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Why Is Creatinine High In Diabetic Ketoacidosis?

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What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin. Depending on the severity, insulin may be given intravenously or by injection under the skin. Usually potassium is also needed to prevent the development of low blood potassium. Throughout treatment blood sugar and potassium levels should be regularly checked. Antibiotics may be required in those with an underlying infection. In those with severely low blood pH, sodium bicarbonate may be given; however, its use is of unclear benefit and typically not recommended. Rates of DKA vary around the world. About 4% of people with type 1 diabetes in United Kingdom develop DKA a year, while in Malaysia the condition affects about 25% a year. DKA was first described in 1886 and, until the introduction of insulin therapy in the 1920s, it was almost universally fatal. The risk of death with adequate and timely treatment is currently around 1–4%. Up to 1% of children with DKA develop a complication known as cerebral edema. The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. Those who measure their glucose levels themselves may notice hyperglycemia (high blood sugar levels). In severe DKA, breathing becomes labored and of a deep, gasping character (a state referred to as "Kussmaul respiration"). The abdomen may be tender to the point that an acute abdomen may be suspected, such as acute pancreatitis, appendicitis or gastrointestinal perforation. Coffee ground vomiting (vomiting of altered blood) occurs in a minority of people; this tends to originate from erosion of the esophagus. In severe DKA, there may be confusion, lethargy, stupor or even coma (a marked decrease in the level of consciousness). On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor. If the dehydration is profound enough to cause a decrease in the circulating blood volume, tachycardia (a fast heart rate) and low blood pressure may be observed. Often, a "ketotic" odor is present, which is often described as "fruity", often compared to the smell of pear drops whose scent is a ketone. If Kussmaul respiration is present, this is reflected in an increased respiratory rate.....

Diabetic Ketoacidosis

Abbas E. Kitabchi, PhD., MD., FACP, FACE Professor of Medicine & Molecular Sciences and Maston K. Callison Professor in the Division of Endocrinology, Diabetes & Metabolism UT Health Science Center, 920 Madison Ave., 300A, Memphis, TN 38163 Aidar R. Gosmanov, M.D., Ph.D., D.M.Sc. Assistant Professor of Medicine, Division of Endocrinology, Diabetes & Metabolism, The University of Tennessee Health Science Center, 920 Madison Avenue, Suite 300A, Memphis, TN 38163 Clinical Recognition Omission of insulin and infection are the two most common precipitants of DKA. Non-compliance may account for up to 44% of DKA presentations; while infection is less frequently observed in DKA patients. Acute medical illnesses involving the cardiovascular system (myocardial infarction, stroke, acute thrombosis) and gastrointestinal tract (bleeding, pancreatitis), diseases of endocrine axis (acromegaly, Cushing`s syndrome, hyperthyroidism) and impaired thermo-regulation or recent surgical procedures can contribute to the development of DKA by causing dehydration, increase in insulin counter-regulatory hormones, and worsening of peripheral insulin resistance. Medications such as diuretics, beta-blockers, co Continue reading >>

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  1. Markette

    Today I learned about ketosis.
    Yesterday, Day 15 for me, I had a lady doctor's appointment wherein they collected a urine sample. My ketones were sky high and prompted my doctor -- who I had never seen before -- to tell me he didn't think I was eating well. I laughed, insisted that I eat quite well, and asked him to explain his concern more fully. He explained that ketones indicate I am passing fat, that I'm not eating well, starving. He insisted that I grab a fruit juice on the way home, push fluids the rest of the night, and follow up with my GP. Let me tell you, that much glucose at once felt weird, but who was I to argue with his quite insistent orders?
    After some Google-fu, I found out that that's not exactly what ketones are, or what high ketones in urine means, but close. They're a byproduct of my body burning fat for energy instead of glucose. They are a warning sign if you're a Type I diabetic (I'm not) or have liver issues (I don't know of any) and can be a tell-tale sign of anorexia or starvation or fasting (uh, no), but for folks on low-carb, high-fat diets, they more often indicate that your metabolism has shifted from processing glucose to processing fat for fuel.
    On top of the high ketone level in my urine, I felt terrible all day long. I couldn't sleep the night before, had another base-of-the-neck migraine-like headache, had the chills, and finally vomited around 3am. I chalked it up to the flu or the issue that had brought me to my doctor to begin with, but after further research, I'm wondering if I might actually be transitioning to a ketogenic metabolism and have a touch of the "ketosis flu".
    I'm not much of an athlete these days, and ketosis certainly isn't the goal of my Whole30. I did some quick research on this forum and saw that other ladies -- mainly pregnant ones -- had doctors who were concerned with high ketones while they were Whole30ing. They increased their caloric intake via more starches. So I also decided to tweak my diet even more this round and increase my starch (yams, bananas, squash, etc.) intake and see how I feel.
    I'm seeing my GP next week -- also for the first time -- and I'd like to be able to ask some pointed questions about the paleo diet and ketosis and ketoacidosis, as I'm sure another urinalysis will reveal the same high ketone levels and probably bring similar concerns. I've been strict paleo since 2011, am 114 pounds, 5'4", and have a very low body fat -- I'm not opposed to remaining in ketosis, but am concerned that I don't have a ton of fat on my frame to burn and want to monitor my diet and health responsibly.
    Has anyone else -- especially ladies -- had high ketone levels in their urine? Any precautions I should be aware of? Any tweaks to a Whole30 you'd recommend?

  2. Tina R

    This has been discussed on this forum http://forum.whole9life.com/topic/2737-why-is-nobody-talking-about-ketosis/. Here is a thread that might help. You can also search google "whole30 Ketosis" for other answers on the forum. Good Luck!

