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What Is A Dka Episode?

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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

Diabetic Ketoacidosis In Adults

Shivani Misra, clinical research fellow and specialist trainee year 6 in metabolic medicine12, Nick S Oliver, consulant diabetologist and reader in diabetes13 1Department of Diabetes, Endocrinology & Metabolism, Imperial College, London W2 1PG, UK 2Clinical Biochemistry & Metabolic Medicine, Imperial Healthcare NHS Trust, London, UK 3Diabetes and Endocrinology, Imperial Healthcare NHS Trust, London, UK Correspondence to: N S Oliver nick.oliver{at}imperial.ac.uk Diabetic ketoacidosis (DKA) is a common, serious, and preventable complication of type 1 diabetes, with a mortality of 3-5%. It can also occur in patients with other types of diabetes It can be the first presentation of diabetes. This accounts for about 6% of cases The diagnosis is not always apparent and should be considered in anyone with diabetes who is unwell Diagnosis is based on biochemical criteria. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA Immediate treatment consists of intravenous fluids, insulin, and potassium, with careful monitoring of blood glucose and potassium levels to avoid hypoglycaemia and hypokalaemia Knowledge of the type of diab Continue reading >>

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  1. iwannalose50lbs

    On my 3rd month of Keto and having some success, but every so often I'm presented with an opportunity to "cheat" and sometimes it's rude if not impossible to pass up. Examples include but are not limited to:
    A friend buying a round of beers at the bar.
    A close friend or relative's child offering a piece of their birthday cake.
    A pancake social or a private dinner at a traditional Italian home.
    I tried searching but couldn't find anything discussing the SCIENCE of cheating while on Keto. For example:
    What are the variables that affect how quickly and how long you are kicked out of ketosis, and how long does it take to get back into ketosis in each scenario?
    How much different is the effect of eating a single Oreo cookie versus a whole plate of pasta?
    How strongly does exercise impact ketosis, and what types of exercises are best for getting back into ketosis if you get "kicked out" after a cheat day?
    How strongly does cheating impact actual weight loss? It seems to be common knowledge that cheating can actually help overcome plateaus, so what's the REAL difference between someone who practices Keto religiously versus someone who does Keto most of the time with the occasional treat thrown in every few days?
    To clarify, this is not a post advocating cheating. I am simply trying to open a discussion about the physical impact that cheating can have on your body while in ketosis. I have gone over a month without cheating, but I have also cheated multiple times in a week and I haven't really noticed much of a difference either way. This is more of a curiosity post than anything else. Looking forward to a good discussion.

