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Why Do You Vomit In Dka?

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic ketoacidosis, also called DKA, is a life-threatening complication occurring with undiagnosed and/or untreated Type 1 diabetes in adults and children. DKA symptoms often remain undiagnosed because they can look like (mimic) influenza, a stomach bug, strep infections, and other common illnesses and conditions. However, someone may actually have a common illness and DKA at the same time, causing the common illness symptoms to hide (mask) the underlying DKA symptoms. Either way, untreated Type 1 diabetes and DKA are 100% fatal. ​IMPORTANT: Diabetic ketoacidosis is LIFE-THREATENING and can progress quickly–often within 24 hours! If you or a loved one have any of the following symptoms with VOMITING AND LETHARGY COMBINED WITH LABORED BREATHING, do not consume sugar and seek emergency medical care immediately. Insist medical personnel Test One Drop of blood or urine for glucose (sugar) levels. DKA can be fatal! ​ SYMPTOMS OF DKA: excessive thirst frequent urination or bedwetting increased appetite or sugar cravings abdominal pain irritability, grouchiness, or mood changes headaches and/or vision changes itchy skin/genitals (yeast or thrush) sudden weight loss flushed, hot, dry skin nausea and vomiting* fruity/acetone scented breath* lethargy, drowsiness, or fatigue* labored, rapid, and/or deep breathing* confusion, stupor, or unconsciousness* *A combination of any of these symptoms can be life-threatening. Seek EMERGENCY CARE. When new onset Type 1 diabetes remains undiagnosed and untreated the shortage of insulin causes blood glucose (sugar) levels to climb above the normal range. Without adequate insulin to regulate levels of glucose in the blood, high levels of acids called ketones build up in the body causing diabetic ketoacidosis. Ketones are toxic and if l 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 >>

Alcoholic Ketoacidosis

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, ketones, amylase, lipase, and plasma osmolality should be measured. Urine should be tested for ketones. Patients who appear significantly ill and those with positive ketones should have arterial blood gas and serum lactate measurement. The absence of hyperglycemia makes DKA improbable. Those with mild hyperglycemia may have underlying diabetes mellitus, which may be recognized by elevated levels of glycosylated Hb (HbA1c). Typical laboratory findings include a high anion gap metabolic acidosis, ketonemia, and low levels of potassium, magnesium, and phosphorus. Detection of acidosis may be com Continue reading >>

Ketoacidosis During A Low-carbohydrate Diet

Ketoacidosis During A Low-carbohydrate Diet

To the Editor: It is believed that low-carbohydrate diets work best in reducing weight when producing ketosis.1 We report on a 51-year-old white woman who does not have diabetes but had ketoacidosis while consuming a “no-carbohydrate” diet. There was no family history of diabetes, and she was not currently taking any medications. While adhering to a regimen of carbohydrate restriction, she reached a stable weight of 59.1 kg, a decrease from 72.7 kg. After several months of stable weight, she was admitted to the hospital four times with vomiting but without abdominal pain. On each occasion, she reported no alcohol use. Her body-mass index (the weight in kilograms divided by the square of the height in meters) was 26.7 before the weight loss and 21.7 afterward. Laboratory evaluation showed anion-gap acidosis, ketonuria, and elevated plasma glucose concentrations on three of the four occasions (Table 1). She had normal concentrations of plasma lactate and glycosylated hemoglobin. Screening for drugs, including ethyl alcohol and ethylene glycol, was negative. Abdominal ultrasonography showed hepatic steatosis. On each occasion, the patient recovered after administration of intravenous fluids and insulin, was prescribed insulin injections on discharge, and gradually reduced the use of insulin and then discontinued it while remaining euglycemic for six months or more between episodes. Testing for antibodies against glutamic acid decarboxylase and antinuclear antibodies was negative. Values on lipid studies were as follows: serum triglycerides, 102 mg per deciliter; high-density lipoprotein (HDL) cholesterol, 50 mg per deciliter; and calculated low-density lipoprotein (LDL) cholesterol, 189 mg per deciliter. The patient strictly adhered to a low-carbohydrate diet for four Continue reading >>

