Diabetic Ketoacidosis
Print Overview Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care. Symptoms Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: Excessive thirst Frequent urination Nausea and vomiting Abdominal pain Weakness or fatigue Shortness of breath Fruity-scented breath Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: High blood sugar level (hyperglycemia) High ketone levels in your urine When to see a doctor If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit. Contact your doctor immediately if: You're vomiting and unable to tolerate food or liquid Your blood sugar level is higher than your target range and doesn't respond to home treatment Your urine ketone level is moderate or high Seek emergency care if: Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 mill Continue reading >>
Diabetic Ketoacidosis: Evaluation And Treatment
Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis can occur in persons of all ages, with 14 percent of cases occurring in persons older than 70 years, 23 percent in persons 51 to 70 years of age, 27 percent in persons 30 to 50 years of age, and 36 percent in persons younger than 30 years. The case fatality rate is 1 to 5 percent. About one-third of all cases are in persons without a history of diabetes mellitus. Common symptoms include polyuria with polydipsia (98 percent), weight loss (81 percent), fatigue (62 percent), dyspnea (57 percent), vomiting (46 percent), preceding febrile illness (40 percent), abdominal pain (32 percent), and polyphagia (23 percent). Measurement of A1C, blood urea nitrogen, creatinine, serum glucose, electrolytes, pH, and serum ketones; complete blood count; urinalysis; electrocardiography; and calculation of anion gap and osmolar gap can differentiate diabetic ketoacidosis from hyperosmolar hyperglycemic state, gastroenteritis, starvation ketosis, and other metabolic syndromes, and can assist in diagnosing comorbid conditions. Appropriate treatment includes administering intravenous fluids and insulin, and monitoring glucose and electrolyte levels. Cerebral edema is a rare but severe complication that occurs predominantly in children. Physicians should recognize the signs of diabetic ketoacidosis for prompt diagnosis, and identify early symptoms to prevent it. Patient education should include information on how to adjust insulin during times of illness and how to monitor glucose and ketone levels, as well as i Continue reading >>
Sweet-smelling Breath Holds Promise As Tool For Diagnosing Diabetes
A simple breath test may be able to quickly and noninvasively diagnose children who have Type 1 diabetes, according to new research from the United Kingdom. Every year, more than 15,000 children (and 15,000 adults) in the United States are diagnosed with Type 1. Roughly one in four children who have Type 1 diabetes are not diagnosed until they develop diabetic ketoacidosis, a severe and potentially fatal hyperglycemic (high blood glucose) condition that develops when the body lacks the insulin to convert glucose into energy and instead begins to break down fat. By-products of this process known as ketones can build up and cause the body to become acidic. Previous studies have indicated that gases in the breath are related to blood glucose and blood ketone levels in adults with Type 1 and Type 2 diabetes. To determine whether this is also true in children, researchers in Oxford collected breath samples from 113 children and adolescents with Type 1 diabetes between the ages of 7 and 18. Levels of the breath gases isoprene and acetone were measured and compared to blood glucose and blood ketone levels taken from the capillaries during the same visit. Although there was no link between isoprene or acetone levels in the breath and glucose levels in the blood, the researchers did find a significant association between increased levels of breath acetone and increased levels of blood ketones. “Our results have shown that it is realistically possible to use measurements of breath acetone to estimate blood ketones,” says study coauthor Gus Hancock, PhD. “We are working on the development of a small hand held device that would allow the possibility of breath measurements for ketone levels and help to identify children with new diabetes before DKA supervenes. Currently testin Continue reading >>
Symptoms Of Ketosis And Diabetic Ketoacidosis Warning Signs
Ketosis or nutritional ketosis is a perfectly healthy metabolic process in which the body burns stored fats for energy when it doesn’t have adequate glucose. Mild ketosis may help you lose weight and even be therapeutic. Unfortunately, there’s another less desirable condition that’s easily confused with ketosis – and that’s diabetic ketoacidosis (DKA). This is a high blood sugar-related emergency that accounts for over 100,000 hospital admissions every single year in the United States alone.1 DKA strikes those with diabetes and, if left unchecked, could even put you in a coma. Understanding ketosis and DKA and knowing how they’re different could save your life if you’re diabetic. Mild Ketosis Has Therapeutic Benefits People on diets like the ketogenic diet or Atkins diet cut down carb intake and switch to a diet that’s high in protein and fat instead. This sets your body up for ketosis, which is intended to help with weight loss. Some studies have even found that ketosis can help lower levels of blood glucose, low-density lipoprotein cholesterol, and triglycerides, besides bringing down body weight and body mass index.2 Mild ketosis has also been explored for its therapeutic applications in diseases associated with free radical damage, hypoxia (oxygen deficiency in tissues), and insulin resistance.3 But There Are Still Some Side Effects Of Ketosis When you are on a low-carb diet or haven’t eaten for a long time, the body undergoes ketosis and you may experience some side effects.4 These are usually temporary and occur initially when your body is adjusting to burning fat and ketones instead of carbs. Some compare these ketosis symptoms to those you’d experience when you are coming down with flu, giving rise to the term “ketosis flu” or just “ket Continue reading >>
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 >>
What Does Bad Breath Have To Do With Diabetes?
