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What Is Alcoholic Ketoacidosis?

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Chapter 221. Alcoholic Ketoacidosis

Woods WA, Perina DG. Woods W.A., Perina D.G. Woods, William A., and Debra G. Perina.Chapter 221. Alcoholic Ketoacidosis. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. Tintinalli J.E., Stapczynski J, Ma O, Cline D.M., Cydulka R.K., Meckler G.D., T Eds. Judith E. Tintinalli, et al.eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e New York, NY: McGraw-Hill; 2011. Accessed March 27, 2018. Woods WA, Perina DG. Woods W.A., Perina D.G. Woods, William A., and Debra G. Perina.. "Chapter 221. Alcoholic Ketoacidosis." Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. Tintinalli J.E., Stapczynski J, Ma O, Cline D.M., Cydulka R.K., Meckler G.D., T Eds. Judith E. Tintinalli, et al. New York, NY: McGraw-Hill, 2011, Alcoholic ketoacidosis is a wide anion gap metabolic acidosis most often associated with acute cessation of alcohol consumption after chronic alcohol abuse and is typically associated with nausea, vomiting, and vague GI complaints. 1 Alcohol metabolism combined with little or no glycogen reserves results in elevated ketoacid levels. Although alcoho Continue reading >>

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  1. Jules_Diet

    Hi There
    I have just started the Atkins diet again after falling off the bandwagon for a few months. First week on induction and I have lost about 5lbs so inspired to keep going!
    Anyway, I went to buy some ketostix from Boots in High St Kensington (London) the other day and I was asked by some jumped up sales person what they were for - I replied 'I don't think that's any business of yours'. She then proceeded to tell me that she could not sell me ketostix unless it was because I was on medication!!!! I said I needed them to test if my body was in ketosis (she probably did not know what I was talking about!) - she ran off and checked with the pharmacist and came back to tell me that they did not have any in stock - which I suspect was not the truth! I was livid!!!
    I have heard similar stories - Where do Boots staff get off telling us they can't sell us what is basically litmus paper on a stick because of a particular diet we may be following!!
    I managed to get the stix at a Boots near my work with no questions asked - So much for company policy huh!
    Needless to say, I wont be shopping at boots again except in emergency!
    Anyone else had similar problems!
    Jules

  2. lucyr

    No, because I decided not to get them online! People who work in chemists act like they are consultant doctors sometimes. A friend bought some Imodium before going abroad. the woman started asking him about what he wanted it for etc.
    The other set of shop workers who get on my nerves are the ones in children's shoe shops. They act like they are consultant foot paediatricians. (if such a thing exists!)
    But to return to your post, what possible reason Boots, or any of its minions can have for objecting to ketostix. It beggars belief.
    I tried to get an electric comb to kill headlice from Boots once, and was told they didn't sell them because they were not very effective. I said 'but you are selling those chemicals which you and I know do not work at all!' The guy had the grace to blush.

  3. LittleAnne

    What you have reported Jules seems to be the common line in many Boots, as I have read the same here. When I first started Atkins I went to my local Boots and got them without any problems. After my second lot I gave up buying them.
    You might be interested in the following link to info on Ketosis I found in the GO-Diet, which I read last week. I have not seen it put so clearly before. Here is the link - Ketosis
    I'm glad to hear you are back on the wagon, and so far things are looking good.

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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.....

Alcoholic Ketoacidosis

Alcoholic ketoacidosis is a common reason for admission of alcohol dependent persons in hospitals emergency rooms. The term refers to a metabolic acidosis syndrome caused by increased ketone levels in serum . Glucose concentration is usually normal or a little lower. In 1940, Drs Edward S. Dillon, W. Wallace, and Leon S. Smelo, first described alcoholic ketoacidosis as a distinct syndrome . They stated that "because of the many and complex factors, both physiologic and pathologic , which influence the acid-base balance of the body, a multitude of processes may bring about the state of acidosis as an end result." [1] In the 1971, David W. Jenkins and colleagues described cases of three nondiabetic patients with a history of chronic heavy alcohol misuse and recurrent episodes of ketoacidosis . This group also proposed a possible underlying mechanism for this metabolic disturbance, naming it alcoholic ketoacidosis. [2] Patients regularly report nausea , vomiting, and pain in abdomen which are the most commonly observed complaints. This syndrome is rapidly reversible and, if taken care of has a low mortality. Other patients present tachypnoea , tachycardia , and hypotension . [3] The Continue reading >>

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  1. fadisaleh

    People always say that running helps you lose weight, and my understanding is that it simply helps you burn more calories, adding to your deficit, and it's as simple as that. But I wanted to see what you all thought. Especially because I'm eating at the minimum calories before losing muscle (according to keto calculator).
    When I tell keto calculator that I'm running (sedentary to lightly active) my calories are already so low that it tells me to eat more so I don't lose muscle. So I end up with the same net calories on days I run vs days I don't.
    My question is: past calories burned, how does running help you lose weight?
    My current guesses: It doesn't, if you have the same net calories. It helps keep insulin levels more stable, helping burn fat more efficiently regardless of calorie deficit (in the same sense as eating fewer carbs).

