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 >>
Sometimes While Working Out And Trying Hard To Hit Last Reps, I Feel A Taste Of Alcohol In My Mouth. Why Does This Happen?
My theory is that your body is burning fat while you are working out (that is part of the goal, no?) and you are tasting ketones/acetone. When our bodies metabolize fat, ketones (ketone bodies) develop and circulate in our bloodstream. This is a mild, usually harmless, condition called ketosis. Ketones spontaneously break down into acetone. Yes, the same acetone that is paint thinner, finger nail polish remover or adhesive remover/glue dissolver. The ketones and acetone have a very distintive taste and smell. To many people, the taste and smell are very similar to alcohol. So similar that people in ketoacidosis* have been arrested for public drunkeness, because their breath smelled like wine breath (also, ketoacidosis makes a person act drunk). [To me, ketones/acetone tastes like Elmer’s Glue when I was a kid.] *Ketoacidosis or Diabetic Ketoacidosis is a life-threatening condition in people whose bodies don’t make enough insulin to metabolize the glucose in their blood. Ketones and excess glucose make the blood too acidic and this hyperacidic blood can cause coma, liver and kidney damage and (if not treated) death. Continue reading >>
What Is Diabetic Ketoacidosis?
Having diabetes means that there is too much sugar (glucose) in your blood. When you eat food, your body breaks down much of the food into glucose. Your blood carries the glucose to the cells of your body. An organ in your upper belly, called the pancreas, makes and releases a hormone called insulin when it detects glucose. Your body uses insulin to help move the glucose from the bloodstream into the cells for energy. When your body does not make insulin (type 1 diabetes), or has trouble using insulin (type 2 diabetes), glucose cannot get into your cells. The glucose level in your blood goes up. Too much glucose in your blood (also called hyperglycemia or high blood sugar) can cause many problems. People with type 1 diabetes are at risk for a problem called diabetic ketoacidosis (DKA). It is very rare in people with type 2 diabetes. DKA happens when your body does not have enough insulin to move glucose into your cells, and your body begins to burn fat for energy. The burning of fats causes a build-up of dangerous levels of ketones in the blood. At the same time, sugar also builds up in the blood. DKA is an emergency that must be treated right away. If it is not treated right away, it can cause coma or death. What can I expect in the hospital? You will need to stay in the hospital in order to bring your blood sugar level under control and treat the cause of the DKA. Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include: Monitoring You will be checked often by the hospital staff. You may have fingersticks to check your blood sugar regularly. This may be done as often as every hour. You will learn how to check your blood sugar level in order to manage your diabetes when you go home. A heart (cardiac) monitor may Continue reading >>
Diabetic Coma Different From Insulin Shock, Role Of Hyperglycemia And Hypoglycemia Crucial
The role of hyperglycemia and hypoglycemia are crucial in diabetic coma. A diabetic coma is a complication of diabetes that leads to unconsciousness. A diabetic coma can result from both hyperglycemia – high blood sugar – or hypoglycemia – low blood sugar. A person in a diabetic coma is still alive, but they do not respond to light, sound, touch or any stimulation. If left untreated a diabetic coma can be fatal. A diabetic coma can be confused with an insulin shock, but although the two may appear similar, they do contain their own unique differences. Diabetic coma vs. insulin shock Insulin shock is the body’s reaction to a drop in blood sugar – or hypoglycemia – as a result of too much insulin. Even though the condition is called insulin shock, there is no shock involved and insulin isn’t the main culprit. Even people without diabetes can experience insulin shock if their blood sugar drops low enough. The condition is called a shock because it makes the body react similarly to when blood pressure drops – a fight or flight response. Symptoms of insulin shock are fast breathing, rapid pulse, dizziness, headache, numbness and hunger. Diabetic coma, on the other hand, causes unconsciousness that can occur over the course of days or even weeks and also cause dehydration. Although both conditions must be treated immediately, diabetic coma can be fatal. Causes of diabetic coma There are various causes of diabetic coma, including diabetic ketoacidosis, diabetic hyperosmolar syndrome, and hypoglycemia. Diabetic ketoacidosis: This is a condition where muscles become starved for energy, so the body begins breaking down fat from storage. This forms a toxin known as ketones and, if untreated, can contribute to diabetic coma. Diabetic hyperosmolar syndrome: Diabetic Continue reading >>