Your breath has an interesting ability to provide clues to your overall health. A sweet, fruity odor can be a sign of ketoacidosis, an acute complication of diabetes. An odor of ammonia is associated with kidney disease. Similarly, a very foul, fruity odor may be a sign of anorexia nervosa. Other diseases, such as asthma, cystic fibrosis, lung cancer, and liver disease, also can cause distinct odors on the breath. Bad breath, also called halitosis, can be so telling that doctors may even be able to use it to identify diabetes. Recently, researchers have found that infrared breath analyzers can be effective in identifying prediabetes or early-stage diabetes. Diabetes-related halitosis has two main causes: periodontal disease and high levels of ketones in the blood. Periodontal diseases Periodontal diseases, also called gum diseases, include gingivitis, mild periodontitis, and advanced periodontitis. In these inflammatory diseases, bacteria attack the tissues and bone that support your teeth. Inflammation can affect metabolism and increase your blood sugar, which worsens diabetes. While diabetes can lead to periodontal diseases, these diseases can also create further problems for people with diabetes. According to a report in IOSR Journal of Dental and Medical Sciences, an estimated one in three people with diabetes will also experience periodontal diseases. Heart disease and stroke, which can be complications of diabetes, are also linked to periodontal disease. Diabetes can damage blood vessels, which can reduce blood flow throughout your body, including your gums. If your gums and teeth aren’t receiving a proper supply of blood, they may become weak and more prone to infection. Diabetes may also raise glucose levels in your mouth, promoting bacteria growth, infection, Continue reading >>
Banishing Bad Breath
Stinky breath. Halitosis. Fetor oris. Whatever the name, it’s something that no one wants. Bad breath can be mildly annoying (as well as socially upsetting), and while it may be traced back to the 13-garlic-clove chicken dinner you ate last night, it can also indicate something more serious, especially if you have diabetes. Read on to learn more about halitosis, its causes, and what you can do to combat it. What is bad breath? If your breath smells bad to you or to others, you have bad breath, otherwise known as halitosis. We’ve probably all had it at some time or another, perhaps related to a food or beverage that we’ve consumed, or possibly we’ve woken up in the morning with what I call “dragon breath.” At its best, bad breath is unpleasant (to you and to others) and can certainly be embarrassing (who wants bad breath when you’re on a job interview or a first date?). Our society deems bad breath as something to be banished, too: just walk down the aisle of the pharmacy and witness the mouthwashes, toothpastes, and other potions to rid yourself of this condition. Unfortunately, most of these products work temporarily and, in some cases, can actually worsen the condition. How do you know if you have bad breath? Surprising as it may seem, you may not know if you have halitosis. The best way to check your breath is to ask a spouse, family member, or close friend to check out your mouth odor and let you know. If no one is around to help you out, lick your wrist, let it dry, and then smell it. If your wrist smells bad, you have bad breath. What causes bad breath? There are many potential causes of bad breath, ranging from food to oral hygiene to health conditions. Here’s a run-down of the main culprits: Food: Food particles that get stuck in your mouth and t Continue reading >>
Bad Breath? Chances Are That You Could Be Diabetic
Bad Breath? Chances are that you could be Diabetic. Breath odour is the scent of the air you breathe out of your mouth. Unpleasant breath odour is commonly called bad breath orhalitosis; this is something you should not ignore. Those close to you would certainly agree. Bad breath can originate from the most common causes like, poor dental or oral hygiene, the cook's heavy hand with garlic or an underlying serious health problem? Regardless, you can take steps to prevent bad breath at home and treat halitosis with the help of your dentist. Your breath has an interesting ability to provide clues to your overall health. ·Bad breath related to poor oral hygiene is most common and caused by release of sulphur compounds by bacteria in the mouth ·Fruity odour in the breath is a sign ofketoacidosis, which may occur in diabetes. It is a potentially life-threatening condition ·Breath that smells like feces can occur with prolongedvomiting,especially when there is abowel obstruction ·Bad breath having an ammonia-like odor (also described as urine-like or"fishy") occurs in people withchronic kidneydisease ·Similarly, a very foul fruit odor may be a sign of anorexia nervosa ·Other diseases, such as asthma, lung and liver disease also can cause distinct odors on the breath. Bad breath, also called halitosis, can be so intense that doctors may even be able to use it to identify diabetes. Recently, researchers have found that infrared breath analyzers can be effective in identifying if you have pre-diabetes or early-stage diabetes. And researchers are testing a breath analyzer that even measures blood glucose levels. What Causes Diabetes Breath? Diabetes induced halitosis has two main causes: Gum disease High levels of ketones in the blood. Gum Diseases (Periodontitis) Gum diseas Continue reading >>