  2. FXOjafar

    Cardio is catabolic so if you're worried about losing muscle, switch to weights and limit cardio to a nice walk outside or 30s Hiit to keep Cortisol down. Muscle will help burn more fat even when you're sitting on the couch so what's not to love? :)

  3. elliebellrox

    I've only recently gotten into running and keto. I'm only losing 1 kg a week and that's regardless of whether I run or not.
    It do believe it's influencing the outline of my legs and ass though, if not helping with weight loss. Just having a bit more definition looks very different.
    Also doing cardio tells your body to increase the ventilation to your lungs so your oxygen/co2 exchange improves. That's always a nice benefit. And the lower heart rate long term... (My sauce is my lecture content but I can probably go find it in relevant physiology book if you want)
    Basically, choose an exercise you think you can maintain and make part of your lifestyle. And reap the physiological benefits that will help you look and feel better because your internal mechanics will be much improved :)

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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 spontaneous decomposition of acetoacetic acid. It is often described as smelling like fruit or nail polish remover. Ketosis may also smell, but the odor is usually more subtle due to lower concentrations of acetone. Treatment consists most simply of correcting blood sugar and insulin levels, which will halt ketone production. If the severity of the case warrants more aggressive measures, intravenous sodium bicarbonate infusion can be given to raise blood pH back to an acceptable range. However, serious caution must be exercised with IV sodium bicarbonate to avoid the risk of equally life-threatening hypernatremia. Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively. In diabetic ketoacidosis, a high concentration of ketone bodies is usually accompanied by insulin deficiency, hyperglycemia, and dehydration. Particularly in type 1 diabetics the lack of insulin in the bloodstream prevents glucose absorption, thereby inhibiting the production of oxaloacetate (a crucial molecule for processing Acetyl-CoA, the product of beta-oxidation of fatty acids, in the Krebs cycle) through reduced levels of pyruvate (a byproduct of glycolysis), and can cause unchecked ketone body production (through fatty acid metabolism) potentially leading to dangerous glucose and ketone levels in the blood. Hyperglycemia results in glucose overloading the kidneys and spilling into the urine (transport maximum for glucose is exceeded). Dehydration results following the osmotic movement of water into urine (Osmotic diuresis), exacerbating the acidosis. In alcoholic ketoacidosis, alcohol causes dehydration and blocks the first step of gluconeogenesis by depleting oxaloacetate. The body is unable to synthesize enough glucose to meet its needs, thus creating an energy crisis resulting in fatty acid metabolism, and ketone body formation.

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. mkathy6

    After reading some threads about supplements, i thought with my water intake that I should add Potassuim to my supplements.
    Went to the pharmacy and all I could find was potassium gluconate. What is gluconate? Sounds like sugar to me. Before I take it I want to find out for sure that it is not.
    Anyone know? Thanks!! :)

  2. Natrushka

    Originally posted by mkathy6
    What is gluconate? Sounds like sugar to me. Before I take it I want to find out for sure that it is not. Through the magic of the "SEARCH" function on this site I found this by Doreen:
    Dextrose and lactose are often used as "carriers" for some supplements ... the intestine is able to absorb them more efficiently with a tiny bit of carb present. The amount is very small, usually less than ¼ of a gram. Some lowcarbers count 1g carb for all their supplements, just to be safe.
    Nat

  3. MAC Artist

    I use "NO salt" substitute when cooking. Its a sodium free "salt" that really is a potassium salt. It contains potassium. You might want to give it a try. It makes dishes tasty and you'll avoid getting too much sodium if u replace your salt shaker with it. I think with all the supplements we're advised to take like EFA oil, vit C, vit B complex, a multi, flax, folic acid, in my case I need to take iron, mag and calcium and VIt E that it might feel overwhelming when u have to gulp all those down . At least u can have one less pill to take if you use the salt substitute. Just a suggestion!
    Piera

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