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What Is The Meaning Of Ketoacidosis?

Diabetic Ketoacidosis In Dogs

Diabetic Ketoacidosis In Dogs

My dog is diabetic. He has been doing pretty well overall, but recently he became really ill. He stopped eating well, started drinking lots of water, and got really weak. His veterinarian said that he had a condition called “ketoacidosis,” and he had to spend several days in the hospital. I’m not sure I understand this disorder. Diabetic ketoacidosis is a medical emergency that occurs when there is not enough insulin in the body to control blood sugar (glucose) levels. The body can’t use glucose properly without insulin, so blood glucose levels get very high, and the body creates ketone bodies as an emergency fuel source. When these are broken down, it creates byproducts that cause the body’s acid/base balance to shift, and the body becomes more acidic (acidosis), and it can’t maintain appropriate fluid balance. The electrolyte (mineral) balance becomes disrupted which can lead to abnormal heart rhythms and abnormal muscle function. If left untreated, diabetic ketoacidosis is fatal. How could this disorder have happened? If a diabetic dog undergoes a stress event of some kind, the body secretes stress hormones that interfere with appropriate insulin activity. Examples of stress events that can lead to diabetic ketoacidosis include infection, inflammation, and heart disease. What are the signs of diabetic ketoacidosis? The signs of diabetic ketoacidosis include: Excessive thirst/drinking Increased urination Lethargy Weakness Vomiting Increased respiratory rate Decreased appetite Weight loss (unplanned) with muscle wasting Dehydration Unkempt haircoat These same clinical signs can occur with other medical conditions, so it is important for your veterinarian to perform appropriate diagnostic tests to determine if diabetic ketoacidosis in truly the issue at hand Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus.[1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness.[1] A person's breath may develop a specific smell.[1] Onset of symptoms is usually rapid.[1] In some cases people may not realize they previously had diabetes.[1] DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances.[1] Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids.[1] DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies.[3] DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine.[1] The primary treatment of DKA is with intravenous fluids and insulin.[1] Depending on the severity, insulin may be given intravenously or by injection under the skin.[3] Usually potassium is also needed to prevent the development of low blood potassium.[1] Throughout treatment blood sugar and potassium levels should be regularly checked.[1] Antibiotics may be required in those with an underlying infection.[6] In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended.[1][6] Rates of DKA vary around the world.[5] In the United Kingdom, about 4% of people with type 1 diabetes develop DKA each year, while in Malaysia the condition affects about 25% a year.[1][5] DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost univ Continue reading >>

Ketones Blood Test

Ketones Blood Test

Acetone bodies; Ketones - serum; Nitroprusside test; Ketone bodies - serum; Ketones - blood; Ketoacidosis - ketones blood test A ketone blood test measures the amount of ketones in the blood. How the Test is Performed How to Prepare for the Test No preparation is needed. How the Test will Feel When the needle is inserted to draw blood, some people feel slight pain. Others feel a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away. Why the Test is Performed Ketones are substances produced in the liver when fat cells break down in the blood. This test is used to diagnose ketoacidosis. This is a life-threatening problem that affects people who: Have diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin. Fat is used for fuel instead. When fat breaks down, waste products called ketones build up in the body. Drink large amounts of alcohol. Normal Results A normal test result is negative. This means there are no ketones in the blood. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your health care provider about the meaning of your specific test results. What Abnormal Results Mean A test result is positive if ketones are found in the blood. This may indicate: Other reasons ketones are found in the blood include: A diet low in carbohydrates can increase ketones. After receiving anesthesia for surgery Glycogen storage disease (condition in which the body can't break down glycogen, a form of sugar that is stored in the liver and muscles) Being on a weight-loss diet Risks Veins and arteries vary in size from one person to another and from one side of the body to the other. Continue reading >>

