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Why Does Metabolic Acidosis Occur In Dka?

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Cardiovascular Complications Of Ketoacidosis

Cardiovascular Complications of Ketoacidosis Ambulatory Care PGY1 Residency Program Coordinator Chronic Care Medication Management, Pharmacy Services ABSTRACT: Ketoacidosis is a serious medical emergency requiring hospitalization. It is most commonly associated with diabetes and alcoholism, but each type is treated differently. Some treatments for ketoacidosis, such as insulin and potassium, are considered high-alert medications, and others could result in electrolyte imbalances. Several cardiovascular complications are associated with ketoacidosis as a result of electrolyte imbalances, including arrhythmias, ECG changes, ventricular tachycardia, and cardiac arrest, which can be prevented with appropriate initial treatment. Acute myocardial infarction can predispose patients with diabetes to ketoacidosis and worsen their cardiovascular outcomes. Cardiopulmonary complications such as pulmonary edema and respiratory failure have also been seen with ketoacidosis. Overall, the mortality rate of ketoacidosis is low with proper and urgent medical treatment. Hospital pharmacists can help ensure standardization and improve the safety of pharmacotherapy for ketoacidosis. In the outpatient Continue reading >>

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  1. Masoodtokyo

    I found the cheapest test strips in the world

    Hi
    I have had diabetes for a few years and my insurance doesnt cover the test strips so I have been paying quite a lot for accu-check strips. I lived in Japan and then Singapore. After a while I got really sick of paying $50 per box of 50 so I started to look around for a cheaper supply. Eventually I asked a cousin to walk into a pharmacy in Pakistan and they were selling 50 accu-check test strips for $11 a box.
    From what I can see this is very very very cheap. I ask him every few months to send me 25 boxes and so I get 25x 50 (1,250 strips) for $275 plus FX costs / bank transfer fees / mailing, all in, I pay about $330. This comes to 26 cents per test strip.
    Now I am really sort of annoyed at Roche because they obviously make a decent profit in Pakistan selling these strips at 22 cents each (thats my price minus the mailing and bank transfer costs) and that is the price on the street. the wholesale price is even cheaper and Roche make a profit at the wholesale price. And yet they sell in wealthy countries at quite extortionate prices.
    I am thinking of setting up a website and selling strips online, mailed from Pakistan and not making a huge profit, but just enough to set up a small business for my cousin over there. He will be seriously happy if he can make $1000 per month as that is a huge sallary in Pakistan.
    My question is this to everybody - If i sell these strips online from Pakistan (takes 2 weeks to arrive) for say $18 a pack of accu-check performa test strips, will people buy them? At what price will people switch to buying online from a small company in Pakistan?
    If I can get enough people interested I am happy to set up an online store, which actually can be done quite quickly. Any thoughts or input very welcome.
    I found that now as they are so cheap I can test 5x per day and this helped me to significantly lower my HBA1c within months so I think if I do this it will save lives. It is way
    Advice / thoughts / Comments please!

  2. furball64801

    Only thought I would have is the heat issue, they would get very hot in transit or at least I think they would.

  3. PeterPumper

    First, no way am I buying from a small company in Pakistan.
    Second, there is probably some "not for export" restrictions. They may not care about an occasional shipment, but start a business and see how quick they crack down.

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Severe Hyperkalaemia In Association With Diabetic Ketoacidosis In A Patient Presenting With Severe Generalized Muscle Weakness

