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What Is The Significance Of Kussmaul Respirations In Ketoacidosis?

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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 And Hyperglycaemic Hyperosmolar State

The hallmark of diabetes is a raised plasma glucose resulting from an absolute or relative lack of insulin action. Untreated, this can lead to two distinct yet overlapping life-threatening emergencies. Near-complete lack of insulin will result in diabetic ketoacidosis, which is therefore more characteristic of type 1 diabetes, whereas partial insulin deficiency will suppress hepatic ketogenesis but not hepatic glucose output, resulting in hyperglycaemia and dehydration, and culminating in the hyperglycaemic hyperosmolar state. Hyperglycaemia is characteristic of diabetic ketoacidosis, particularly in the previously undiagnosed, but it is the acidosis and the associated electrolyte disorders that make this a life-threatening condition. Hyperglycaemia is the dominant feature of the hyperglycaemic hyperosmolar state, causing severe polyuria and fluid loss and leading to cellular dehydration. Progression from uncontrolled diabetes to a metabolic emergency may result from unrecognised diabetes, sometimes aggravated by glucose containing drinks, or metabolic stress due to infection or intercurrent illness and associated with increased levels of counter-regulatory hormones. Since diabetic Continue reading >>

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  1. Saraleesaralee

    Is it possible to stay on ketogenic diet for life-long?

    I have been on ketogenic diet for 2 weeks. It controls my blood sugar level really well. However I am not over weight. And I am worried about potential long term side effects of the diet. For example, high LDL level, steoporosis, auto immune disease, too much weight loss, vesicular stiffness. I was wondering if there is anyone in this forum has been on ketogenic diet for years? And do you experience any side effects from the diet?

  2. Aaron1963

    I've been on a strict ketogenic diet for 6 months, and was doing LCHF for much of the 5 months prior to that but didn't make any attempts at it being ketogenic so I may have been in and out of ketosis some during that period. I now have a blood ketone meter and remain in ketosis according to it.
    I did suffer excessive weight loss initially. I lost about 40kg (about 90 lbs.), and it ended up sending me from being very obese to being underweight. But I've always eaten very little protein, which I continued to do, plus I was doing intermittent fasting, sometimes not eating anything for days at a time. Once I stopped the intermittent fasting and concentrated on getting adequate protein, my weight went back up to my ideal weight and stabilized there. I've heard from several people that you really need to watch your protein when doing a ketogenic diet being it's easy for excess to hinder weight loss and/or increase your BG.
    I have had a few issues while doing a ketogenic diet, but not 100% sure which if any can be attributed to ketosis vs. some other factor. First off, as winter was approaching I got extremely cold all the time, especially my fingers and toes, but even my whole body was cold. I thought it might have been the caffeine I was getting as part of my ketogenic diet involves drinking lots of coffee with HWC, coconut oil, and butter. I switched to decaf and the problem pretty much went away, but I don't know if it was the caffeine, the ketosis, the massive weight loss (lack of body fat), something else, or a combination of factors.
    I've also had excessive itching and a rash. That's normal for me during the winter months, but this year it started a bit early, went longer, and was much worse than normal. I think it may very well have been my usual sensitivity to the cold dry weather, aggravated by toxins released during my rapid weight loss, and perhaps ketones being emitted through the skin. It's just recently started to clear up and the rash is gone and most of the itching.
    I got keto-breath for a week or two when I first concentrated on going keto. It was very noticeable, but disappeared after that and no issues anymore with my breath.
    This diet is very sustainable for me. I tried my whole adult life to diet to lose weight and was never successful. This time I wanted to lose weight, but my primary focus was controlling my BG, meaning reducing carbs down to a low-carb level, which caused me to gravitate naturally to a LCHF diet. For the first time I have no desire to go back to my old way of eating. I love this diet and it's completely satisfying. So I killed two birds with one stone - got my BG under control, down to non-diabetic levels, and got my weight down to ideal. Plus with the huge benefits (IMHO) of having my body use ketones rather than glucose, I'm totally sold on this way of eating for the rest of my life and have absolutely no worries about not being able to stick to my diet. I really have no strong urges for carbs anymore, and only end up going off the plan rarely due to social pressures or inadvertently eating hidden/unknown carbs.
    My LDL has gone up, but I've heard from others that usually it's benign large fluffy LDL that typically goes up when on a ketogenic diet. And my body is still adjusting. Also I've heard that LDL by itself is not a good measure of risk. So I'm not worried about it, but will keep an eye on things. I also have taken my ketogenic diet to an extreme, hitting a KR of 3.0 or higher almost everyday, and sometimes up to 4.0 or more. Not sure if eating much more fat than necessary for ketosis affected my LDL any or not. Initially my LDL dropped significantly as well as my trigs, but both increased at my last doctor's visit. I may try a more normal KR in the future while monitoring my blood ketones to verify I stay in ketosis and see if there's any difference in my BG, cholesterol, or other tests.
    I did also suffer from other typical symptoms during my keto adaptation phase. Most went away within about two weeks. But it's just been here at the 6-month mark where my BG numbers suddenly stabilized with very little change, and quite low, and overall I just feel absolutely fantastic. I feel like I'm bursting with energy and joined a gym and suddenly love running and working out whereas I hated them all my life.
    Well, I don't have years of experience with ketosis to report anything to you about that. Other than I've heard lots of other people with years of experience and not heard of anyone having any real side effects other than the things I've mentioned. However some people do find ketosis isn't for them and give up very soon. For those that feel it is working for them and stick with it, seems there's no significant side effects. But I'll let the others who've been in ketosis for longer than me speak for themselves.