Diabetic Ketoacidosis Causes, Symptoms, Treatment, And Complications

Diabetic Ketoacidosis Causes, Symptoms, Treatment, And Complications

Diabetic ketoacidosis definition and facts Diabetic ketoacidosis is a life-threatening complication of type 1 diabetes (though rare, it can occur in people with type 2 diabetes) that occurs when the body produces high levels of ketones due to lack of insulin. Diabetic ketoacidosis occurs when the body cannot produce enough insulin. The signs and symptoms of diabetic ketoacidosis include Risk factors for diabetic ketoacidosis are type 1 diabetes, and missing insulin doses frequently, or being exposed to a stressor requiring higher insulin doses (infection, etc). Diabetic ketoacidosis is diagnosed by an elevated blood sugar (glucose) level, elevated blood ketones and acidity of the blood (acidosis). The treatment for diabetic ketoacidosis is insulin, fluids and electrolyte therapy. Diabetic ketoacidosis can be prevented by taking insulin as prescribed and monitoring glucose and ketone levels. The prognosis for a person with diabetic ketoacidosis depends on the severity of the disease and the other underlying medical conditions. What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a severe and life-threatening complication of diabetes. Diabetic ketoacidosis occurs when the cells in our body do not receive the sugar (glucose) they need for energy. This happens while there is plenty of glucose in the bloodstream, but not enough insulin to help convert glucose for use in the cells. The body recognizes this and starts breaking down muscle and fat for energy. This breakdown produces ketones (also called fatty acids), which cause an imbalance in our electrolyte system leading to the ketoacidosis (a metabolic acidosis). The sugar that cannot be used because of the lack of insulin stays in the bloodstream (rather than going into the cell and provide energy). The kidneys f Continue reading >>

Understanding Diabetic Ketoacidosis Lab Values

Understanding Diabetic Ketoacidosis Lab Values

Diabetes can be a difficult condition to monitor. You need to consistently eat right and be aware of even slight changes concerning how you’re feeling physically… especially when there are really scary things that can happen, like diabetic ketoacidosis (DKA). When your cells don’t get the sugar they need to make into energy, your body then starts to burn fat for energy, which produces ketones. This happens when your body doesn’t have enough of the hormone insulin to turn the glucose (sugar) into energy. Excess ketones can be extremely dangerous when they build up in the blood because they can make the blood too acidic. Acidic blood is toxic to your cells and can impair them so they can’t function properly. This causes them to have a hard time fighting bacterias and viruses and they also won’t be able to process the oxygen and nutrients in your blood properly, depleting you of energy. If you’re not careful, this condition could be fatal. Warning Signs of DKA DKA usually occurs over several hours and there are variety of warning signs that you should be aware of to prevent this condition from becoming dangerous. Here are a few symptoms to watch for: Extreme dry mouth or thirst Dry or flushed skin Always feeling tired Difficulty breathing Your breath smells sweet or fruity Confusion or having a hard time paying attention How to Test for DKA If you have diabetes, you should consider buying at home ketone tests to ensure that your blood levels are in the appropriate range at all times. For example, Amazon.com has a variety of easy-to-use tests that are extremely inexpensive. If you are feeling any of the above symptoms, you can simply use a urine sample to know if you are within healthy ketone limits. The test pad will change colors and you can match your test Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

As fat is broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis. Diabetic ketoacidosis (DKA) is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to DKA in people with type 1 diabetes. People with type 2 diabetes can also develop DKA, but it is less common. It is usually triggered by uncontrolled blood sugar, missing doses of medicines, or a severe illness. Continue reading >>

What Is The Difference Between Ketosis And Ketoacidosis?

What Is The Difference Between Ketosis And Ketoacidosis?

