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Which Of The Following Signs And Symptoms Are Most Characteristic Of Hyperglycemic Ketoacidosis?

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Visit us (http://www.khanacademy.org/science/he...) for health and medicine content or (http://www.khanacademy.org/test-prep/...) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Matthew McPheeters. Watch the next lesson: https://www.khanacademy.org/test-prep... Missed the previous lesson? https://www.khanacademy.org/test-prep... NCLEX-RN on Khan Academy: A collection of questions from content covered on the NCLEX-RN. These questions are available under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States License (available at http://creativecommons.org/licenses/b...). About Khan Academy: Khan Academy offers practice exercises, instructional videos, and a personalized learning dashboard that empower learners to study at their own pace in and outside of the classroom. We tackle math, science, computer programming, history, art history, economics, and more. Our math missions guide learners from kindergarten to calculus using state-of-the-art, adaptive technology that identifies strengths and learning gaps. We've also partnered with institutions like NASA, The Museum of Modern Art, The California Academy of Sciences, and MIT to offer specialized content. For free. For everyone. Forever. #YouCanLearnAnything Subscribe to Khan Academys NCLEX-RN channel: https://www.youtube.com/channel/UCDx5... Subscribe to Khan Academy: https://www.youtube.com/subscription_...

Hyperosmolar Hyperglycemic State

Background Hyperosmolar hyperglycemic state (HHS) is one of two serious metabolic derangements that occurs in patients with diabetes mellitus (DM). [1] It is a life-threatening emergency that, although less common than its counterpart, diabetic ketoacidosis (DKA), has a much higher mortality rate, reaching up to 5-10%. (See Epidemiology.) HHS was previously termed hyperosmolar hyperglycemic nonketotic coma (HHNC); however, the terminology was changed because coma is found in fewer than 20% of patients with HHS. [2] HHS is most commonly seen in patients with type 2 DM who have some concomitant illness that leads to reduced fluid intake, as seen, for example, in elderly institutionalized persons with decreased thirst perception and reduced ability to drink water. [3] Infection is the most common preceding illness, but many other conditions, such as stroke or myocardial infarction, can cause this state. [3] Once HHS has developed, it may be difficult to identify or differentiate it from the antecedent illness. (See Etiology.) HHS is characterized by hyperglycemia, hyperosmolarity, and dehydration without significant ketoacidosis. Most patients present with severe dehydration and focal Continue reading >>

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  1. Dan360

    The good, the bad and the ugly of metformin

    I have been taking metformin sense the day I was first diagnosed with type 2 diabetes. As you probably know, it is the first-line drug of choice for the treatment of type 2 diabetes and I doubt that there are many of you that do not take metformin. Metformin works by suppressing glucose production by the liver. Evidence suggests metformin may prevent the cardiovascular and possibly the cancer complications of diabetes. It helps reduce LDL cholesterol and triglyceride levels and is not associated with weight gain; in some people, it promotes weight loss. Metformin is one of only two oral antidiabetics in the World Health Organization Model List of Essential Medicines.
    One of my first experiences with diabetes was finding that when I worked out my glucose level would actually increase. That was very frustrating sense I was working out to lower levels of glucose. When I told my doctor she put me on a heavier dose of metformin, 1000 mg twice a day. As with most drugs the treatment of one problem often causes another. There is a whole list of side effects associated with metformin: abdominal or stomach discomfort, cough or hoarseness, decreased appetite, diarrhea, fast or shallow breathing, fever or chills, general feeling of discomfort, lower back or side pain, muscle pain or cramping and painful or difficult urination. Other problems metformin may cause which will usually diminish over time is: Acid or sour stomach, belching, bloated, excess air or gas in the stomach or intestines, full feeling, heartburn, indigestion, loss of appetite, metallic taste in the mouth, passing of gas, stomachache, stomach upset or pain and vomiting. I hope this isn’t too much information!
    My latest experience with metformin was excess air or gas in the stomach. I experienced what seem to be a swelling in my throat followed by belching or burping. I cut my dose of metformin in half and the problem went away. Have any of you experienced discomforts with metformin?

  2. govna

    Let me tell you about my awful 3 year journey with metformin! I dealt with all the horrible side affects for a few years Mostly massive pain and intestinal bloating all that goes with it to the point of doctors taking out my gall bladder then on to a colonoscopy and endoscopy and then on to a stress test! All was "just fine" Finally doc said take me off the metformin since a small percentage of people cannot tolerate metformin. Well low and behold I was one of them! After about two weeks most all of the hellish discomfort disappeared! I now take 50 units of toujeo every morning feel great and found a new lease on life energy wise! I am back baby!!!! It is just a shame looking back on how long I suffered needlessly. Not to mention the metformin wasn't even bringing my sugar down anyhow. All it did was make me extremely sick!!!