  2. gogge

    What are the variables that affect how quickly and how long you are kicked out of ketosis, and how long does it take to get back into ketosis in each scenario?
    The carbs you take in will stop ketone production until they're used up, or stored away in muscle. Full liver glycogen (~100 grams of carbs) last roughly 12-16 hours, so you'll probably be able to clear around 6-9 grams of carbs per hour by just existing (and not all carbs you eat will get stored as liver glycogen, your muscles take up some).
    The major determinant of whether the liver will produce ketone bodies is the amount of liver glycogen present (8). The primary role of liver glycogen is to maintain normal blood glucose levels. When dietary carbohydrates are removed from the diet and blood glucose falls, glucagon signals the liver to break down its glycogen stores to glucose which is released into the bloodstream. After approximately 12-16 hours, depending on activity, liver glycogen is almost completely depleted. At this time, ketogenesis increases rapidly. In fact, after liver glycogen is depleted, the availability of FFA will determine the rate of ketone production. (12)
    "The Ketogenic Diet", by Lyle McDonald, page 30.
    It will also take a few hours to clear the ketones already produced (circulating in your blood) even if ketone production stops, here's a post on ketone clearance from blood.
    How much different is the effect of eating a single Oreo cookie versus a whole plate of pasta?
    Assuming one oreo has 21 grams of carbs and that a whole plate of pasta is something like 121 grams of carbs (three servings).
    You'll probably not get noticeably kicked out from the oreo as it'll probably be digested over 30 minutes and then you'll use up the carbs within an hour or two, it'll take longer than that for the ketones to clear your blood.
    The plate of pasta will probably be digested over several hours, a normal mixed meal takes 4-6 hours but your intestines can absorb around 60-100 grams of carbs per hour, so two or three hours to digest highly processed carbs sounds more likely. At 6-8 grams of carbs used per hour it'll take 15-20 hours to clear all the glucose if it was only burned, but some will probably get used by your digestive system and some will get picked up by other tissues of the body (stored in muscles). You have peripherial insulin resistance on keto, manifested as impaired glucose tolerance, which likely means that a large part of the glucose will end up as liver glycogen. So a full plate of pasta might kick you out of ketosis for at least 15-20 hours (assuming resuming ketone production takes about as long as ketone clearance), longer if your body uses less glucose.
    How strongly does exercise impact ketosis, and what types of exercises are best for getting back into ketosis if you get "kicked out" after a cheat day?
    High intensity exercise burns glucose, high intensity endurance close to the lactate threshold is probably the best way of depleting liver glycogen (muscle taking up blood glucose, forcing the liver to use stored glycogen to maintain blood glucose levels).
    Higher intensity cardiovascular exercise is a little bit harder to pinpoint in terms of carbohydrate requirements and can vary pretty significantly depending on the intensities and volumes. A sprinter running 60m repeats isn’t using a lot of glycogen, a trained endurance athlete working near their lactate threshold for extended periods can deplete glycogen fairly completely in 1-2 hours. Even at lower intensities, the 2-6 hour sessions done by endurance athletes can completely deplete both muscle and liver glycogen stores on a daily basis.
    Lyle McDonald, "How Many Carbohydrates Do You Need?".
    How strongly does cheating impact actual weight loss? It seems to be common knowledge that cheating can actually help overcome plateaus, so what's the REAL difference between someone who practices Keto religiously versus someone who does Keto most of the time with the occasional treat thrown in every few days?
    Actual short term fat gain (or lower loss) directly contributed to by the carbs is likely negligible, what matters for fat stored (or lower fat loss) directly affected by the cheat meal/day is total caloric intake.
    Short term weight gain might be because when carbs are stored as glycogen they bind 3-4 grams of water and the increased insulin levels can also lead to higher sodium retention (leading to water retention), which can help explain why some people gain large amounts of weight with cheat meals/days despite not eating a lot of calories (longer post on water loss on keto).
    Long term weight loss effects might be slightly different, a single cheat day might help you lower cortisol, raise leptin, and thyroid levels, which could help lessen water retention (and possibly increase metabolic rate, but not a lot of research on this that I know of). This might be why people break plateaus after cheat meals/days, Lyle talks some about it in "The LTDFLE".
    Eating a few carbs from time to time is unlikely to negatively influence your weight loss unless it adds significant calories.

  3. lovesfunnyposts

    Great helpful response!!

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Reducing Episodes Of Diabetic Ketoacidosis Within A Youth Population: A Focus Group Study With Patients And Families

Reducing episodes of diabetic ketoacidosis within a youth population: a focus group study with patients and families Daniel Albrechtsons , Donna Hagerty , and Leigh Anne Newhook Janeway Pediatric Research Unit, Division of Pediatrics, Faculty of Medicine, Memorial University of Newfoundland, Room 409, Janeway Hostel, 300 Prince Phillip Drive, St. Johns, NL A1B 3V6 Canada Division of Pediatrics, Faculty of Medicine, Janeway Child Health Care Centre, Memorial University of Newfoundland, St. Johns, NL Canada Janeway Pediatric Research Unit, Division of Pediatrics, Faculty of Medicine, Memorial University of Newfoundland, Room 409, Janeway Hostel, 300 Prince Phillip Drive, St. Johns, NL A1B 3V6 Canada Memorial University of Newfoundland, St. Johns, NL Canada Eastern Health, Outreach Department, St. Johns, NL Canada Division of Pediatrics, Faculty of Medicine, Janeway Child Health Care Centre, Memorial University of Newfoundland, St. Johns, NL Canada Roger Chafe, Phone: 1-709-777-2944, Email: [email protected] . Received 2015 Mar 5; Accepted 2015 Aug 17. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which Continue reading >>

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Popular Questions

  1. Abrane

    Squatters high is the only life for me

  2. baconmecrazy

    I should add that regular aerobic exercise dampens my appetite, big time. I only want a little food after hiking but if I go several days without getting outside, this is me:

