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Why Does Ketoacidosis Cause Vomiting

Vomiting, Nausea, And Diarrhea – Adjusting Your Diabetes Medication

Vomiting, Nausea, And Diarrhea – Adjusting Your Diabetes Medication

Vomiting, nausea, and diarrhea are most commonly caused by bacterial or viral infections sometimes associated with flu-like illness. An essential part of treatment is to stop eating. Since you can certainly survive a few days without eating, this should pose no problem. But if you’re not eating, it makes sense to ask what dose of insulin or ISA you should take. Adjusting Your Diabetes Medication If you’re on one of the medication regimens described in this book, the answer is simple: you take the amount and type of medication that you’d normally take to cover the basal, or fasting, state and skip any doses that are intended to cover meals. If, for example, you ordinarily take detemir or glargine as basal insulin upon arising and at bedtime, and regular or lispro (or aspart or glulisine) insulin before meals, you’d continue the basal insulin and skip the preprandial regular or lispro for those meals you won’t be eating. Similarly, if you take an ISA on arising and/or at bedtime for the fasting state, and again to cover meals, you skip the doses for those meals that you do not plan to eat. In both of the above cases, it’s essential that the medications used for the fasting state continue at their full doses. This is in direct contradiction to traditional “sick day” treatment, but it’s a major reason why patients who carefully follow our regimens should not develop DKA or hyperosmolar coma when they are ill. Of course, if you’re vomiting, you won’t be able to keep down oral medication and this poses yet another problem. Remember, because infection and dehydration may each cause blood sugar to increase, you may need additional coverage for any blood sugar elevation. Such additional coverage should usually take the form of lispro insulin. This is one of Continue reading >>

Nausea And Vomiting

Nausea And Vomiting

Tweet Most, if not all of us will be familiar with the feeling of nausea, which is basically the feeling of needing to be sick, felt in the stomach area. Both nausea and vomiting can be a sign of a number of underlying health conditions, including diabetes. When there is an issue that can affect the stomach or gastric system of their body, people can feel sick. Even if it is a fairly tenuous connection, such as angina affecting blood flow, the sufferer may still feel queasy. Causes of nausea Both type 1 diabetes and type 2 diabetes can cause nausea or vomiting in several ways. Hyperglycemia and Hypoglycemia As the blood glucose levels rise and fall, the body's metabolism can get interrupted and confused which can lead to a mixed feeling of nausea. Low blood pressure (Hypotension) Low blood pressure often leads to dizzy spells which, for some people, can induce a feeling of nausea as the world appears to spin around them. Certain medications The side effect of a lot of drugs is a feeling of nausea, and even vomiting. Metformin, the most widely used diabetes drug, is known to have nauseating side effects. Gastroparesis Due to neuropathy, the body may not be able to move food from the stomach or along the intestines. This can cause a back log of food, which can result in sickness. Bezoars Bezoars are stone like formations created from undigested food matter, which can block the gastro-intestinal track and stop food processing and digesting. This can eventually cause nausea and vomiting. When to see your doctor If you are having recurrent or consistent bouts of nausea or vomiting, then it is a good idea to go and see your doctor to get the issue sorted as soon as possible. Keeping a diary of nausea or vomiting episodes and what you ate or were doing beforehand may help the Continue reading >>

Alcoholic Ketoacidosis

Alcoholic Ketoacidosis

What is alcoholic ketoacidosis? Cells need glucose (sugar) and insulin to function properly. Glucose comes from the food you eat, and insulin is produced by the pancreas. When you drink alcohol, your pancreas may stop producing insulin for a short time. Without insulin, your cells won’t be able to use the glucose you consume for energy. To get the energy you need, your body will start to burn fat. When your body burns fat for energy, byproducts known as ketone bodies are produced. If your body is not producing insulin, ketone bodies will begin to build up in your bloodstream. This buildup of ketones can produce a life-threatening condition known as ketoacidosis. Ketoacidosis, or metabolic acidosis, occurs when you ingest something that is metabolized or turned into an acid. This condition has a number of causes, including: shock kidney disease abnormal metabolism In addition to general ketoacidosis, there are several specific types. These types include: alcoholic ketoacidosis, which is caused by excessive consumption of alcohol diabetic ketoacidosis (DKA), which mostly develops in people with type 1 diabetes starvation ketoacidosis, which occurs most often in women who are pregnant, in their third trimester, and experiencing excessive vomiting Each of these situations increases the amount of acid in the system. They can also reduce the amount of insulin your body produces, leading to the breakdown of fat cells and the production of ketones. Alcoholic ketoacidosis can develop when you drink excessive amounts of alcohol for a long period of time. Excessive alcohol consumption often causes malnourishment (not enough nutrients for the body to function well). People who drink large quantities of alcohol may not eat regularly. They may also vomit as a result of drinking too 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 >>

Why Does Diabetes Cause Excessive Thirst?