Ketoacidosis is a dangerous condition, where toxic levels of ketone bodies build up in the blood because the body is not producing insulin. Ketosis, on the other hand, results when the body has exhausted its stored glycogen and begins to burn fatty tissue for energy. Ketosis The process of ketosis is the basis of the many low-carb diets marketed to the public. In ketosis, the body does not have sufficient glucose or glycogen available to give cells what they need to create energy. The body then turns to fat cells as an energy source. Ketone bodies in the bloodstream are a natural product of this process. These diets work, and ketosis is achieved, when carbohydrates are essentially eliminated from the diet. With minimal carbohydrate intake, there is little sugar to convert to glycogen. Without glycogen, the body breaks down and excretes fat cells, leaving ketones behind in the blood. In an ideal situation, this results in weight loss. Ketones in the body can be toxic in high enough concentrations. The body often has small amounts of ketones in the bloodstream, including during the overnight period. This is a mild, natural reaction, with low levels of ketones (blood ketones at 1-3 millimolar) and a normal pH of 5, that reverses in the morning when the nightly fast is broken. Low levels of ketones in the bloodstream do not represent a danger to health. Ketoacidosis Ketoacidosis occurs when blood sugar levels are high (meaning they are not being metabolized properly in the absence of insulin) and the body is experiencing dehydration. This means the normally small concentration of ketones in the bloodstream becomes much larger. Ketoacidosis is a pathological condition where the body cannot control the level of ketones building up in the blood. The ketones are being excreted Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is defined by the biochemical triad of ketonaemia, hyperglycaemia and acidaemia (1). DKA may result from: absolute deficiency of circulating insulin e.g. - previously undiagnosed type 1 diabetes mellitus patients who do not take insulin deliberately or inadvertently (especially the long acting component of a basal-bolus regimen) relative deficiency caused by increased levels of the counter regulatory hormones: catecholamines, glucagon, cortisol and growth hormone as a response to tress in conditions such as sepsis, trauma, or gastrointestinal illness with diarrhea and vomiting etc. despite taking the usual recommended dose of insulin (2) DKA is thought to be indicative, or even diagnostic, of type 1 diabetes, but increasingly there are cases of ketone-prone type 2 diabetes being recognised (3). patients with type 2 diabetes who have ketosis-prone diabetes represents 20 to 50 % of persons with DKA (these patients have impaired insulin secretion) It should be regarded a medical emergency; its rapid recognition and accurate treatment are essential to prevent morbidity and mortality. It should be noted that there are subtle differences in the management in children and in adults. Reference: (1) Savage MW et al. Joint British Diabetes Societies guideline for the management of diabetic ketoacidosis. Diabet Med. 2011;28(5):508-15 (2) Wolfsdorf JI et al. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2014;15 Suppl 20:154-79. (3) Joint British Diabetes Societies (JBDS) 2013. Inpatient Care Group. The management of diabetic ketoacidosis in adults. Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

What Is It? Diabetic ketoacidosis is a potentially fatal complication of diabetes that occurs when you have much less insulin than your body needs. This problem causes the blood to become acidic and the body to become dangerously dehydrated. Diabetic ketoacidosis can occur when diabetes is not treated adequately, or it can occur during times of serious sickness. To understand this illness, you need to understand the way your body powers itself with sugar and other fuels. Foods we eat are broken down by the body, and much of what we eat becomes glucose (a type of sugar), which enters the bloodstream. Insulin helps glucose to pass from the bloodstream into body cells, where it is used for energy. Insulin normally is made by the pancreas, but people with type 1 diabetes (insulin-dependent diabetes) don't produce enough insulin and must inject it daily. Your body needs a constant source of energy. When you have plenty of insulin, your body cells can get all the energy they need from glucose. If you don't have enough insulin in your blood, your liver is programmed to manufacture emergency fuels. These fuels, made from fat, are called ketones (or keto acids). In a pinch, ketones can give you energy. However, if your body stays dependent on ketones for energy for too long, you soon will become ill. Ketones are acidic chemicals that are toxic at high concentrations. In diabetic ketoacidosis, ketones build up in the blood, seriously altering the normal chemistry of the blood and interfering with the function of multiple organs. They make the blood acidic, which causes vomiting and abdominal pain. If the acid level of the blood becomes extreme, ketoacidosis can cause falling blood pressure, coma and death. Ketoacidosis is always accompanied by dehydration, which is caused by high Continue reading >>