The Scary Experience Of Diabetic Ketoacidosis

The Scary Experience Of Diabetic Ketoacidosis

Today, we’re excited to share with you another guest blog from Katie Janowiak, who works for the Medtronic Foundation, our company’s philanthropic arm. When she first told me her story about food poisoning and Diabetic Ketoacidosis (DKA), I knew others could benefit from hearing it as well. Thanks Katie for your openness and allowing us to share your scary story so that the LOOP community can learn from it. Throughout this past year, I’ve had the honor of sharing with you, the amazing LOOP community, my personal journey and the often humorous sequence of events that is my life with T1. Humor is, after all, the best (and cheapest) therapy. Allow me to pause today to share with you the down and dirty of what it feels like to have something that is not the slightest bit humorous: diabetic ketoacidosis.You are hot. You are freezing. You are confused. You are blacked out but coherent. You go to talk but words fail you. Time flies and goes in slow motion simultaneously. You will likely smell and look like death. In my instance, this was brought on by the combination of excessive vomiting and dehydration caused by food poisoning and the diabetic ketoacidosis that followed after my body had gone through so much. In hindsight, I was lucky, my husband knew that I had food poisoning because I began vomiting after our meal. But I had never prepped him on diabetic ketoacidosis and the symptoms (because DKA was for those other diabetics.) Upon finding me in our living room with a bowl of blood and bile by my side (no, I am not exaggerating), he got me into the car and took me to emergency care. It was 5:30 p.m. – and I thought it was 11:00 a.m. The series of events that led up to my stay in the ICU began innocently enough. It was a warm summer night and my husband and I walke Continue reading >>

Juvenile Diabetes Foundation

Juvenile Diabetes Foundation

The most serious and perhaps the only life threatening complication of childhood diabetes encountered in the pediatric age group is diabetic ketoacidosis (DKA in short). In DKA, along with a marked rise in blood glucose, there is also a buildup of acetone in the blood stream. This leads to abdominal pain, vomiting, dehydration, breathlessness, a peculiar fruity odor in the breath, drowsiness, and finally coma. There are two situations in which DKA can develop: When insulin is discontinued for some reason. (We hope you will never commit that blunder!). On days when you are sick if you fail to take supplemental doses of insulin as required. To prevent DKA, therefore, never omit your insulin shots and make sure you are well-versed in what we call "Sick day management." When you are sick your appetite goes down and so you would expect your insulin requirement also to decrease. However, it is usually the reverse that happens. Yes, additional insulin is almost always required. If you do not know how to adjust your insulin dose as well as your diet in “sick days,” you are at risk for developing DKA. So please study carefully the guidelines given below: Sick day guidelines We will discuss these under four headings: Monitoring Insulin When should you go to the hospital? Monitoring On sick days, check your blood glucose and your urine acetone every 2-4 hours all through the day and night. In case you are not in a position to check blood glucose, you may resort to urine glucose testing, but remember, this is a far inferior alternative. Each result will have to be interpreted and acted upon immediately as explained below. Insulin Take your morning and evening doses as on any routine day except if your blood glucose is low (less than 100 mg/dl), in which case you may reduce your Continue reading >>

Diabetic Ketoacidosis

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 odor In addition, evaluate patients for signs of possible intercurrent illnesses such as MI, UTI, pneumonia, and perinephric abscess. Search for signs of infection is mandatory in all cases. Testing Initial and repeat laboratory studies for patients with DKA include the following: Serum electrolyte levels (eg, potassium, sodium, chloride, magnesium, calcium, phosphorus) Note that high serum glucose levels may lead to dilutional hyponatremia; high triglyceride levels may lead to factitious low glucose levels; and high levels of ketone bodies may lead to factitious elevation of creatinine levels. Continue reading >>