  3. Scared ****less

    join the club Metformin was a nightmare too the stomach pain was terrible but lucky my dr took me them a week later

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Clinical And Biochemical Characteristics Of Diabetes Ketoacidosis In A Tertiary Hospital In Riyadh

Diabetes is the fifth leading cause of death worldwide. Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes. The aim of this study is to investigate the clinical and biochemical characteristics of DKA among 400 patients admitted to hospital, most of whom had type 1 diabetes (n = 372; 93%). Vomiting (n = 319; 79.8%), nausea (n = 282; 70.5%), and abdominal pain (n = 303; 75.8%) were the presenting symptoms most commonly experienced by the patients. Tachycardia was the most common clinical sign noted in the patients on admission (n = 243; 61.8%). The predominant precipitating cause of DKA was noncompliance to an insulin regimen (n = 215; 54.2%). Recurrent DKA admissions in type 1 diabetes patients was higher than those with type 2 diabetes (n = 232 versus n = 9, respectively; P = 0.002). Recurrent DKA admissions in female patients were higher than in male patients (n = 167 versus n = 74, respectively; P = 0.002). Continued diabetic education (given to n = 384; 94%) and counseling on the importance of adhering to the recommended medical regime, addressing the social and cultural barriers that precipitate DKA, as well as the provision of timely medical atten Continue reading >>

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Popular Questions

  1. blue4lemon

    > boyfriend and atkins breath

    my boyfriend complains constantly about my atkins breath. he fully supports me in eating low carb. he has been with me while i am eating carby, and he hates to be around me when i eat bad. i get moody, cranky, and irrational. he also knows diabetes runs in my family, and that i am hypoglycemic so i have to eat LC. since my personal plan keeps me in ketosis 24-7, i have dragon breath 24-7. i chew carefree polar ice gum, i drink 100 oz of water a day, i use listerine breath strips. i keep my mouth clean. i can be in his face, chewing away on a new piece of gum, and he will turn away from me and say "whooo your breath stinks". i can brush my teeth and use listerine, and he will still complain. the problem is that the smell is coming from my stomach, NOT my mouth. sometimes he won't kiss me during you-know-what. and please don't read into this that he is mean and doesn't care about me, because he is a sweetheart. i know it stinks. what else can i do???

  2. Nancy LC

    You don't have to be at induction level of carbs forever. You can bump it up a bit until you're out of induction yet still be comfortably low carb.

  3. blue4lemon

    the reason i stay in ketosis is because when i get out of it, i get cravings and my blood sugar is not stable. people ca be on ketogenic diets for a lifetime. it's actually recommended for epilepsy. i generally eat 30g a day, sometimes 40g, but no more than that.
    so, can anyone answer my question? what else can i do?

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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

Practice Essentials 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. Signs and symptoms The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia 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: See Clinical Presentation for more detail. Diagnosis On examination, general findings of DKA may include the following: Characteristic acetone (ketotic) breath od Continue reading >>

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  1. Gunna-make-it

    When I bought my Ketone Strips recently, I was provided with a leaflet explaining about Ketosis and the different colours. I thought I would share as I know there has been some confusion...
    Ketone Strips are used for Urinalysis of Ketones (Acetoacetic Acid). Ketostix provides a fast, convenient way of testing urine for the presence and concentration of Ketones.
    1) A colour change means you are excreting ketones, burning fat and are in Ketosis but it is wise to remember that it is possible to be in Ketosis and NOT lose or even to gain weight. While a positive test means you are burning fat as your promary fuel it does not necessarily mean you are losing weight. If you eat ecessively some fuel will be used by your bady, some will be excreted (making the stick positive) and some will be retained (and stored as fat).
    2) The degree of colour chage is NOT important with respect to identifying ketosis - you are either in ketosis or not, the sticks do not accurately measure degree in all people. Different people get different colours and this is completely unrelated to either their degree of weightloss or their adherance to the plan.
    3) No colour change does not necessarily mean you are not in ketosis. Some people never see a change. No change just means that the sticks are detecting none of the specific ketones for which it checks in the Urine.
    4) A dark colour many indicate that you are dehydrated however, a dark colour may just be normal for you. If you are drinking enough water and it is still dark, do not overload on water as it is probably your normal colour and too much water can be harmful.
    So in Summary:
    You are either in Ketosis or not - it does not matter what the colours say..
    Dark colours are not dangerous and could be your natural colour
    As long as the stick is showing any colour of pink, you are in Ketosis.
    Also, it is worth remembering that not eveyone has side effects when getting into ketosis..many people enter ketosis after day 1 and are unaware!

  2. annaphylactic

    Great post - puts a few old wives tales to rest I think... Thanks xx

  3. Huseyin

    good post and very well said.
    More info on this one too, there is a greater break down
    http://www.minimins.com/lighter-life-forum/67569-readings-ketosis.html

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