Why Does Diabetes Cause Excessive Thirst?

7 0 We’ve written before about the signs and symptoms of diabetes. While there are a lot of sources about what symptoms diabetes causes, and even some good information about why they’re bad for you, what you don’t often get are the “whys”. And while the “whys” aren’t necessarily critical for your long-term health, they can help you to understand what’s going on with your body and why it acts the way it does. That, in turn, can help with acceptance and understanding of how to better treat the symptoms, which in turn can help you stay on a good diabetes management regimen. In short, you don’t NEED to know why diabetes causes excessive thirst, but knowing the mechanism behind it can make your blood glucose control regimen make more sense and help you stick to it. So why DOES diabetes cause thirst? First, we’d like to start by saying that excessive thirst is not a good indicator of diabetes. For many people, the symptom creeps up so slowly that it’s almost impossible to determine if your thirst has noticeably increased (unless you keep a spreadsheet of how much water you drink, in which case you also probably get tested pretty regularly anyway). It’s also a common enough symptom that a sudden increase in thirst can mean almost anything. Some conditions that cause thirst increases include allergies, the flu, the common cold, almost anything that causes a fever, and dehydration caused by vomiting or diarrhea. So while excessive thirst is one of those diabetes symptoms that happens, and needs to be addressed, it’s not always a great sign that you should immediately go out and get an A1C test. Why does diabetes cause thirst? Excessive thirst, when linked to another condition as a symptom or comorbidity, is called polydipsia. It’s usually one of the Continue reading >>

Symptoms And Detection Of Ketoacidosis

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 >>

Vomiting In Diabetic Cats

Vomiting In Diabetic Cats

It’s not difficult to recognize the more common diabetes symptoms in cats. They drink a lot of water, urinate more frequently and lose weight. Treatment of diabetes involves regular injections of insulin to keep blood glucose levels within normal limits. Vomiting isn’t one of the most common feline symptoms of this disease. Having said that, if a cat is being treated for feline diabetes, vomiting is definitely something to watch out for. It can indicate that their blood glucose is not being well controlled, and they may be developing diabetic ketoacidosis. This is a potentially fatal condition that needs urgent veterinary treatment. However, if a diabetic cat starts throwing up, it doesn’t necessarily mean that their diabetes is worsening. Other symptoms of diabetic ketoacidosis to look for are increased thirst, loss of appetite and extreme lethargy. Another reason for diabetic vomiting in cats is pancreatitis. This condition can be hard to diagnose in our feline family members but should always be considered when cat vomiting in a diabetic pet becomes a problem. Some veterinarians believe that up to one half of all cases of diabetes in cats are accompanied by a low grade chronic inflammation of the pancreas. When they have a flare up, it can reduce their appetite and make them vomit. They need to be closely monitored until they recover because the change in their food intake will affect the amount of insulin they need. Don’t forget that there are many other cat vomiting causes that are totally unrelated to diabetes. Some examples include gastroenteritis, kidney disease and inflammatory bowel disease. Because a diabetic cat has an underlying chronic medical condition, any illness will need a thorough investigation including comprehensive blood tests and possibly Continue reading >>

Gastroparesis: A Complication Of Diabetes

Gastroparesis: A Complication Of Diabetes

"Gastro" means stomach and "paresis" means impairment or paralysis. Diabetic gastropathy is a term for the spectrum of neuromuscular abnormalities of the stomach caused by diabetes. The abnormalities include gastric-dysrhythmias, antral hypomotility, incoordination of antroduodenal contractions and gastroparesis. Quick Stomach Anatomy Lesson The stomach is a neuromusclar organ that receives the food we ingest, mixes the food with acid and pepsin, and empties the nutriment suspension into the small intestine for absorption. The proximal stomach or fundus relaxes in order to receive the swallowed food (that's called receptive relaxation). The body and antrum mix and empty the food via recurrent gastric peristalic waves. The peristaltic contractions are paced by neoelectrical events called pacesetter potentials or slow waves. When gastric motility is normal, the postprandial (after eating) period is associated with pleasant epigastric sensations. Gastric motility disorders or gastroparesis presents with unpleasant, but non-specific postprandial symptoms: upper abdominal bloating, distention, discomfort, early satiety, nausea, and vomiting. If the vomitus contains undigested food, then gastroparesis is very likely to be present. Fluctuating, difficult-to-predict glucose levels may also reflect the presence of gastroparesis. Diabetes and the GI Tract The motility of your GI tract, which we were just speaking of, is controlled by an outer sleeve of muscles that surrounds your GI tract. They are controlled by a complex nervous system. Diabetes can damage these nerves, and it is this neurological long-term complication of diabetes that can lead to gastrointestinal disorders. How do we know this is the case? First, many of the people with gastroparesis have long-standing diabete Continue reading >>