Symptoms And Detection Of Ketoacidosis
Symptoms These symptoms are due to the ketone poisoning and should never be ignored. As soon as a person begins to vomit or has difficulty breathing, immediate treatment in an emergency room is required to prevent coma and possible death. Early Signs, Symptoms: Late Signs, Symptoms: very tired and sleepy weakness great thirst frequent urination dry skin and tongue leg cramps fruity odor to the breath* upset stomach* nausea* vomiting* shortness of breath sunken eyeballs very high blood sugars rapid pulse rapid breathing low blood pressure unresponsiveness, coma * these are more specific for ketoacidosis than hyperosmolar syndrome Everyone with diabetes needs to know how to recognize and treat ketoacidosis. Ketones travel from the blood into the urine and can be detected in the urine with ketone test strips available at any pharmacy. Ketone strips should always be kept on hand, but stored in a dry area and replaced as soon as they become outdated. Measurement of Ketones in the urine is very important for diabetics with infections or on insulin pump therapy due to the fact it gives more information than glucose tests alone. Check the urine for ketones whenever a blood sugar reading is 300 mg/dl or higher, if a fruity odor is detected in the breath, if abdominal pain is present, if nausea or vomiting is occurring, or if you are breathing rapidly and short of breath. If a moderate or large amount of ketones are detected on the test strip, ketoacidosis is present and immediate treatment is required. Symptoms for hyperglycemic hyperosmolar syndrome are linked to dehydration rather than acidosis, so a fruity odor to the breath and stomach upset are less likely. How To Detect Ketones During any illness, especially when it is severe and any time the stomach becomes upset, ketone Continue reading >>
3 Sudden Warning Signs That Could Save Your Life
Your Video is Loading Diabetes. Ovarian cancer. Stroke. These serious medical conditions can stop a woman in her tracks. The three sudden warning signs associated with diabetes, ovarian cancer and stroke may seem unusual and are often overlooked. Commit them to memory, and you’ll gain a leg up on how to detect potentially major health problems. Sudden Warning Sign #1 Your Breath Smells Like Nail Polish Remover = Possible Symptom of Diabetes Over 80 million Americans suffer from diabetes. Disturbingly, almost one-third of Americans living with diabetes are unaware they have it. The sudden warning sign of one’s breath smelling like nail polish remover occurs when your body is unable to utilize sugar properly, and burns fat for fuel instead. The chemical compounds released during this process are known as ketones. The ketone, acetone – a key ingredient in nail polish remover – produces the telltale diabetes warning sign of fruity-smelling breath. You may also experience a fruity taste in your mouth that persists even after you’ve brushed your teeth. Referred to medically as diabetic ketoacidosis (DKA), this symptom can result in a diabetic coma if left untreated. Additional warning signs of diabetes include: Fatigue Dizziness Frequent thirst and urination Craving sweets If you experience acetone-scented breath or any other warning signs linked to diabetes, schedule an appointment with your physician. You’ll likely be asked to fast for at least 8 hours beforehand so the doctor can check your blood sugar level via a simple blood test. Bear in mind, a healthy fasting blood sugar level is between 70 and 100mg/dl; a reading over 200mg/dl may signal diabetes. While type 1 diabetes is managed with insulin injection therapy, type 2 diabetes treatment often includes lif Continue reading >>
Diabetic Ketoacidosis (dka)
