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Why Does Ketoacidosis Cause Fruity Breath

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 >>

How To Avoid Diabetic Ketoacidosis

How To Avoid Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a possible complication of diabetes caused by extreme hyperglycemia, or high blood glucose. It is a serious and potentially life-threatening complication, one that you should work hard to avoid when you have diabetes. Diabetic ketoacidosis mainly affects people with type 1 diabetes, but it is a very rare possible complication for people with type 2 diabetes. Your doctor and certified diabetes educator will teach you how to recognize and manage diabetic ketoacidosis. It's critical to know and recognize the signs and symptoms of DKA, as well as how to treat it. What Is Diabetic Ketoacidosis? Diabetic ketoacidosis happens when your blood glucose level gets too high—usually higher than 300 mg/dL. Because people with type 1 diabetes do not have the insulin to process this extra glucose, their body cannot break down this glucose to create energy. To create energy for itself, the body starts to aggressively break down fat. Ketones or ketoacids are a byproduct of this process. Your body can handle a small amount of ketones circulating in your blood. However, the sizeable amounts from DKA are toxic. Diabetic Ketoacidosis Causes Illness, infections, stress, injuries, neglecting diabetes care (not properly taking your insulin, for example), and alcohol consumption can cause DKA. Diabetic Ketoacidosis Symptoms Initial symptoms of DKA include a stomach ache, nausea, and vomiting. One problem with DKA is that people could mistake it for an illness that typically gets better over time like the flu or food poisoning. Other symptoms of diabetic ketoacidosis include: fruity breath (when fat is broken down by the body, it creates a chemical called acetone that smells fruity) fatigue frequent urination intense thirst headache If you feel any of these sympto Continue reading >>

3 Sudden Warning Signs That Could Save Your Life

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

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 >>

What Is The Difference Between Hyperglycemia And Hypoglycemia?

What Is The Difference Between Hyperglycemia And Hypoglycemia?

By Debra A. Sokol-McKay, MS, CVRT, CDE, CLVT, OTR/L, SCLV What Is Hyperglycemia? In relation to diabetes, hyperglycemia refers to chronically high blood glucose levels. Most medical professionals define hyperglycemia by using the blood glucose goals that you and your physician have established and combining those goals with the blood glucose target ranges set by the American Diabetes Association. It's important to understand that you'll probably experience high blood glucose levels from time to time, despite your best efforts at control. As with any chronic disease, talk with your physician and diabetes care team if the pattern of your blood glucose readings is consistently higher or lower than your blood glucose goals. Complications from Hyperglycemia Persistent hyperglycemia can cause a wide range of chronic complications that affect almost every system in your body. When large blood vessels are affected, it can lead to: Stroke (cerebral vascular disease) Heart attack or Congestive Heart Failure (coronary heart disease) Circulation disorders and possible amputation (peripheral vascular disease) When smaller blood vessels are affected, it can lead to: Kidney disease (nephropathy) Nerve damage (neuropathy) Diabetic eye disease (retinopathy) Joseph Monks: Writer, Producer, and Film Director Joseph Monks, who has diabetic retinopathy, creates and produces films for his production company Sight Unseen Pictures. He is also the first blind filmmaker to direct a feature film. Says Joe, "I'm not uncomfortable with the term 'blind.' I'm not thrilled about it, of course, but it's accurate. The lights went out for me in early 2002 as a result of diabetic retinopathy—the death of my retinas. It is what it is, so when it happened, I decided that I wasn't going to let it put an en Continue reading >>

Why Does My Breath Smell Like Acetone?

Why Does My Breath Smell Like Acetone?

People often associate strong smelling breath with the food someone has eaten or poor dental hygiene. But it may reveal much more than that. If a person's breath smells like acetone or nail polish remover, it could indicate health conditions, including diabetes. The way a person's breath smells can be an indicator of their overall health. This article explores why a person's breath might smell like acetone and what this might mean about their health. Contents of this article: How diabetes can affect breath Diabetes can affect the way a person's breath smells and can cause bad breath, or halitosis. In a 2009 study, researchers found that analyzing a person's breath helped to identify prediabetes when diabetes is in its early stages. There are two conditions associated with diabetes that can cause bad breath: gum disease and a high ketone level. The proper name for gum diseases in periodontal disease, and its forms include: Diabetes can be associated with an increased risk of gum disease, which may cause a person's breath to smell bad. However, gum disease does not cause a person's breath to smell like acetone. If a person has diabetes and their breath smells like acetone, this is usually caused by high levels of ketones in the blood. Diabetes and acetone breath When diabetes is not managed well, the body does not make enough insulin to break down glucose in the blood. This means that the body's cells do not receive enough glucose to use as energy. When the body cannot get its energy from sugar, it switches to burning fat for fuel instead. The process of breaking down fat to use as energy releases by-products called ketones. Ketone bodies include acetone. Acetone is the same substance that is used in nail varnish remover and is distinguished by its fruity smell. When a pe Continue reading >>