Symptoms

Symptoms

The symptoms of type 1 diabetes can develop very quickly (over a few days or weeks), particularly in children. In older adults, the symptoms can often take longer to develop (a few months). However, they should disappear when you start taking insulin and the condition is under control. The main symptoms of diabetes are: feeling very thirsty urinating more frequently than usual, particularly at night feeling very tired weight loss and loss of muscle bulk itchiness around the genital area, or regular bouts of thrush (a yeast infection) blurred vision caused by the lens of your eye changing shape slow healing of cuts and grazes Vomiting or heavy, deep breathing can also occur at a later stage. This is a dangerous sign and requires immediate admission to hospital for treatment. See your GP if you think you may have diabetes. When to seek urgent medical attention You should seek urgent medical attention if you have diabetes and develop: a loss of appetite nausea or vomiting a high temperature stomach pain fruity smelling breath – which may smell like pear drops or nail varnish (others will usually be able to smell it, but you won't) Hypoglycaemia (low blood glucose) If you have diabetes, your blood glucose levels can become very low. This is known as hypoglycaemia (or a "hypo"), and it's triggered when injected insulin in your body moves too much glucose out of your bloodstream. In most cases, hypoglycaemia occurs as a result of taking too much insulin, although it can also develop if you skip a meal, exercise very vigorously or drink alcohol on an empty stomach. Symptoms of a "hypo" include: feeling shaky and irritable sweating tingling lips feeling weak feeling confused hunger nausea (feeling sick) A hypo can be brought under control simply by eating or drinking somethin Continue reading >>

Acute Complications Of Diabetes - Diabetic Ketoacidosis

Acute Complications Of Diabetes - Diabetic Ketoacidosis

- [Voiceover] Oftentimes we think of diabetes mellitus as a chronic disease that causes serious complications over a long period of time if it's not treated properly. However, the acute complications of diabetes mellitus are often the most serious, and can be potentially even life threatening. Let's discuss one of the acute complications of diabetes, known as diabetic ketoacidosis, or DKA for short, which can occur in individuals with type 1 diabetes. Now recall that type 1 diabetes is an autoimmune disorder. And as such, there's an autoimmune destruction of the beta cells in the pancreas, which prevents the pancreas from producing and secreting insulin. Therefore, there is an absolute insulin deficiency in type 1 diabetes. But what exactly does this mean for the body? To get a better understanding, let's think about insulin requirements as a balancing act with energy needs. Now the goal here is to keep the balance in balance. As the energy requirements of the body go up, insulin is needed to take the glucose out of the blood and store it throughout the body. Normally in individuals without type 1 diabetes, the pancreas is able to produce enough insulin to keep up with any amount of energy requirement. But how does this change is someone has type 1 diabetes? Well since their pancreas cannot produces as much insulin, they have an absolute insulin deficiency. Now for day-to-day activities, this may not actually cause any problems, because the small amount of insulin that is produced is able to compensate and keep the balance in balance. However, over time, as type 1 diabetes worsens, and less insulin is able to be produced, then the balance becomes slightly unequal. And this results in the sub-acute or mild symptoms of type 1 diabetes such as fatigue, because the body isn Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) happens when your blood sugar is high and your insulin level is low. This imbalance in the body causes a build-up of ketones. Ketones are toxic. If DKA isn’t treated, it can lead to diabetic coma and even death. DKA mainly affects people who have type 1 diabetes. But it can also happen with other types of diabetes, including type 2 diabetes and gestational diabetes (during pregnancy). DKA is a very serious condition. If you have diabetes and think you may have DKA, contact your doctor or get to a hospital right away. The first symptoms to appear are usually: frequent urination. The next stage of DKA symptoms include: vomiting (usually more than once) confusion or trouble concentrating a fruity odor on the breath. The main cause of DKA is not enough insulin. A lack of insulin means sugar can’t get into your cells. Your cells need sugar for energy. This causes your body’s glucose levels to rise. To get energy, the body starts to burn fat. This process causes ketones to build up. Ketones can poison the body. High blood glucose levels can also cause you to urinate often. This leads to a lack of fluids in the body (dehydration). DKA can be caused by missing an insulin dose, eating poorly, or feeling stressed. An infection or other illness (such as pneumonia or a urinary tract infection) can also lead to DKA. If you have signs of infection (fever, cough, or sore throat), contact your doctor. You will want to make sure you are getting the right treatment. For some people, DKA may be the first sign that they have diabetes. When you are sick, you need to watch your blood sugar level very closely so that it doesn’t get too high or too low. Ask your doctor what your critical blood sugar level is. Most patients should watch their glucose levels c 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 >>