Physiology Of Vomiting

Physiology Of Vomiting

"At least after death you're not nauseous." Woody Allen in Sleeper Vomiting is the forceful expulsion of contents of the stomach and often, the proximal small intestine. It is a manifestation of a large number of conditions, many of which are not primary disorders of the gastrointestinal tract. Regardless of cause, vomiting can have serious consequences, including acid-base derangments, volume and electrolyte depletion, malnutrition and aspiration pneumonia. The Act of Vomiting Vomiting is usually experienced as the finale in a series of three events, which everyone reading this has experienced: Nausea is an unpleasant and difficult to describe psychic experience in humans and probably animals. Physiologically, nausea is typically associated with decreased gastric motility and increased tone in the small intestine. Additionally, there is often reverse peristalsis in the proximal small intestine. Retching ("dry heaves") refers to spasmodic respiratory movements conducted with a closed glottis. While this is occurring, the antrum of the stomach contracts and the fundus and cardia relax. Studies with cats have shown that during retching there is repeated herniation of the abdominal esophagus and cardia into the thoracic cavity due to the negative pressure engendered by inspiratory efforts with a closed glottis. Emesis or vomition is when gastric and often small intestinal contents are propelled up to and out of the mouth. It results from a highly coordinated series of events that could be described as the following series of steps (don't practice these in public): A deep breath is taken, the glottis is closed and the larynx is raised to open the upper esophageal sphincter. Also, the soft palate is elevated to close off the posterior nares. The diaphragm is contracted sharp Continue reading >>

The Signs, Diagnosis & Types Of Diabetes Mellitus In Cats

The Signs, Diagnosis & Types Of Diabetes Mellitus In Cats

There are certain signs or symptoms which are commonly seen in cats with diabetes mellitus. Unfortunately, these signs also occur in other diseases and conditions. Therefore, laboratory tests are necessary to diagnose diabetes mellitus in cats. The following article includes a discussion of how this diagnosis is made and the types of diabetes found in cats. What are the signs of diabetes mellitus in cats and why do they occur? Depending on how severely insulin production is impaired, there may be few signs of disease, or the signs may be severe. Dogs with diabetes often develop cataracts; cats do not. The most common signs of diabetes are: Increased thirst (polydipsia) and urination (polyuria) Change in appetite Weight loss Change in gait (walking) Decreased activity, weakness, depression Vomiting Increased Thirst and Urination: Because the glucose cannot enter the cells, the glucose levels in the blood become abnormally high (hyperglycemia). The glucose is filtered out by the kidneys and is found in the urine (glucosuria). When it is filtered out, it carries water with it. The animal, then, is losing more water through the urine than normal and has to make up for it by drinking more. Inappropriate Elimination: The increased urination may result in the cat not always urinating in the litter box. This inappropriate urination may be one of the first signs of diabetes in cats. In addition, cats with diabetes can often develop urinary tract infections, which may also result in inappropriate elimination. Change in Appetite: Some diabetic cats eat less, because frankly, they do not feel well. Other cats may have voracious appetites and eat a lot (polyphagia) because their hypothalamus keeps telling them they are hungry. Weight Loss: Because the cat cannot use the calories he Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

A Preventable Crisis People who have had diabetic ketoacidosis, or DKA, will tell you it’s worse than any flu they’ve ever had, describing an overwhelming feeling of lethargy, unquenchable thirst, and unrelenting vomiting. “It’s sort of like having molasses for blood,” says George. “Everything moves so slow, the mouth can feel so dry, and there is a cloud over your head. Just before diagnosis, when I was in high school, I would get out of a class and go to the bathroom to pee for about 10–12 minutes. Then I would head to the water fountain and begin drinking water for minutes at a time, usually until well after the next class had begun.” George, generally an upbeat person, said that while he has experienced varying degrees of DKA in his 40 years or so of having diabetes, “…at its worst, there is one reprieve from its ill feeling: Unfortunately, that is a coma.” But DKA can be more than a feeling of extreme discomfort, and it can result in more than a coma. “It has the potential to kill,” says Richard Hellman, MD, past president of the American Association of Clinical Endocrinologists. “DKA is a medical emergency. It’s the biggest medical emergency related to diabetes. It’s also the most likely time for a child with diabetes to die.” DKA occurs when there is not enough insulin in the body, resulting in high blood glucose; the person is dehydrated; and too many ketones are present in the bloodstream, making it acidic. The initial insulin deficit is most often caused by the onset of diabetes, by an illness or infection, or by not taking insulin when it is needed. Ketones are your brain’s “second-best fuel,” Hellman says, with glucose being number one. If you don’t have enough glucose in your cells to supply energy to your brain, yo Continue reading >>

