Diabetic ketoacidosis

It is a potentially deadly problem that occurs in people with diabetes and occurs when the body cannot use sugar (glucose) as a source of energy, because there is no insulin or this is insufficient.Instead, fat is used to obtain energy.

When the fat breaks down to provide energy to the body, chemicals called ketones are accumulated in the body.

Causes

As the fats break down, acids called ketones accumulate in the blood and urine.At high levels, ketones are toxic.This condition is called ketoacidosis.

Diabetic ketoacidosis (DKA) Sometimes it is the first sign of type 1 diabetes in people who have not yet received the diagnosis.It can also occur in someone who has already been diagnosed with type 1 diabetes. An infection, an injury, a serious disease, surgery or overlooking insulin can lead DKA in people with type 1 diabetes.

People with type 2 diabetes can also present DKA, but it is rare.It is generally triggered by a poorly controlled blood sugar level, overlooking medicines or serious illness.

symptoms

Common symptoms may include:

- Decreased state of consciousness
- Accelerated and deep breathing
- Mouth and skin dryness
- Redness of the face
- Frequent or thirst urination that lasts a day or more
- Fruit breath
- Headache
- Dolores or muscle rigidity
- Nausea and vomiting
- Stomachache

tests and exams

The ketone exam can be used in type 1 diabetes to detect early ketoacidosis.This test is usually done using a sample of urine or a blood sample.

The ketone exam is usually carried out when DKA is suspected:

More frequently, a urine test is first carried out.
If the urine test result is positive for ketones, the blood is usually measured in the blood.This is the most common ketones measurement.

Other exams for ketoacidosis include:

- Arterial gasometry
- Basic metabolic tests (a group of blood tests that measures sodium and potassium levels, renal function, and other chemicals and functions)
- Blood glucose examination
- Blood pressure measurement

treatment

The objective of the treatment is to correct the high level of glucose in the blood with insulin.Another objective is to replenish lost liquids through urination, inappropriateness and vomit if it has these symptoms.

If you have diabetes, your medical care provider probably told you how to detect DKA warning signals.If you think you have DKA, examine in search of ketones through urine strips or its glucometer.If ketones are presented, call your attention provider immediately.It is not delayed.Follow the instructions you give.

You may need to go to the hospital.There, you will receive insulin, liquids and other treatments for DKA.Then, doctors will find and treat the cause of this disease, such as an infection.

expectations (prognosis)

Most people respond to treatment within the first 24 hours.Sometimes, it takes more time to recover.

If the DKA is not treated, it can lead to a serious illness or death.

possible complications

Health problems that can occur as a result of DKA include any of the following:

- Accumulation of fluid in the brain (cerebral edema)
- The heart stops working (heart attack)
- Renal insufficiency
- When to contact a medical professional

When to contact a medical professional DKA is often an emergency.Call your attention provider if you notice the symptoms of this condition.

Go to the Emergency Room or call the local emergency number (911 in the United States) if you or a family member with diabetes presents any of the following symptoms:

- Decreased state of consciousness
- Breath with fruits smell
- Nausea
- Difficulty breathing
- Vomiting

Prevention

If you have diabetes, you must learn to recognize the preliminary warning signs and symptoms of the DKA.You should know when to do a ketone exam, for example, when you are sick.

If you use an insulin pump, you frequently review it to see that insulin is flowing through the tube and that there are no obstructions, twisting or disconnections.

alternative names
DKA;Ketoacidosis

References

American Diabetes Association.Standards of Medical Care in Diabetes - 2015. Care Diabetes.2015; 38: S1-S76.PMID: 25537706 www.ncbi.nlm.nih.gov/pubmed/25537706.

Pasquel FJ, Umpierrez Ge.Hyperglycemic Crises.In: Jameson JL, by Groot LJ, by Kretser DM, et al, eds.Endocrinology: Adult and Pediatric.7th ed.Philadelphia, Pa: Elsevier Saunders;2015: Chap 46.

Westerberg DP.Diabetic Ketoacidosis: Evaluation and Treatment.AM Fam Physician.2013; 87: 337-46.PMID: 23547550 www.ncbi.nlm.nih.gov/pubmed/23547550.

English version reviewed by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Amp;Nutrition, University of Washington School of Medicine, Seattle, WA.Also Reviewed by David Zieve, MD, MHA, OGILVIE ISLAND, PHD, AND THE A.D.A.M.Editorial Team.