Diabetic Coma Causes
Diabetics with prolonged blood-sugar extremes (either too high or too low blood-sugar level) may lead to a diabetic coma. Causes of Diabetes coma Many condition diabetes conditions lead to the cause of diabetes coma. They are: Diabetic ketoacidosis (DKA) - If the muscle cells become energy starved, and the body may respond by breaking down stored fats. Breaking down of fats produces a toxic acid known as ketones and this breakdown is called as ketoacidosis. If it left untreated, DKA can lead to a diabetic coma. DKA is most common among diabetes type 1, but can also affect the type 2 diabetes or gestational diabetes. Diabetic hyperosmolar syndrome - If the blood-sugar level rises to 600 milligrams per deciliter (mg/dL), or 33 millimoles per liter (mmol/L) it is called as diabetic hyperosmolar syndrome. Such a high level of glucose in blood makes the blood thicker like syrup. This excess sugar level is removed from the blood through the urine, which remove tremendous amounts of fluid from the body causing dehydration. If it left untreated diabetic hyperosomolar syndrome can lead to dangerous dehydration and coma. Hyperosmolar syndrome is more common among type 2 diabetes. Hypoglycemia - Brain needs glucose to function properly. An extreme low blood-sugar level may lead to pass out. Hypoglycemia can be caused by large quantityof insulin or too little of food or vigorous exercise or drinking lot of alcohol. Anyone who has diabetes is at risk of a diabetic coma. Type 1 is more at risk of a diabetic coma caused by: Low blood-sugar (hypoglycemia), and DKA Type 2 is more at risk of a diabetic coma caused by: hyperosmolar syndrome. Diabetic coma risk factors. Some factors can increase the risk of diabetic coma they include: Insulin delivery system problems - If on an insulin pum Continue reading >>
What Is A Diabetic Coma?
Diabetic coma is a rare but serious occurrence. It is important to be aware of the risks of coma in diabetic patients and the possible causes. Diabetes mellitus is typically characterized by high blood sugar and an inability to reduce this sugar level. This may be due to a true (as in type 1) or relative (as in type 2) deficiency of insulin, the hormone responsible for lowering blood sugar. The three most common causes of coma in diabetic patients are: Very low blood sugar or severe hypoglycaemia If the blood sugar level in the brain drops to a critical level (below 3.5 mmol/l), a person is at risk of losing consciousness and falling into a diabetic coma. Normally, as blood sugar begins to fall, the body compensates for this by releasing glucagon, a hormone that opposes the actions of insulin by raising blood glucose. A coma is more likely to occur if an individual has taken an overdose of insulin or other anti-diabetic medications, consumed a lot of alcohol or taken part in an unusual amount of exercise (especially if they are also on insulin). Diabetic ketoacidosis This is mostly seen in people with type 1 diabetes or those who are taking insulin. If there is shortage of insulin, the body fails to use the glucose in the blood for energy and instead fats are broken down to provide it, which forms acidic compounds called ketones. A build up ketones in the body causes a condition called ketoacidosis. Ketoacidosis may occur as a result of a missed dose of insulin or as a result of acute infection, injury or surgery causing a rise in hormones that counteract the effects of insulin. Hyperosmolar hyperglycemic state (HHS) This condition is characterized by severe dehydration and very high blood glucose. A missed dose of insulin, acute infection or injury, and heavy food or s Continue reading >>
Diabetic Ketoacidosis (dka)
Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. DKA occurs mostly in type 1 diabetes mellitus (DM). It causes nausea, vomiting, and abdominal pain and can progress to cerebral edema, coma, and death. DKA is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia. Treatment involves volume expansion, insulin replacement, and prevention of hypokalemia. Diabetic ketoacidosis (DKA) is most common among patients with type 1 diabetes mellitus and develops when insulin levels are insufficient to meet the body’s basic metabolic requirements. DKA is the first manifestation of type 1 DM in a minority of patients. Insulin deficiency can be absolute (eg, during lapses in the administration of exogenous insulin) or relative (eg, when usual insulin doses do not meet metabolic needs during physiologic stress). Common physiologic stresses that can trigger DKA include Some drugs implicated in causing DKA include DKA is less common in type 2 diabetes mellitus, but it may occur in situations of unusual physiologic stress. Ketosis-prone type 2 diabetes is a variant of type 2 diabetes, which is sometimes seen in obese individuals, often of African (including African-American or Afro-Caribbean) origin. People with ketosis-prone diabetes (also referred to as Flatbush diabetes) can have significant impairment of beta cell function with hyperglycemia, and are therefore more likely to develop DKA in the setting of significant hyperglycemia. SGLT-2 inhibitors have been implicated in causing DKA in both type 1 and type 2 DM. Continue reading >>
Diabetic Emergencies (ketoacidosis And Coma)
The blood glucose (sugar) level is maintained with a narrow range that is sufficient for the cells to have an adequate supply of nutrition for energy production. High glucose levels can damage or even destroy cells over time while low levels will prevent cells from functioning optimally and lead to key systems in the body shutting down. Glucose like all other nutrients are derived from the food we eat. The food is digested and absorbed within the alimentary tract that runs from the mouth to the anus. The stomach and intestines (gastrointestinal tract) are the main sites for digestion and absorption. The nutrients then enter the bloodstream and travel to the liver where it is processed further. Other organs like the pancreas play a role in managing the nutrient levels within the body and its availability to the body’s cells. The pancreas specifically impacts on the blood glucose levels by secreting the hormone insulin which lowers blood glucose levels by promoting the cells to take up more glucose from the bloodstream and stimulating the liver to convert the glucose into other storage forms like glycogen and even fat. What is a diabetic emergency? Diabetes mellitus is a clinical condition which is characterized by high blood sugar levels (hyperglycemia) due to absolute (type 1 diabetes) or relative (type 2 diabetes) deficiency of insulin. This means that the body lacks insulin, secretes too little insulin or the body cells becomes resistant to the effects of insulin. The elevated blood glucose levels gradually diminishes different cells and organs. Diabetic emergencies can occur due to very high or very low blood sugar levels (hypoglycemia). They may arise in a person undergoing diabetes treatment but can also occur in new diabetic cases. Types of Diabetic Emergencies Continue reading >>
Your Intensive Care Hotline - Diabetic Coma
What is Diabetic Coma? Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency. Three different types of diabetic coma are identified: Severe diabetic hypoglycemia Diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion Hyperosmolar nonketotic coma in which extreme hyperglycemia and dehydration alone are sufficient to cause unconsciousness. In most medical contexts, the term diabetic coma refers to the diagnostical dilemma posed when a physician is confronted with an unconscious Patient about whom nothing is known except that he has diabetes. An example might be a physician working in an emergency department who receives an unconscious Patient wearing a medical identification tag saying DIABETIC. Paramedics may be called to rescue an unconscious person by friends who identify him as diabetic. Brief descriptions of the three major conditions are followed by a discussion of the diagnostic process used to distinguish among them, as well as a few other conditions which must be considered. An estimated 2 to 15 percent of diabetics will suffer from at least one episode of diabetic coma in their lifetimes as a result of severe hypoglycemia. What is diabetes? Diabetic Ketoacidosis (DKA) Hyperosmolar Hypoglycemic Non-Ketotic Coma (HHNKC) Hypoglycemic Coma What happens In Intensive Care? How long will your loved one remain in Intensive Care? Internet Links What is Diabetes? Diabetes mellitus, or simply diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.This high blood sugar produces Continue reading >>