Ketosis Vs. Ketoacidosis: What You Should Know

Ketosis Vs. Ketoacidosis: What You Should Know

Despite the similarity in name, ketosis and ketoacidosis are two different things. Ketoacidosis refers to diabetic ketoacidosis (DKA) and is a complication of type 1 diabetes mellitus. It’s a life-threatening condition resulting from dangerously high levels of ketones and blood sugar. This combination makes your blood too acidic, which can change the normal functioning of internal organs like your liver and kidneys. It’s critical that you get prompt treatment. DKA can occur very quickly. It may develop in less than 24 hours. It mostly occurs in people with type 1 diabetes whose bodies do not produce any insulin. Several things can lead to DKA, including illness, improper diet, or not taking an adequate dose of insulin. DKA can also occur in individuals with type 2 diabetes who have little or no insulin production. Ketosis is the presence of ketones. It’s not harmful. You can be in ketosis if you’re on a low-carbohydrate diet or fasting, or if you’ve consumed too much alcohol. If you have ketosis, you have a higher than usual level of ketones in your blood or urine, but not high enough to cause acidosis. Ketones are a chemical your body produces when it burns stored fat. Some people choose a low-carb diet to help with weight loss. While there is some controversy over their safety, low-carb diets are generally fine. Talk to your doctor before beginning any extreme diet plan. DKA is the leading cause of death in people under 24 years old who have diabetes. The overall death rate for ketoacidosis is 2 to 5 percent. People under the age of 30 make up 36 percent of DKA cases. Twenty-seven percent of people with DKA are between the ages of 30 and 50, 23 percent are between the ages of 51 and 70, and 14 percent are over the age of 70. Ketosis may cause bad breath. Ket Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Initial Evaluation Initial evaluation of patients with DKA includes diagnosis and treatment of precipitating factors (Table 14–18). The most common precipitating factor is infection, followed by noncompliance with insulin therapy.3 While insulin pump therapy has been implicated as a risk factor for DKA in the past, most recent studies show that with proper education and practice using the pump, the frequency of DKA is the same for patients on pump and injection therapy.19 Common causes by frequency Other causes Selected drugs that may contribute to diabetic ketoacidosis Infection, particularly pneumonia, urinary tract infection, and sepsis4 Inadequate insulin treatment or noncompliance4 New-onset diabetes4 Cardiovascular disease, particularly myocardial infarction5 Acanthosis nigricans6 Acromegaly7 Arterial thrombosis, including mesenteric and iliac5 Cerebrovascular accident5 Hemochromatosis8 Hyperthyroidism9 Pancreatitis10 Pregnancy11 Atypical antipsychotic agents12 Corticosteroids13 FK50614 Glucagon15 Interferon16 Sympathomimetic agents including albuterol (Ventolin), dopamine (Intropin), dobutamine (Dobutrex), terbutaline (Bricanyl),17 and ritodrine (Yutopar)18 DIFFERENTIAL DIAGNOSIS Three key features of diabetic acidosis are hyperglycemia, ketosis, and acidosis. The conditions that cause these metabolic abnormalities overlap. The primary differential diagnosis for hyperglycemia is hyperosmolar hyperglycemic state (Table 23,20), which is discussed in the Stoner article21 on page 1723 of this issue. Common problems that produce ketosis include alcoholism and starvation. Metabolic states in which acidosis is predominant include lactic acidosis and ingestion of drugs such as salicylates and methanol. Abdominal pain may be a symptom of ketoacidosis or part of the inci Continue reading >>

Ketoacidosis

Ketoacidosis

ketoacidosis [ke″to-as″ĭ-do´sis] the accumulation of ketone bodies in the blood, which results in metabolic acidosis; it is often associated with uncontrolled diabetes mellitus. See also ketosis. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. ke·to·ac·i·do·sis (kē'tō-as'i-dō'sis), Acidosis, as in diabetes or starvation, caused by the enhanced production of ketone bodies. ketoacidosis /ke·to·ac·i·do·sis/ (ke″to-as″ĭ-do´sis) acidosis accompanied by the accumulation of ketone bodies in the body tissues and fluids. ketoacidosis (kē′tō-ăs′ĭ-dō′sĭs) n. pl. ketoaci·doses (-dō′sēz) 1. Metabolic acidosis caused by an abnormally high concentration of ketone bodies in the blood and body tissues. 2. This condition occurring as a complication of untreated or improperly controlled diabetes mellitus, especially type 1 diabetes, characterized by thirst, fatigue, a fruity odor on the breath, and other symptoms, and having the potential to progress to coma or death. Also called diabetic ketoacidosis. ketoacidosis [kē′tōas′idō′sis] acidosis accompanied by an accumulation of ketones in the body, resulting from extensive breakdown of fats because of faulty carbohydrate metabolism. It occurs primarily as a complication of diabetes mellitus and is characterized by a fruity odor of acetone on the breath, mental confusion, dyspnea, nausea, vomiting, dehydration, weight loss, and, if untreated, coma. Emergency treatment includes the administration of insulin and IV fluids and the evaluation and correction of electrolyte imbalance. Nasogastric intubation and bladder catheterization may be required if the patient is comatose. Continue reading >>

