Diabetic Ketoacidosis

A Preventable Crisis
People who have had diabetic ketoacidosis, or DKA, will tell you it’s worse than any flu they’ve ever had, describing an overwhelming feeling of lethargy, unquenchable thirst, and unrelenting vomiting.
“It’s sort of like having molasses for blood,” says George. “Everything moves so slow, the mouth can feel so dry, and there is a cloud over your head. Just before diagnosis, when I was in high school, I would get out of a class and go to the bathroom to pee for about 10–12 minutes. Then I would head to the water fountain and begin drinking water for minutes at a time, usually until well after the next class had begun.”
George, generally an upbeat person, said that while he has experienced varying degrees of DKA in his 40 years or so of having diabetes, “…at its worst, there is one reprieve from its ill feeling: Unfortunately, that is a coma.”
But DKA can be more than a feeling of extreme discomfort, and it can result in more than a coma.
“It has the potential to kill,” says Richard Hellman, MD, past president of the American Association of Clinical Endocrinologists. “DKA is a medical emergency. It’s the biggest medical emergency related to diabetes. It’s also the most likely time for a child with diabetes to die.”
DKA occurs when there is not enough insulin in the body, resulting in high blood glucose; the person is dehydrated; and too many ketones are present in the bloodstream, making it acidic. The initial insulin deficit is most often caused by the onset of diabetes, by an illness or infection, or by not taking insuli Continue reading

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Can frequent, moderate drinking ward off diabetes?

(CNN)It's not every day that medical studies say alcohol could be good for you. People who drink moderately often have a lower risk of developing diabetes than those who never drink, according to a new study published in Diabetologia, the journal of the European Association for the Study of Diabetes.
Men and women who hoist a few glasses three to four days a week have the lowest risks of developing diabetes, Danish researchers found. Compared to people drinking less than one day each week, men who drink frequently had a 27% lower risk while women had a 32% lower risk, the researchers said.
Diabetes is a disease in which blood glucose -- sugar -- levels are high. When we eat, most of our food is turned into glucose to be burned as energy, with a hormone called insulin helping our cells absorb glucose. People who have diabetes either don't make enough insulin or don't use it effectively. As a result, sugar builds up in their blood, leading to health problems.
Past studies consistently showed that light to moderate drinking carried a lower risk of diabetes compared to sobriety, while heavy drinking had an equal or greater risk. Though the World Health Organization reports "harmful use of alcohol" contributes to more than 200 diseases and injuries, it also acknowledges that light to moderate drinking may be beneficial with respect to diabetes.
Since an important relationship exists between drinking and diabetes, Professor Janne Tolstrup and her colleagues from the National Institute of Public Health of the University of Southern Denmark studied the specifics.
They began by gath Continue reading

Life Expectancy for Type 1 Diabetes

New study shows recent improvement in years of life lost.
With minimal studies to evaluate the impact of type 1 diabetes on life expectancy, studies have been developed to retrospectively look at the effects of diabetes on mortality. Diabetes was also compared to other disease states and causes that had an influence on years of life lost (YLL). The YLL of patients with type 1 diabetes and patients with other disease states were compared to those of the general healthy population.
This autoimmune disorder accounts for 10% of all Americans diagnosed with diabetes, and the ability to prevent the development of type 1 diabetes is minimal. Causes have been linked to genetics, and viral infections such as mumps, rubella, cytomegalovirus, measles, influenza, encephalitis, polio, or Epstein-Barr virus.
In a study conducted on Australians with type 1 diabetes between the years of 1997 and 2010, researchers looked at the estimated YLL of the type 1 diabetic patients compared to the general public. Researchers used the Chiang method to estimate life expectancy and Arriaga’s method to estimate the impact of age-specific and cause-specific mortalities.
Results showed no disparity in terms of YLL from type 1 diabetes in women vs. men. When the YLL was organized into two groups, 1997-2003 and 2004-2010, the 2004-2010 groups showed improvement in life expectancies of 1.9 years in men and 1.5 years in women. Overall, over the time period of the study, patients with type 1 diabetes had a life expectancy of 12.2 years less than the general population.
The majority of the YLL was attributed Continue reading

What Does Liver Disease Have to do With Diabetes?

The American College of Gastroenterology released new guidelines on liver chemistry tests in December 2016. Changed level recommendations were included for ALT- alanine aminotransferase, AST- aspartate aminotransferase, and alkaline phosphatase and bilirubin levels. In the past, ALT levels were accepted at a range from 30-40 IU/L and up to 70-80 IU/L while being hospitalized (body under stress). The new acceptable levels are 19-25 IU/L for women and 29-33IU/L for men. The vast change in “normal levels” of liver enzymes were updated since “multiple studies have demonstrated that if you have ALT levels even innocuously elevated, your risk of liver related death is significantly higher” according to Paul Kwo, MD from Stanford University. Liver disease can stem from alcohol, viral hepatitis A, B or C, genetic disorders, liver injury, drugs, supplements, Lyme disease and non-alcoholic fatty liver disease – NAFLD. Liver disease can often tell us about your overall health and liver function tests should be part of the work up utilized by your MD. What does this all mean for people with type 2 diabetes?
What Does the Liver Do?
The liver turns food into nutrients and filters toxins from the blood. The toxins include alcohol, medications, supplements, pollutants and insecticides. When the fat content of the liver reaches 10%, due to weight gain especially around the middle section and in visceral organs (internal fat), the spongy texture of the liver becomes coarse and the function declines. Liver problems begin.
Non-Alcoholic Fatty Liver Disease – NAFLD
Elevated ALT leve Continue reading

Cholesterol-Lowering Drugs May Be Linked to Diabetes

You may have concerns about taking a cholesterol-lowering statin drug, such as atorvastatin (Lipitor and generic), rosuvastatin (Crestor), and simvastatin (Zocor and generic), after a recent study linked those drugs to an increased risk of type 2 diabetes. But Consumer Reports Best Buy Drugs experts say the heart-protective benefit of statins usually outweighs the risk of diabetes, so don’t skip a statin if you need one to lower your cholesterol.
Diabetes isn’t a new side effect of statins. The Food and Drug Administration added it to the label of all statins in 2012 based on a review of studies that found a slightly elevated risk. For example, one study that reviewed 13 randomized, controlled clinical trials of statins found that 4.9 percent of people who took one of the drugs for 4 years developed diabetes compared with 4.5 percent of those who didn’t take a statin.
Lower Cholesterol vs. Higher Blood Glucose
The new study, published in the Journal of General Internal Medicine, raises questions about whether the diabetes risk is higher than previously thought. Researchers looked at medical data of nearly 7,000 men and women with an average age of 53. About 31 percent of those who took a statin for an average of 5.5 years developed diabetes compared with 19 percent of those who didn’t.
But since the study was not a randomized, controlled study—the gold standard for determining whether a drug causes a particular side effect—it’s not known for sure that the increase in diabetes was entirely due to statins. The study participants might have had other factors that Continue reading