Tweet Coma is relatively rare in diagnosed diabetes but it is very important to be aware of the situations that increase risk of coma. Causes of diabetic coma The main causes of coma occurring in people with diabetes are as a result of very low or very high blood glucose levels. The three most common causes of coma in people with diabetes are: Severe hypoglycemia and coma Severe hypoglycemia (very low blood glucose levels) can lead to loss of consciousness and coma if not treated. In most cases the body will restore blood sugar levels to normal by releasing glucagon to raise blood sugar levels. Coma is more likely to occur from low blood glucose levels if: A large insulin overdose is taken Alcohol is in the body during hypoglycemia Exercise has depleted the body’s glycogen supply Diabetic ketoacidosis and coma Diabetic ketoacidosis is a dangerous state of having very high blood glucose levels (typically above 17 mmol/L) in combination with high ketone levels. Ketoacidosis is able to occur if the body runs out of insulin and is therefore a factor for people with type 1 diabetes to be aware of. Insulin can prevent ketone levels rising and this is the key reason why people with diabetes are advised never to miss their long term (basal) insulin injections. The symptoms of ketoacidosis include nausea, vomiting, dehydration, disorientation and deep, laboured breathing. If someone with diabetes is displaying these symptoms call for emergency medical help as loss of consciousness and coma could follow. Illness in type 1 diabetes can lead to high blood glucose and ketone levels. It is advisable to test for ketones during periods of illness to prevent ketoacidosis developing. Diabetic coma at diagnosis of type 1 diabetes If the symptoms of type 1 diabetes are not spotted soon e Continue reading >>
What Is The Difference Between Insulin Shock & A Diabetic Coma?
Nearly 26 million Americans had diabetes in 2010, and many were not being adequately treated, according to the Centers for Disease Control and Prevention. Most people have heard about the long-term complications of poorly controlled diabetes, such as kidney failure, cardiovascular disease and blindness. People with diabetes can also develop acute complications. If your blood glucose gets too high due to inadequate treatment, or falls too low due to overly aggressive treatment, you could suddenly lose consciousness. Insulin shock, diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome are all potential causes of diabetic coma. Insulin Shock Insulin is a hormone your pancreas normally produces in response to rising glucose levels. Many people with diabetes must take insulin to prevent their blood glucose from rising too high. If you take more insulin than your body needs, you could suddenly develop hypoglycemia, or low blood glucose. People who take insulin and exercise without eating or drink too much alcohol are particularly susceptible to hypoglycemia. Insulin shock, which is a form of diabetic coma, may occur if your blood glucose falls too low to support your brain’s metabolic demands -- usually below 50 mg/dL. Seizures may occur before the onset of coma. Diabetic Ketoacidosis Just as a low blood glucose level can trigger unconsciousness, extremely high blood glucose levels can alter brain function and lead to coma. Diabetic ketoacidosis, which usually affects people with type 1 diabetes, happens when you don’t have enough insulin in your system. DKA may be the initial manifestation of newly developed diabetes, or it may result from a skipped insulin dose in a person who has already been diagnosed with diabetes. Infections and alcohol abuse can also trigge Continue reading >>
Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome
In Brief Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are two acute complications of diabetes that can result in increased morbidity and mortality if not efficiently and effectively treated. Mortality rates are 2–5% for DKA and 15% for HHS, and mortality is usually a consequence of the underlying precipitating cause(s) rather than a result of the metabolic changes of hyperglycemia. Effective standardized treatment protocols, as well as prompt identification and treatment of the precipitating cause, are important factors affecting outcome. The two most common life-threatening complications of diabetes mellitus include diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). Although there are important differences in their pathogenesis, the basic underlying mechanism for both disorders is a reduction in the net effective concentration of circulating insulin coupled