's Experience With Ketoacidosis.

's Experience With Ketoacidosis.

Signs Treatment Zama's experience Diabetic ketoacidosis is caused by a lack of insulin or an insufficient amount of insulin. Since the lack of insulin means that glucose in not able to be used, the body searches for a new source of energy. In this condition, the diabetic breaks down body fat (lipolysis) to use as energy. During lipolysis, waste products called ketones are produced. Ketones are eliminated in the urine and through the lungs. Under normal conditions, the body can tolerate and eliminate ketones. But in diabetic ketoacidosis, fats are being broken down at such a high rate that the body can not eliminate the ketones fast enough and they build up in the blood. In high amounts, ketones are toxic to the body. They cause the acid-base balance to change and serious electrolyte and fluid imbalances result. Some of the signs of ketoacidosis include polyuria polydipsia lethargy anorexia weakness vomiting dehydration There will probably be ketones in the urine (ketonuria) The breath may have a sweet chemical smell similar to nail polish remover. However, some owners have said that even during documented ketoacidosis, their pet's breath did NOT have any unusual odor. Treatment Mildly ketoacidotic animals can be alert and well hydrated. After your pet is stabilized, your pet can return home and be treated with proper diabetes management techniques including insulin therapy, diet, and exercise. "Sick" ketoacidotic animals require intensive medical management in the vet hospital. This is a life-threatening emergency that requires complex medical management and monitoring. It may take several days for the animal to be out of danger. Treatment involves injections of regular insulin, intravenous fluids, electrolytes, and frequent monitoring of blood glucose, blood chemistry, Continue reading >>

What Are Symptoms Of Diabetic Ketoacidosis (dka)?

What Are Symptoms Of Diabetic Ketoacidosis (dka)?

Diabetic ketoacidosis (DKA) often gives plenty of warning before it happens, but it can also occur with little warning. If you regularly check your blood glucose several times during the day, you won’t miss the most important warning signs: high blood glucose and ketones in your urine. Test your urine for ketones whenever your blood glucose is over 300 mg/dl or you feel ill. Signs of DKA include the following: High blood glucose above 240 mg/dl and not falling Classic signs of hyperglycemia: intense thirst, dry mouth, need to urinate frequently Lack of appetite or pains in your stomach Vomiting or nausea Blurry vision Fever or warm, dry, or flushed skin Difficulty breathing Feeling of weakness Sleepiness A fruity odor on your breath If you have high blood glucose, ketones, and dehydration, you can have a serious condition called diabetic ketoacidosis (DKA). With severe DKA you might have to go to the hospital or clinic for intravenous fluids and insulin. DKA can become a medical emergency. Besides high blood glucose and ketones, DKA can come with these symptoms: chills, fever deep, labored breathing -- called "Kussmaul respirations" Sweet, fruity-smelling breath Dehydration (dry mouth, dry eyes, little or no urination, dark circles under the eyes) Tenderness or pain in your stomach area Confusion, slowness, or drowsiness Call your doctor or diabetes educator if you have vomiting or the symptoms above along with blood glucose over 300 mg/dL and ketones. Your doctor can decide whether you should treat it at home -- or whether you need to go to a hospital. Continue reading >>

