Diabetic Ketoacidosis

Question: Diabetic Ketoacidosis ? I am a type 1 diabetic and I have a problem that I cant seem to figure out. I have an appointment with my doctor in about a month, because they cant get me in any earlier. But what happens is I get really sick to my stomach, my blood sugar usually drops EXTREMELY fast, I get dizzy, a headache, and I always seem to yawn a lot. I have some ideas about what it might be, like ketoacidosis. But I am not entirely sure. Do you have any ideas?

Answer: I would suggest that you go to your local drug store and obtain a canister of ketosticks. Check your urine for ketone. It is a very simple test. This will tell if you have ketonuria. If this is the case it is important that you see a doctor immediately. Call you doctor and tell them what is happening and you need help very quickly. If your doctor does not see you, go to an emergency room. This is a very serious situation. Take care, Wanda QUOTE posted on the "about portions'' thread: "The presence of ketones is called "ketonuria," and further dehydration and ketone build-up can result in ketoacidosis which is a medical emergency. The bottom line is that the presence of ketones in someone with type 1 diabetes shows a dangerous lack of insulin and the immediate need for more insulin. Exercise, at this time, will only burn more fat and produce more ketones. "

Question: diabetic ketoacidosis? if you die of diabetic ketoacidosis are there warning signs before you die and when does it alert your body? and is this something that just happens to some one or is it due to the fact of foul play by the person or someone else. how is foul pay involved. if you die at the age of 40 is it required for an autopsy to be preformed

Answer: There are major warning signs if diabetic ketoacidosis (DKA). Once the DKA is advanced the diabetic will vomit everything he or she drinks and will become severly dehydrated. They will get very dark circles and their eyes will look sunken in due to the dehydration. If DKA advances with no treatment the diabetic will go into a diabetic coma before they die. Foul play can be involved on both ends. The diabetic can not take their insulin causing their bloodsugar to shoot way up, which then causes the body to produce ketones and without giving any insulin, the body will go into DKA. On the other end someone could have messed with their diabetic supplies and put something like salt water in their insulin vile so that the diabetic thinks they are giving themselves insulin when they are not. As a diabetic, I have to tell you that we know when our bloodsugar is way too high. For me, I get very thirsty and irritated and I start to feel a little sick. To make sure though, I always check my bloodsugar to see if I need to give more insulin. If I am already sick (cold, flu, period, etc.) I tend not to notice as easy. But the fact of the matter is, for someone to die of DKA is from how they care for themselves. Very rarely is it out of the control of the diabetic to get DKA. It is very easy to detect a high blood sugar and when someone is taking proper care of themselves they should be checking their sugar enough times so that they know how high or low their blood sugar is. Diabetics know to look for expiration dates and if they fear their insulin is bad, they should get knew insulin.

Question: Is there a medical explanation for treated & regulated feline diabetes to progress to diabetic ketoacidosis? With great sadness we recently decided to euthanize our 15 year old diabetic kittie when she came down with diabetic ketoacidosis and deteriorated very quickly. She had been on insulin for about a year. Everything seemed fine, then she stopped eating and was gone two days later. I talked to the vet during the ordeal and have looked unsuccessfully for a medical description of how this progression occurs. It won't help us now, but I am just trying to make sense of what happened.

Answer: i am very sorry for your loss. while nothing i can say can bring your baby back i hope it helps. regulating diabetic kitties is an art not a science. each cat is different. while you can have a cat that is perfectly regulated things can change at a moments notice and send them into dka. i don't think your vet really did any thing wrong. dks is treatable but is not always successful.

Question: Are Ketones always present in urine if you have diabetic ketoacidosis? or can you have Diabetic Ketoacidosis without the presence of ketones in the urine?

Answer: Yes, but ... your ketones may be much higher than what is showing in your urine. The ketones collect in the blood first before they spill into the urine. So you can have very high ketones and but your urine may show small. It takes a couple of hours to catch up. My daughter's endocrinologist told me this once, but I also did a web search to find you a link that explains it better than I can :o) and here it is: http://www.diabetesnet.com/diabetes_cont… (read the third paragraph from the bottom)

Question: I know there are mnay different symptoms of diabetic ketoacidosis. is shakiness one of them? i know that a person who has diabetic ketoacidosis will experience many symptoms of the illness, and they will definitely feel quite ill. I have read about it. I just want to know if the person also feels shaky, in addition to the other symptoms.