  3. furball64801

    Hi and welcome to DD I know of a guy called no more carbs that was on it over 2 yrs. It is possible he is still on it, that chat site closed down but he was going strong on it.

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In this video we present a patient with DKA who is exhibiting the Kussmaul breathing pattern associated with metabolic acidosis.

Kussmaul Breathing

Also found in: Dictionary, Thesaurus, Legal, Encyclopedia, Wikipedia. Related to Kussmaul breathing: Biot's breathing Kussmaul breathing abnormally deep, very rapid sighing respirations characteristic of diabetic ketoacidosis. Kussmaul breathing Air hunger Clinical medicine Rapid, deep respiration 2º to stimulation of the respiratory center of the brain triggered by ↓ pH, normal during exercise, and common in Pts with severe metabolic acidosis–eg, DKA. See Metabolic acidosis, Diabetes. breathing (breth'ing) abdominodiaphragmatic breathing A controlled method of breathing in which the diaphragm is used for inspiration and the abdominal muscles for expiration. This technique improves exertional dyspnea, esp. in patients with chronic pulmonary disease. Synonym: diaphragmatic breathing apneustic breathing An abnormal breathing pattern marked by prolonged inspiration followed by an inspiratory pause. This is usually associated with brainstem injuries. assisted breathing Any technique that improves respiration. Such breathing includes the provision of supplemental oxygen, bag-valve-mask ventilation, noninvasive ventilation, mechanical ventilation, and mouth-to-mouth ventilation. ast Continue reading >>

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Popular Questions

  1. Desley

    Help! I'm frustrated, I'm into my 2nd week on Induction & I'm still not into Ketosis. I've been keeping my carbs below 20 carbs a day.
    If fact I've been averaging 18. Testing my Urine every 2sd day for the recommended 15 seconds. Anybody got any ideas?

  2. Desley

    Have been reading some old posts (2011) about bringing on Ketosis by upping your fat intake using Coconut Oil. Has anyone got any info on this. What does Atkins think about this?

  3. Helen

    The ketostix are not always accurate. You may be in ketosis when they say you aren't.
    Are you thirsty all the time? Has your hunger gone away? Those are generally the best two ways to recognise that you are in ketosis.
    Saying that, while most people can achieve ketosis in 3-6 days, for some it can take a few weeks, especially if they are insulin resistant.
    Not sure about the Coconut oil (although it is good for you). I have read that it can help in ketogenic diets, but not sure if it will help in the case of Atkins.
    Helen

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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.

Diabetic Ketoacidosis

Diabetes mellitus is the name given to a group of conditions whose common hallmark is a raised blood glucose concentration (hyperglycemia) due to an absolute or relative deficiency of the pancreatic hormone insulin. In the UK there are 1.4 million registered diabetic patients, approximately 3 % of the population. In addition, an estimated 1 million remain undiagnosed. It is a growing health problem: In 1998, the World Health Organization (WHO) predicted a doubling of the worldwide prevalence of diabetes from 150 million to 300 million by 2025. For a very tiny minority, diabetes is a secondary feature of primary endocrine disease such as acromegaly (growth hormone excess) or Cushing’s syndrome (excess corticosteroid), and for these patients successful treatment of the primary disease cures diabetes. Most diabetic patients, however, are classified as suffering either type 1 or type 2 diabetes. Type 1 diabetes Type 1 diabetes, which accounts for around 15 % of the total diabetic population, is an autoimmune disease of the pancreas in which the insulin-producing β-cells of the pancreas are selectively destroyed, resulting in an absolute insulin deficiency. The condition arises in ge Continue reading >>

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  1. boobear

    Hi everyone, I've done keto/low carb on/off last few years. Got really keto serious three weeks ago. On the whole last week my husband pretty much wanted to puke every time I spoke near him as he said my breath was soooo bad. I drink tons of water, chew gum etc. It was making me so self conscious that I went off the next day. It's been two days off and Breath is better but I really hate the way I feel eating carbs. Is there any tips for the keto breath, will it pass, and if so after how long??? It is literally the only thing that stops me from going back! Thanks in advance!

  2. Jessica

    They say that burning fat can cause bad breath due to chemicals released in the process. It's metabolic and not hygiene related. It doesn't usually last forever! Don't let it discourage you! Keep drinking lots of water

  3. boobear

    I'm trying really hard not too! I'm going to get back on tomorrow and keep ketoing but I hate being paranoid about my breath :(.

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