> Hyperglycemia And Diabetic Ketoacidosis

> Hyperglycemia And Diabetic Ketoacidosis

When blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy. Hyperglycemia is the hallmark of diabetes — it happens when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia. If it's not treated, hyperglycemia can cause serious health problems. Too much sugar in the bloodstream for long periods of time can damage the vessels that supply blood to vital organs. And, too much sugar in the bloodstream can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, they can happen in adulthood in some people, particularly if they haven't managed or controlled their diabetes properly. Blood sugar levels are considered high when they're above someone's target range. The diabetes health care team will let you know what your child's target blood sugar levels are, which will vary based on factors like your child's age. A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible. It's a three-way balancing act of: diabetes medicines (such as in Continue reading >>

Ketoacidosis - Complication From Atkins Diet

Ketoacidosis - Complication From Atkins Diet

...I just got out of the hospital yesterday evening. I started the Atkins Diet on Sunday and was doing induction - on Monday night/Tuesday morning I woke up *terribly* sick and continued vomiting at intervals of every 2 hours. When the frequency increased to every hour (and I was just throwing up water and bile) I went to my doctor, who advised me to go to the ER for some IV fluids and some intravenous Zofran to stop the vomiting. Once at the ER, the doctors ran some blood tests and found that I was in a severe state of ketoacidosis - the acid level of my blood had become dangerously high. This is similar to what happens to diabetics when they don't take their insulin. If I hadn't gone to the doctor when I did, I might've gone into a diabetic coma (even though I am *not* diabetic). The doctors believe this was purely a complication of the Atkins Diet and have advised me *never* to try it again, as it could be fatal for me. I'm an otherwise healthy, normal person, 34 years old. I've never had any major health problems before. I'm not overweight - I just wanted a more streamlined look, and I've known a lot of people who've supposedly done Atkins. Anyway, this diet scares the shit out of me. I just wanted to put my experience out there, so people are aware that serious complications can arise. Barely 36 hours on this shit almost killed me. You obviously were doing the Atkins diet of the 1970s which encourages a person to go into ketosis/ketoacidosis. If you read the new literature on Atkins induction allows a much higher portion of carbs which would make ketosis impossible. You took it too far. You can't eat bacon and cheese and eggs on induction and nothing else. Your breath probably also smelled like a shit sandwich. Glad you're alive. Now eat a tomato slice and 2 cups o Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Introduction Diabetic ketoacidosis (DKA) is a dangerous complication of diabetes caused by a lack of insulin in the body. Diabetic ketoacidosis occurs when the body is unable to use blood sugar (glucose) because there isn't enough insulin. Instead, it breaks down fat as an alternative source of fuel. This causes a build-up of a by-product called ketones. Most cases of diabetic ketoacidosis occur in people with type 1 diabetes, although it can also be a complication of type 2 diabetes. Symptoms of diabetic ketoacidosis include: passing large amounts of urine feeling very thirsty vomiting abdominal pain Seek immediate medical assistance if you have any of these symptoms and your blood sugar levels are high. Read more about the symptoms of diabetic ketoacidosis. Who is affected by diabetic ketoacidosis? Diabetic ketoacidosis is a relatively common complication in people with diabetes, particularly children and younger adults who have type 1 diabetes. Younger children under four years of age are thought to be most at risk. In about 1 in 4 cases, diabetic ketoacidosis develops in people who were previously unaware they had type 1 diabetes. Diabetic ketoacidosis accounts for around half of all diabetes-related hospital admissions in people with type 1 diabetes. Diabetic ketoacidosis triggers These include: infections and other illnesses not keeping up with recommended insulin injections Read more about potential causes of diabetic ketoacidosis. Diagnosing diabetic ketoacidosis This is a relatively straightforward process. Blood tests can be used to check your glucose levels and any chemical imbalances, such as low levels of potassium. Urine tests can be used to estimate the number of ketones in your body. Blood and urine tests can also be used to check for an underlying infec Continue reading >>

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