  3. kirkor

    Bonus ketosis! Lucky!
    Several of us are aiming for it here.

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Diabetic Ketoacidosis Linked To Higher Risk For Aki In Youth

High rates of acute kidney injury (AKI) were reported among youth in the hospital for diabetic ketoacidosis (DKA), researchers reported. A low serum bicarbonate level (<10 mEq/L) among hospitalized children with type 1 diabetes and DKA was associated with a significant increase in the risk for stage 2 or 3 AKI (aOR 5.22; 95% CI; 1.35-20.22), according to Brenden E. Hursh, MD, of the University of British Columbia, and colleagues. In the study, published in JAMA Pediatrics, stage 1 acute kidney injury for children with DKA was also linked to an initial corrected sodium level of 145 mEq/L or more (aOR 3.29; 1.25-8.66). Using a multinomial logistic regression model, the researchers also reported a linear relationship between heart rate and severe AKI, with a 22% increase in risk for AKI associated with each increase of five beats per minute in initial heart rate (aOR 1.22; 1.07-1.39). In an interview with MedPage Today, the senior author, Constadina Panagiotopoulos, MD, also of the University of British Columbia, noted, "While I thought we would detect more cases of AKI than that previously represented by the two isolated case reports in the literature, I was surprised by the high pro Continue reading >>

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  1. Kimberley

    For the best answers, search on this site https://smarturl.im/aDO7m
    If your blood sugar levels have been "okay today", your ketone levels will soon dissipate, my friend. In fact, if your blood sugar levels really are OK, the ketones will be gone within a few hours. You could try drinking lots of water in a deliberate attempt to make you pee. This will aid your body getting rid of the ketones.

  2. Comment

    I'm not sure what ketones are but my mum was diagnosed with diabetes a couple of years back and she was really bad. Her sister who's a pharmacist told her to slice an aubergine, immerse it in water and drink the water all day. She also did a bit of research and cinnamon kept coming up so she drank lots of cinnamon tea and put it in all her food. When she next went back to the doctor they couldn't believe how quickly her diabetes had come under control. Maybe coincidence, I don't know, but these things can't hurt you so worth a try.

  3. Comment

    Ketones are an acid remaining when the body burns its own fat. If you do test for ketones when you are at home, should you keep getting high blood sugar readings tests that show positive for ketones then call for medical advice.
    Diet is the KEY to getting rid of ketones. You must eat a healthy, well-balanced diet in order for your body to stop burining its own fat resources. You shouldn't exercise too much if you've got ketones either, as your body is already burning fat and you want that to subside.
    You can also test for ketones using ketone testing kits like the Ketostix, Acon urine reagent ketone and some blood glucose meters also detect ketones.

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What is KETOACIDOSIS? What does KETOACIDOSIS mean? KETOACIDOSIS meaning - KETOACIDOSIS definition - KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... 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 ß-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. 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. Ketosis may also smell, 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. Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively. In diabetic ketoacidosis, a high concentration of ketone bodies is usually accompanied by insulin deficiency, hyperglycemia, and dehydration. Particularly in type 1 diabetics the lack of insulin in the bloodstream prevents glucose absorption, thereby inhibiting the production of oxaloacetate (a crucial molecule for processing Acetyl-CoA, the product of beta-oxidation of fatty acids, in the Krebs cycle) through reduced levels of pyruvate (a byproduct of glycolysis), and can cause unchecked ketone body production (through fatty acid metabolism) potentially leading to dangerous glucose and ketone levels in the blood. Hyperglycemia results in glucose overloading the kidneys and spilling into the urine (transport maximum for glucose is exceeded). Dehydration results following the osmotic movement of water into urine (Osmotic diuresis), exacerbating the acidosis. In alcoholic ketoacidosis, alcohol causes dehydration and blocks the first step of gluconeogenesis by depleting oxaloacetate. The body is unable to synthesize enough glucose to meet its needs, thus creating an energy crisis resulting in fatty acid metabolism, and ketone body formation.

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus.[1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness.[1] A person's breath may develop a specific smell.[1] Onset of symptoms is usually rapid.[1] In some cases people may not realize they previously had diabetes.[1] DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances.[1] Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids.[1] DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies.[3] DKA is typically diagnosed when testing finds high blood sugar, low blood pH, and ketoacids in either the blood or urine.[1] The primary treatment of DKA is with intravenous fluids and insulin.[1] Depending on the severity, insulin may be given intravenously or by injection under the skin.[3] Usually potassium is also needed to prevent the development of low blood potassium.[1] Th Continue reading >>

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  1. successful_great_guy

    I hear the experts say in interviews that a ketogenic diet is not for everyone. I recall D'Agostino saying 70-75% of people thrive on a ketogenic diet, but 25-30% do not. Do we have evidence-based examples of where keto does not work, is unhealthy, or is dangerous to one's health? There are clearly a multitude of anecdotal examples, but there are also a multitude of people who love eating sugar and won't make it past keto flu or who think they are doing keto when they're not (ex. low carb low fat) or eat the wrong things. Is there evidence either way on this?

  2. ShadedSpaces

    Well, I mean, I have no idea how one would create a PKU-friendly keto diet when everything like eggs, meat, fish, cheese, nuts, and dairy are best avoided.
    I can't imagine how someone with fat-intolerant IBS would be able to eat keto either. Or someone with one of the diseases that results in fat malabsorption.
    I don't think that conditions like these amount to a quarter of the population though. But we certainly have evidenced-based examples of people who are better off eating carbs. Feeding a traditional ketogenic diet to a kid with PKU would literally cause irreversible brain damage.

  3. saralt

    Dr. Noakes mentioned a number in the 10% range. The truth is that we just don't know yet how many people don't do well.

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