Diabetic Ketoacidosis (DKA) Diabetic ketoacidosis (DKA) occurs when the body does not have enough insulin. Insulin is what breaks down sugar into energy. When insulin is not present to break down sugars, our body begins to break down fat. Fat break down produces ketones which spill into the urine and cause glucose build up in the blood, thus acidifying the body. Because sugar is not entering into our body’s cells for energy breakdown, the sugar is being processed by the kidneys and excreted through the urine; as a result, we become dehydrated and our blood becomes even more acidic. This leads to sickness and hospitalization if not treated. If a person’s blood sugar is over 240, they should start checking their blood for ketones. If you have diabetes, or love someone who does, being aware of warning signs of diabetic ketoacidosis (DKA) can help save a life. Early Symptoms of DKA: High blood glucose level, usually > 300 High volume to ketones present in blood or urine Frequent urination or thirst that lasts for a day or more Dry skin and mouth Rapid shallow breathing Abdominal pain (especially in children) Muscle stiffness or aches Flushed face As DKA Worsens: Decreases alertness, confusion – brain is dehydrating Deep, labored, and gasping breathing Headache Breath that smells fruity or like fingernail polish remover Nausea and/or vomiting Abdomen may be tender and hurt if touched Decreased consciousness, coma, death If you think you might have DKA, test for ketones. If ketones are present, call your health care provider right away. To treat high blood sugar, hydrate with water or sugar free, caffeine free drinks. Sugar free popsicles and snacks are also good alternatives. Always call the doctor if vomiting goes on for more than two hours. Symptoms can go from mild Continue reading >>
Ketoacidosis In Cats – Causes, Symptoms & Treatment
Ketoacidosis in cats at a glance Ketoacidosis is a serious complication of diabetes in which ketones and blood sugar levels build up in the body due to insufficient levels of insulin which is required to move glucose into the cells for energy. As a result, the body uses fat as an alternate energy source which produces ketones causing the blood to become too acidic. Common causes include uncontrolled diabetes, missed or insufficient insulin, surgery, infection, stress and obesity. Symptoms of ketoacidosis include increased urination and thirst, dehydration, nausea, diarrhea, confusion, rapid breathing which may later change to laboured breathing. What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes characterised by metabolic acidosis (increased acids in the blood), hyperglycemia (high blood glucose) and ketonuria (ketones in the urine). It is caused by a lack of or insufficient amounts of insulin which is required to move glucose from the bloodstream and into the cells to be used for energy. When this occurs, the body begins to search for alternate sources of energy and begins to break down fat. When fat is broken down (metabolised) into fatty acids, waste products known as ketones (acetoacetate, beta-hydroxybutyrate, acetone) are released from the liver and accumulate in the bloodstream (known as ketonemia). This causes the blood to become too acidic (metabolic acidosis). As well as metabolic acidosis, ketones also cause central nervous depression.The body will try to get rid of the ketones by excreting them out of the body via the urine, increased urine output leads to dehydration, making the problem worse. Meanwhile, the unused glucose remains in the bloodstream, resulting in hyperglycemia (high blood sugar).Insulin Continue reading >>
Diabetic Ketoacidosis (dka)
Diabetes is a long-term condition that can have a major impact on the life of a child or young person, as well as their family or carers. In addition to insulin therapy, diabetes management should include education, support and access to psychological services, as detailed here and in this guideline. Preparations should also be made for the transition from paediatric to adult services, which have a somewhat different model of care and evidence base. Rapid‐acting insulin analogues (artificial insulin such as insulin lispro, insulin aspart, or insulin glulisine) act more quickly than regular human insulin. In people with a specific type of life‐threatening diabetic coma due to uncontrolled diabetes, called diabetic ketoacidosis, prompt administration of intravenous regular insulin is standard therapy. The rapid‐acting insulin analogues, if injected subcutaneously, act faster than subcutaneously administered regular insulin. The need for a continuous intravenous infusion, an intervention that usually requires admission to an intensive care unit, can thereby be avoided. This means that subcutaneously given insulin analogues for diabetic ketoacidosis might be applied in the emergency department and a general medicine ward. Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the preventio Continue reading >>
Ketoacidosis
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 β-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.[1] 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.[2] Ketosis may also give off an odor, 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. Cause[edit] Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively.[3] In diabetic ketoacidosis, a high concentration of ketone bodies is usually accomp Continue reading >>
> 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 >>