Diabetic ketoacidosis (DKA) is an acute, life‐threatening metabolic complication of diabetes mellitus. Hyperglycaemia, ketosis (ketonaemia or ketonuria) and acidosis are the cardinal features of DKA [1]. Other features that indicate the severity of DKA include volume depletion, acidosis and concurrent electrolyte disturbances, especially abnormalities of potassium homeostasis [1,2]. We describe a type 2 diabetic patient presenting with severe generalized muscle weakness and electrocardiographic evidence of severe hyperkalaemia in association with DKA and discuss the related pathophysiology. A 65‐year‐old male was admitted because of impaired mental status. He was a known insulin‐treated diabetic on quinapril (20 mg once daily) and was taking oral ampicillin 500 mg/day because of dysuria which had started 5 days prior to admission. He was disoriented in place and time with severe generalized muscle weakness; he was apyrexial (temperature 36.4°C), tachycardic (120 beats/min) and tachypneic (25 respirations/min) with cold extremities (supine blood pressure was 100/60 mmHg). An electrocardiogram (ECG) showed absent P waves, widening of QRS (‘sine wave’ in leads I, II, V5 a Continue reading >>

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  1. Jules

    Hi LInda, I have been doing Atkins for three months now and managed to stay in ketosis...just recently I have finished a week of antibiotics, I have to go back to the drs because I ended up with a lump in my throat and pains in my bladder, she said it was down to the antibiotics and se how it goes after a couple of weeks...the question is would it affect me being in ketosis? I can't seem to get back into ketosis since taking the tablets ....I check twice a day but it just stays on the first colour (beige) ..... Having the buzz from the pink colour really spurs me on...I'm beginning to feel a bit down :-(
    Hope you can help
    Jules x

  2. gordon

    719 Posts

    Quote from: Jules at Nov 21, 2014, 10:44 PM
    Hi LInda, I have been doing Atkins for three months now and managed to stay in ketosis...just recently I have finished a week of antibiotics, I have to go back to the drs because I ended up with a lump in my throat and pains in my bladder, she said it was down to the antibiotics and se how it goes after a couple of weeks...the question is would it affect me being in ketosis? I can't seem to get back into ketosis since taking the tablets ....I check twice a day but it just stays on the first colour (beige) ..... Having the buzz from the pink colour really spurs me on...I'm beginning to feel a bit down :-(
    Hope you can help
    Jules x hi Jules i haven't had a pink test strip for a few weeks weight lose has been very slow i was 2 lbs down last week but have put it back on this week, i am doing every thing right carbs are always under 20g fat is up and moderate protien as soon as i see a lose on the scales its back on a few days later

  3. Jo

    You can't rely on those strips, they really aren't accurate.

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A Rare Cause Of Metabolic Acidosis: Ketoacidosis In A Non-diabetic Lactating Woman

Go to: Case presentation A 27-year-old lady, 8 weeks post-partum, presented with a four-day history of nausea and vomiting. She described a variety of non-specific symptoms including general malaise, polydipsia, polyuria, fatigue, headache and generalised body aching. Due to her condition, she had been unable to tolerate any food intake in the preceding four days. She had no significant past medical history and took no prescribed medications or recreational substances. She did not drink excessive quantities of alcohol. The patient had strictly followed a low carbohydrate diet for two years. She described herself as being in a state of ‘safe ketosis’ as a result of her diet. Her approximate daily macronutrient targets were as follows: carbohydrate 10%, fat 70% and protein 20%. Her average carbohydrate intake was 20 g per day. Due to her malaise in the days preceding admission, her carbohydrate intake had been reduced to 15–17 g per day. Her pregnancy had been uncomplicated. She had a normal vaginal delivery of her child and had been well post-partum. She had been exclusively breastfeeding her child since birth. The child had been healthy until the preceding week when he contra Continue reading >>

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  1. mtnbknggrl

    My trainer recently put my on a 1300 calorie meal plan. She has broken it up to 5 meals per day at 260 p/m. She wants me to break it down to a 45/25/20 ratio p/m but i am struggling with making that work. Everything that i find that is healthy for me to eat, i cannot fit it together. Any ideas or suggestions on what to do? It is very frustrating, i have been working on it for a few days and cannot seem to make it fit.
    Thanks for your help.

  2. ianianian

    1. get rid of that trainer
    2. start at 2200 calories (if weight loss stalls, drop 100-150 calories, rinse repeat)
    3. sit and read these forums

  3. PBateman2

    Before you get rid of the trainer, can you ask him/her why 1300 calories to start? Im curious to know.

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