  3. mikki

    pre keto i would sometimes leave the gym because i was convinced i was starving and gonna die...now i'm less hungry during and after training....yep i miss my "anabolic window" everyday now LOL

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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

Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP more... Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria. The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Malaise, generalized weakness, and fatigability Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia Rapid weight loss in patients newly diagnosed with type 1 diabetes History of failure to comply with insulin therapy or missed insulin injections due to vomiting or psychological reasons or history of mechanical failure of insulin infusion pump Altered consciousness (eg, mild disorientation, confusion); frank coma is uncommon but may occur when the condition is neglected or with severe dehydration/acidosis Signs and symptoms of DKA associated with possible intercurrent infection are as follows: Gl Continue reading >>

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  1. * DKA explanation

    * DKA explanation

    Below you will find a terrific explanation of DKA from one of the instructors at Med School Tutors. If you like what you see and may be interested in learning more about one-on-one instruction from MST, then please visit their website at www.medschooltutors.com
    In order to understand how to treat DKA, it is useful to first understand what is going on in the body when DKA develops. First of all, DKA (diabetic ketoacidosis) typically develops when a Type I diabetic does not take his or her insulin for a prolonged period of time. It may also be the presentation for new onset diabetes. Because these patients are insulin deficient, they are not able to take up glucose into their cells. This results in two important consequences: 1)glucose builds up in the blood and causes hyperglycemia and 2)the body's cells are forced to breakdown fat for energy, instead of glucose.
    These are very significant consequences... The hyperglycemia results in an osmotic diuresis, because the proximal tubule of the kidney can't reabsorb all the glucose filtered into the nephron. What is osmotic diuresis? Simply that the hyperglycemia (usually >300) causes the body to excrete lots and lots of water, because the osmotic pull of all the glucose particles prevents the reabsorbtion of water in the collecting duct. This means that patients with DKA are peeing their brains out!! They pee out sodium, potassium, and water.. And are therefore, very very very DEHYDRATED, sodium depleted, and potassium depleted.
    Now for the metabolism end of things... The body cells are forced to metabolize fat for energy rather than glucose. How do they accomplish this? - beta-oxidation of fatty acids. This results in excess production of ketone bodies which deplete available acid buffers. This causes a significant metabolic acidosis, with a high anion gap due to the presence of ketoacids. The acidosis causes potassium to shift from the intracellular space to the extracellular space. This may result in a normal or high serum potassium level. This normal or high potassium level masks what is typically significant potassium depletion because the person was peeing all their potassium out as a result of the uncontrolled hyperglycemia.
    So what are we going to do now? I will give a very brief answer for now, expect people to ask questions in the meantime, and then provide a more thorough approach to treatment in the coming days.
    1)Give the patient tons of normal saline. Why? - because your patient is dehydrated as all hell. They have been peeing out every last drop of water because of their severe uncontrolled hyperglycemia. These patients require liters of fluid to replenish all the fluid they've lost as a result of the osmotic diuresis.
    2)Give them insulin. Why? - NOT because it will lower the blood glucose level, but because it will cause a shift away from fat metabolism and toward glucose metabolism. This will slow the production of ketone bodies which are precipitating the metabolic acidosis. Thus, I will repeat, we give insulin to shift away from fat metabolism and stop the production of ketone bodies.
    3)Give the patient potassium. Why? - As we discussed earlier, the person has been peeing out all of their potassium stores and are overall very potassium depleted, despite having normal or high serum potassium levels to begin with. In addition to being potassium depleted, the insulin you are giving will cause a shift of potassium from the extracellular space to the intracellular space, which will drop the serum potassium. Thus, we give DKA patients potassium way before they become hypokalemic.
    4)Give the patient dextrose. Why? - They insulin you are giving the patient is obviously going to cause the serum glucose to decrease. We give glucose to prevent hypoglycemia as we continue to give insulin.
    How do we know when we are finished treating these patients? - When the anion gap returns to normal.
    That's all for now. Please ask any questions you have. I will be giving more specifics about DKA management in the near future.
    PS: Does anyone know the dangerous consequence of giving DKA patients fluid too rapidly? What are the symptoms this may cause, and what is the pathophysiology behind these symptoms?

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