Diabetic Ketoacidosis Causes, Symptoms, Treatment, And Complications

Diabetic Ketoacidosis Causes, Symptoms, Treatment, And Complications

Diabetic ketoacidosis definition and facts Diabetic ketoacidosis is a life-threatening complication of type 1 diabetes (though rare, it can occur in people with type 2 diabetes) that occurs when the body produces high levels of ketones due to lack of insulin. Diabetic ketoacidosis occurs when the body cannot produce enough insulin. The signs and symptoms of diabetic ketoacidosis include Risk factors for diabetic ketoacidosis are type 1 diabetes, and missing insulin doses frequently, or being exposed to a stressor requiring higher insulin doses (infection, etc). Diabetic ketoacidosis is diagnosed by an elevated blood sugar (glucose) level, elevated blood ketones and acidity of the blood (acidosis). The treatment for diabetic ketoacidosis is insulin, fluids and electrolyte therapy. Diabetic ketoacidosis can be prevented by taking insulin as prescribed and monitoring glucose and ketone levels. The prognosis for a person with diabetic ketoacidosis depends on the severity of the disease and the other underlying medical conditions. Diabetic ketoacidosis (DKA) is a severe and life-threatening complication of diabetes. Diabetic ketoacidosis occurs when the cells in our body do not receive the sugar (glucose) they need for energy. This happens while there is plenty of glucose in the bloodstream, but not enough insulin to help convert glucose for use in the cells. The body recognizes this and starts breaking down muscle and fat for energy. This breakdown produces ketones (also called fatty acids), which cause an imbalance in our electrolyte system leading to the ketoacidosis (a metabolic acidosis). The sugar that cannot be used because of the lack of insulin stays in the bloodstream (rather than going into the cell and provide energy). The kidneys filter some of the glucose (suga Continue reading >>

Diabetic Ketoacidosis (dka) - Topic Overview

Diabetic Ketoacidosis (dka) - Topic Overview

Diabetic ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are unable to get the sugar (glucose) they need for energy because there is not enough insulin. When the sugar cannot get into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood and remove it from the body through urine. Because the cells cannot receive sugar for energy, the body begins to break down fat and muscle for energy. When this happens, ketones, or fatty acids, are produced and enter the bloodstream, causing the chemical imbalance (metabolic acidosis) called diabetic ketoacidosis. Ketoacidosis can be caused by not getting enough insulin, having a severe infection or other illness, becoming severely dehydrated, or some combination of these things. It can occur in people who have little or no insulin in their bodies (mostly people with type 1 diabetes but it can happen with type 2 diabetes, especially children) when their blood sugar levels are high. Your blood sugar may be quite high before you notice symptoms, which include: Flushed, hot, dry skin. Feeling thirsty and urinating a lot. Drowsiness or difficulty waking up. Young children may lack interest in their normal activities. Rapid, deep breathing. A strong, fruity breath odor. Loss of appetite, belly pain, and vomiting. Confusion. Laboratory tests, including blood and urine tests, are used to confirm a diagnosis of diabetic ketoacidosis. Tests for ketones are available for home use. Keep some test strips nearby in case your blood sugar level becomes high. When ketoacidosis is severe, it must be treated in the hospital, often in an intensive care unit. Treatment involves giving insulin and fluids through your vein and closely watching certain chemicals in your blood (electrolyt Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

The Facts Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, most often in those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a fatal coma. DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. It can also occur in people already diagnosed with type 1 diabetes that have missed an insulin dose, have an infection, or have suffered a traumatic event or injury. Although much less common, DKA can occasionally occur in people with type 2 diabetes under extreme physiologic stress. Causes With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take in glucose from the blood. In the case of type 2 diabetes, the pancreas is unable to make sufficient amounts of insulin in order to take in glucose from the blood. Glucose, a simple sugar we get from the foods we eat, is necessary for making the energy our cells need to function. People with diabetes can't get glucose into their cells, so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL) while insulin levels are very low. Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood, causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able Continue reading >>

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