Answer: I've never read where shakiness is one of the symptoms of diabetic ketoacidosis. I have, however, experienced shakiness when my glucose is high as well as when it's low. I've never been high enough for long enough to experience DKA. So I can't tell you from experience. Here's one of the more comprehensive sites: http://www.diabetesnet.com/diabetes_cont…

Question: What's the difference between Hypoglycemia and Diabetic Ketoacidosis in Type 1 Diabetics? Does one lead to the other, or are they completely different?

Answer: They are completely different. Hypoglycemia is, by definition, the condition of having too little glucose in your blood. ("Hypo" = low, "glycemia" refers to "glucose") Ketoacidosis is a condition caused by the inability of your muscles to obtain sufficient energy from glucose. In people with type 1 diabetes, this is most commonly associated with a lack of insulin, which also leads to high blood sugar (also known as hypERglycemia). There is a widespread misconception that diabetic ketoacidosis is caused by high blood sugar, but this is incorrect. As already explained, both are caused by lack of insulin. Neither the high glucose level nor the ketoacidosis causes or is caused by the other. (It is possible for anyone, whether they have diabetes or not, to experience hypoglycemia and ketoacidosis at the same time. This typically occurs because they're in the process of starving to death.)

Question: What is the reason why patients with Diabetic Ketoacidosis vomit? Is it because of metabolic acidosis? If you could explain it more thoroughly I would appreciate it. Thank you.

Answer: 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. For more on Diabetic Ketoacidosis visit my free website http://www.reddiabetes.com http://www.reddiabetes.com/Diabetes_Shor… Ketoacidosis is always accompanied by dehydration, which is caused by high levels of glucose in the blood. Glucose builds up in the blood if there is not enough insulin to move glucose into your cells. During an episode of ketoacidosis, it is common for blood sugar to rise to a level over 400 milligrams per deciliter. When blood sugar levels are so high, some sugar "overflows" into the urine. As sugar is carried away in the urine, water, salt and potassium are drawn into the urine with each sugar molecule, and your body loses large quantities of your fluid and electrolytes, which are minerals that play a crucial role in cell function. As this happens, you produce much more urine than normal. Eventually it may become impossible for you to drink enough fluids to keep up with amounts that you urinate. Vomiting caused by the blood's acidity also contributes to fluid losses and dehydration. If you have diabetes type 1, you usually can prevent diabetic ketoacidosis by following the insulin regimen and diet prescribed by your doctor and by testing your blood glucose regularly. If your body is stressed by an infection, ketoacidosis can develop within hours, and you may not be able to prevent it. It is important for you to check your blood sugar more frequently during an infection, so you can adjust your treatment. It is also important for you to recognize that vomiting and abdominal pain may be signs of ketoacidosis, so that you can get medical help quickly.

Question: What happens when you go unconscious from diabetic ketoacidosis? Is it reversible ?

Answer: Your blood sugar gets to high for your body to handle, and your systems start trying to compensate for this, which causes them to over work. It can start into metabolic alkalosis which is difficult to control. DKA (diabetes ketoacidosis) is reversible with meds and probably a long stay in the ICU.

Question: what are home treatments and cures for Diabetic ketoacidosis? i think my mum has it she refuses medical treatment and last time she had it.. she would not let me call the paramedics and refused to go to the hospital and had a big fight with the paramedics because she refused to leave home to go hospital. what are things i can do at home for her to make it better? is going to the hospital the only way for treatment?

Answer: If you are pretty sure she has it, call the paramedics anyway. Even if she refuses treatment, you can use the EMT paperwork as proof to support a case of her not being able to care for herself (especially if she allows herself to reach DKA often) should you need to evetually need to have a court of law give you "custody" of her (which would then make you legally able to force her to go to a hospital).

