen.
    - starvation is an entirely different matter. Fasting for longer than a day or so can be sufficient for ketogenesis to start.
    Astrocytes in the brain can produce ketone bodies in response to hypoglycemia, but this will not provide adequate protection in the event of hypoglycemia caused by insulin overdose.
    The simple reason why ketogenesis as caused by a ketogenic diet is probably safe is because ketones only transiently rise in response to food, and the levels sustained should not be sufficient to disturb the body's buffer system.
    if however you spent long periods without food, or lacking insulin then that is a very different matter.
    I can't find anything definitive about ketones and kidney function - the only thing of note is an association with kidney stones for children on ketogenic diets to control epilepsy - but this could be due to the components of the diet (high protein) rather than ketones. There are no long term safety studies on ketogenic diets, but they are though to be safe (probably).
    Those on this forum on low carbohydrate diets 50g to 120g of carbs probably do not experience ketogenesis to any significant degree. Significant ketogenesis only occurs at <30g.

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