Diabetic Ketoacidosis: A Serious Complication

Diabetic Ketoacidosis: A Serious Complication

A balanced body chemistry is crucial for a healthy human body. A sudden drop in pH can cause significant damage to organ systems and even death. This lesson takes a closer look at a condition in which the pH of the body is severely compromised called diabetic ketoacidosis. Definition Diabetic ketoacidosis, sometimes abbreviated as DKA, is a condition in which a high amount of acid in the body is caused by a high concentration of ketone bodies. That definition might sound complicated, but it's really not. Acidosis itself is the state of too many hydrogen ions, and therefore too much acid, in the blood. A pH in the blood leaving the heart of 7.35 or less indicates acidosis. Ketones are the biochemicals produced when fat is broken down and used for energy. While a healthy body makes a very low level of ketones and is able to use them for energy, when ketone levels become too high, they make the body's fluids very acidic. Let's talk about the three Ws of ketoacidosis: who, when, and why. Type one diabetics are the group at the greatest risk for ketoacidosis, although the condition can occur in other groups of people, such as alcoholics. Ketoacidosis usually occurs in type one diabetics either before diagnosis or when they are subjected to a metabolic stress, such as a severe infection. Although it is possible for type two diabetics to develop ketoacidosis, it doesn't happen as frequently. To understand why diabetic ketoacidosis occurs, let's quickly review what causes diabetes. Diabetics suffer from a lack of insulin, the protein hormone responsible for enabling glucose to get into cells. This inability to get glucose into cells means that the body is forced to turn elsewhere to get energy, and that source is fat. As anyone who exercises or eats a low-calorie diet knows, fa Continue reading >>

Severe Ketoacidosis (ph ≤ 6.9) In Type 2 Diabetes: More Frequent And Less Ominous Than Previously Thought

Severe Ketoacidosis (ph ≤ 6.9) In Type 2 Diabetes: More Frequent And Less Ominous Than Previously Thought

BioMed Research International Volume 2015 (2015), Article ID 134780, 5 pages 1Division of Endocrinology, Internal Medicine Department, University Hospital “Dr. José E. González”, Autonomous University of Nuevo León, 64460 Monterrey, NL, Mexico 2Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA 3Department of Internal Medicine, University Hospital “Dr. José E. González”, Autonomous University of Nuevo León, 64460 Monterrey, NL, Mexico 4Latino Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA Academic Editor: Gianluca Bardini Copyright © 2015 René Rodríguez-Gutiérrez 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. Diabetic ketoacidosis is a life-threatening acute metabolic complication of uncontrolled diabetes. Severe cases of DKA (pH ≤ 7.00, bicarbonate level ≤ 10.0, anion gap > 12, positive ketones, and altered mental status) are commonly encountered in patients with type 1 diabetes and are thought to carry an ominous prognosis. There is not enough information on the clinical course of severely acidotic type 2 diabetes (pH ≤ 6.9) patients with DKA, possibly because this condition is rarely seen in developed countries. In this series, we present 18 patients with type 2 diabetes, DKA, and a pH ≤ 6.9 that presented to a tertiary university hospital over the past 11 years. The objective was to describe their clinical characteristics, the triggering cause, and emphasis on treatment, evolution, and outcomes. The majority of Continue reading >>

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