Diabetic Ketoacidosis (dka)

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 >>

Banishing Bad Breath

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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia:[1] Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA.[2] Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA.[2] However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>

Diabetic Ketoacidosis: Evaluation And Treatment

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 >>

Bad Breath? Chances Are That You Could Be Diabetic

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 >>

Ketoacidosis

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 >>

Diabetic Ketoacidosis In Children

Diabetic Ketoacidosis In Children

WHAT YOU NEED TO KNOW: What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening condition caused by dangerously high blood sugar levels. Your child's blood sugar levels become high because his body does not have enough insulin. Insulin helps move sugar out of the blood so it can be used for energy. The lack of insulin forces his body to use fat instead of sugar for energy. As fats are broken down, they leave chemicals called ketones that build up in the blood. Ketones are dangerous at high levels. What increases my child's risk for DKA? Not enough insulin Poorly controlled diabetes Infection or other illness Heart attack, stroke, trauma, or surgery Emotional stress Being female What are the signs and symptoms of DKA? Your child may feel very thirsty, and urinate more than usual. He may have a fever. He may also have any of the following: Dry mouth, eyes, and skin Fast, deep breathing Faster heartbeat than normal for him Abdominal pain, nausea, and vomiting Fruity, sweet breath Mood changes and irritability Feeling very weak, tired, and confused Weight loss How is DKA treated? DKA can be life-threatening. Your child must get immediate medical attention. The goal of treatment is to replace lost body fluids, and to bring blood sugar levels back to normal. How can I help prevent DKA? The best way to prevent DKA is to help your child control his diabetes. Ask your child's healthcare provider for more information on how to manage your child's diabetes. The following may help decrease your child's risk for DKA: Monitor your child's blood sugar levels closely if he has an infection, is stressed, sick, or experiences trauma. Check his blood sugar levels often. You may need to check at least 3 times each day. If your child's blood sugar level is too high, Continue reading >>

Symptoms Of Ketosis And Diabetic Ketoacidosis Warning Signs

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 >>

Sglt2 Inhibitors And Diabetic Ketoacidosis: What's Behind The Fda Warning

Sglt2 Inhibitors And Diabetic Ketoacidosis: What's Behind The Fda Warning

With commentary by Yehuda Handelsman, MD, FACP, FACE, FNLA, an endocrinologist in private practice in Tarzana, CA, Medical Director and Principal Investigator of the Metabolic Institute of America and President of the American College of Endocrinology People with diabetes who take blood sugar-lowering drugs called SGLT2 inhibitors were recently warned by the U.S. Food and Drug Administration (FDA) that they should watch for signs of a life-threatening condition called diabetic ketoacidosis. canagliflozin (Invokana) dapagliflozin (Farxiga) empagliflozin (Jardiance) as well as the combination pills: canagliflozin plus metformin (Invokamet) dapagliflozin plus metformin extended-release (Xigduo XR) empagliflozin plus linagliptin (Glyxambi). “Diabetic ketoacidosis (DKA) can be deadly,” says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE, an advanced practice dietitian at the University of Chicago Kovler Diabetes Center and a member of EndocrineWeb’s advisory board. “DKA is usually more of a concern for people with type 1 diabetes, but this warning is for people with type 2 diabetes who are taking the SGLT2 inhibitors, as well as people with type 1 diabetes who take these medications off label. DKA — dangerously high acid levels in the bloodstream — happens when your body breaks down fat instead of glucose for energy, releasing acidic compounds called ketones. Early symptoms include thirst, frequent urination and sweet, fruity breath, Hess-Fischl says. You may feel tired and confused, and develop nausea, stomach pain, vomiting and difficulty breathing. “If you notice symptoms, call your doctor immediately. But if you’re vomiting, can’t catch your breath or are concerned, go to the emergency room,” she says. Putting the Risk in Perspective The FDA warning, relea Continue reading >>

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