with a concomitant elevation of counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone). These hyperglycemic emergencies continue to be important causes of morbidity and mortality among patients with diabetes. DKA is reported to be responsible for more than 100,000 hospital admissions per year in the United States1 and accounts for 4–9% of all hospital discharge summaries among patients with diabetes.1 The incidence of HHS is lower than DKA and accounts for <1% of all primary diabetic admissions.1 Most patients with DKA have type 1 diabetes; however, patients with type 2 diabetes are also at risk during the catabolic stress of acute illness.2 Contrary to popular belief, DKA is more common in adults than in children.1 In community-based studies, more than 40% of African-American patients with DKA were >40 years of age and more than 2 Continue reading >>
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 >>
What You Should Know About Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a buildup of acids in your blood. It can happen when your blood sugar is too high for too long. It could be life-threatening, but it usually takes many hours to become that serious. You can treat it and prevent it, too. It usually happens because your body doesn't have enough insulin. Your cells can't use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones and, if the process goes on for a while, they could build up in your blood. That excess can change the chemical balance of your blood and throw off your entire system. People with type 1 diabetes are at risk for ketoacidosis, since their bodies don't make any insulin. Your ketones can also go up when you miss a meal, you're sick or stressed, or you have an insulin reaction. DKA can happen to people with type 2 diabetes, but it's rare. If you have type 2, especially when you're older, you're more likely to have a condition with some similar symptoms called HHNS (hyperosmolar hyperglycemic nonketotic syndrome). It can lead to severe dehydration. Test your ketones when your blood sugar is over 240 mg/dL or you have symptoms of high blood sugar, such as dry mouth, feeling really thirsty, or peeing a lot. You can check your levels with a urine test strip. Some glucose meters measure ketones, too. Try to bring your blood sugar down, and check your ketones again in 30 minutes. Call your doctor or go to the emergency room right away if that doesn't work, if you have any of the symptoms below and your ketones aren't normal, or if you have more than one symptom. You've been throwing up for more than 2 hours. You feel queasy or your belly hurts. Your breath smells fruity. You're tired, confused, or woozy. You're having a hard time breathing. Continue reading >>
Diabetes With Coma In Dogs
Though diabetes is a relatively common disease in canines, the problem of accompanying complications is less seen. Often, with insulin therapy, diabetes can be managed quite well in our pets. However, difficulties can arise that can cause our pets to become very ill. Urgent care is required and some pets arrive at the clinic in a comatose, or near comatose state. The list of pets predisposed to diabetes is very long, with some of the breeds being Labrador and Golden Retrievers, Poodles, Miniature Schnauzers, Beagles, Doberman Pinschers, Chow Chow, Dachshund, and West Highland Terrier. Females are affected more often than males. When the pancreas is unable to regulate blood sugar, diabetes results. Once a dog is diagnosed with diabetes, the main protocol is to regulate the blood glucose levels. There can be cases of canine diabetes that occur with serious complications, resulting in issues like hyperglycemia and hyperosmolar coma. A dog with diabetes displays symptoms that are easily recognized. Increased thirst (polydipsia) Frequent urination (polyuria) Increased appetite (polyphagia) Weight loss (even though he is eating regularly) Weakness A dog with complications that can lead to coma will exhibit additional signs. Lethargy and fatigue Restlessness Muscle twitching Depression Dehydration Vomiting Seizure Daze, confusion, and unresponsiveness Rapid breathing (tachypnea) Coma Death Types There are many types of disorders that can lead to diabetes with coma. Each one has specific causes that will lead your dog to a state of being unresponsive and comatose. If your pet is becoming extremely lethargic and moving in and out of consciousness, bring him to the veterinarian or emergency clinic without delay. Insulin resistance Insulin effectiveness Diabetic ketoacidosis Hyper Continue reading >>