Question: Should you give water to a person vomitting because of Diabetic Ketoacidosis? What should be the interventions for these patients?

Answer: In Diabetic Ketoacidosis glucose begins to spill into the urine as the proteins responsible for reclaiming it from urine (the SGLT family) reach maximum capacity (the renal threshold for glucose). As glucose is excreted in the urine, it takes a great deal of body water with it, resulting in dehydration. Dehydration further concentrates the blood and worsens the increased osmolality of the blood. Severe dehydration forces water out of cells and into the bloodstream to keep vital organs perfused. This shift of intracellular water into the bloodstream occurs at a cost as the cells themselves need the water to complete chemical reactions that allow the cells to function. For more information Diabetic Ketoacidosis visit my free website http://www.reddiabtes.com Treatment consists of hydration to lower the osmolality of the blood, replacement of lost electrolytes, insulin to force glucose and potassium into the cells, and eventually glucose simultaneously with insulin in order to correct other metabolic abnormalities, such as lowered blood potassium (hypokalemia) and elevated ketone levels. Many patients require admission to a step-down unit or an intensive care unit (ICU) so that vital signs, urine output, and blood tests can be monitored frequently. Brain edema is not rare, and so this may suggest intensive monitoring as well. In patients with severe alteration of mental status, intubation and mechanical ventilation may be required. Survival is dependent on how badly-deranged the metabolism is at presentation to a hospital, but the process is only occasionally fatal. DKA occurs more commonly in type 1 diabetes because insulin deficiency is most severe, though it can occur in type 2 diabetes. In about a quarter of young people who develop type 1 diabetes, insulin deficiency and hyperglycemia lead to ketoacidosis before the disease is recognized and treated. This can occur at the onset of type 2 diabetes as well, especially in young people. In a person known to have diabetes and being adequately treated, DKA usually results from omission of insulin, mismanagement of acute gastroenteritis, the flu, or the development of a serious new health problem (e.g., bacterial infection, myocardial infarction). Insulin deficiency switches many aspects of metabolic balance in a catabolic direction. The liver becomes a net producer of glucose by way of gluconeogenesis (from protein) and glycogenolysis (from glycogen, though this source is usually exhausted within hours). Fat in adipose tissue is reduced to triglycerides and fatty acids by lipolysis. Muscle is degraded to release amino acids for gluconeogenesis. The rise of fatty acid levels is accompanied by increasing levels of ketone bodies (acetone, acetoacetate and beta-hydroxybutyrate; only one, acetone, is chemically a ketone -- the name is an historical accident). As ketosis worsens, it produces a metabolic acidosis, with anorexia, abdominal distress, and eventually vomiting. The rising level of glucose increases the volume of urine produced by the kidneys (an osmolar diuresis). The high volume of urination (polyuria) also produces increased losses of electrolytes, especially sodium, potassium, chloride, phosphate, and magnesium. Reduced fluid intake from vomiting combined with amplified urination produce dehydration. As the metabolic acidosis worsens, it induces obvious hyperventilation (termed Kussmaul respiration). Kussmaul's respirations are the body's attempt to remove carbon dioxide from the blood that would otherwise form carbonic acid and further worsen the ketoacidosis. See also arterial blood gas. On presentation to hospital, patients in DKA are typically suffering dehydration and breathing both fast and deeply. Abdominal pain is common and may be severe. Consciousness level is typically normal until late in the process, when obtundation (dulled or reduced level of alertness or consciousness) may progress to coma. Dehydration can become severe enough to cause shock. Laboratory tests typically show hyperglycemia, metabolic acidosis, normal or elevated potassium, and severe ketosis. Many other tests can be affected. At this point the patient is urgently in need of intravenous fluids. The basic principles of DKA treatment are: Rapid restoration of adequate circulation and perfusion with isotonic intravenous fluids Gradual rehydration and restoration of depleted electrolytes (especially sodium and potassium), even if serum levels appear adequate Insulin to reverse ketosis and lower glucose levels Careful monitoring to detect and treat complications Treatment usually results in full recovery, though death can result from inadequate treatment or a variety of complications, such as cerebral edema (occurs mainly in children).