I have ketones in my urine, I can't control glucose for a while, I have 5 in urine, it is mild but I have an extreme tiredness, they have only recommended to adjust my treatment to have good control and that with that would disappear the problem.If someone has or had good, it will be that they will tell us their experience.For my part as I have been told in the doctor and I have read, while they have ketones it is important not to practice sports, raise the intake of hydrates and therefore the amount of insulin.

I debuted with ketoacidosis @kerensammolina, nothing pleasant the truth.It was since I could not walk and breathe very acceleratedly and cost me ... are very high glucose results?
I know little, I just advise you not to leave it, because that, every time it is worse and the truth is not pleasant, 5 I think it is enough, and it can be complicated.I guess the best thing is that you correct insulin when you stay very high of glucose, and that you adjust the basal if necessary.On that eating the truth is that I don't know that it is better, I put some notes that @jconegar in another post, I have searched but I do not find it.
He and others have much more experience, to see if they can happen and give you some advice,
Luck!

When you are in that situation, forget the @kerensammolina sport, I abandon a sports test for that.
There is something wrong with your control if you are always like that.Because of HC only, I cannot be me right now I am carrying a very strict and scarce diet in HC the days that I do not train and nothing happens.
The best real advice that I can give you is to see you a specialist, that situation does not keep it for a long time.

Good evening impressive article best does not lack detail.It will allow me if it is so kind to use an easy explanation that I use with the adolescent children DM1 I take care of you and teach all my knowledge acquired I am hired by their parents to teach them how to prick when clicking diet and especially standards and basic laws that must be puteach.When they ask me about ketoacidosis I tell you the following with a high blood sugar rate The liver is not too sweet blood and tries to return the azid from there its name.What I feel most proud of the children that I take care of is when they touch the visit to Endocrine what with their parents they mean that the doctor stays with his mouth open to hear them talk and express themselves about their illness.I simply try to have it a little easier than I had it and as I tell you if I tell you how to do something and you do it for yourself you owe me anything, you have learned to do it alone alone.A FER GREETING.Even if you have pointed out something of your article I hope you have not bothered you and if it has been, I tell me immediately.

recover this thread of 2016 .
Right now I have ketacidosis, I don't know how because I am in an average of 100mg/dl, hemo of 6.0% (according to Diabox) and I ingest about 40g of HC but some more per day, and I have the circulating insulin well.
The fact is that the ketone strip gives me positive and with the medical strike I see myself hours and hours in the emergency room.
Any home remedy?

@Ruthbia If you eat so little HC you will be in ketosis and it is normal to have ketones in urine.Ask for blood measuring strips that is more reliable and if you are in normal range of ketosis with normal glucose do not worry.To get to ketoacidosis you have to be hours or days with high glucose.In Normaglycemia it is only worrisome if you are dehydrated (by a gastroenteritis for example) and still takes days to really be bad.I have been with gastroenteritis 24 hours without eating or drinking anything by breastfeeding and I have not reached levels of worrying ketones.
In blood up to 3 mmol/l in blood it is totally normal nutritional ketosis.From there in diabetes I would monitor it and if you go from 5 it would be to act.Ketoacidosis is more than 10 so calm.

ruthbia said:
recover this thread of 2016 .
Right now I have ketacidosis, I don't know how because I am in an average of 100mg/dl, hemo of 6.0% (according to Diabox) and I ingest about 40g of HC but some more per day, and I have the circulating insulin well.
The fact is that the ketone strip gives me positive and with the medical strike I see myself hours and hours in the emergency room.
Any home remedy?

Don't scare yourself, @ruthbia.What they indicate the strips of ketones is that you are in ketosis, which is the objective of your thinning diet.To have ketoacidosis you should have total absence of insulin and blood sugar levels through the clouds.
Cetosis is a physiological state of your body, which what you are doing is using your reserve fats as fuel, given the shortage of hydrates of your diet.
Ketoacidosis is an unfeasible state, in which the body does not have access to glucose due to lack of insulin, sugar is maintained in the blood and the amount of ketone bodies is so high that blood is acidified.

Thanks girls, I have made a cetona strip and I am in the middle of half.Go from pink to purple.Neutral pink.My free reader measures ketones but I have no strips.

I noticed it for breath.I hadn't noticed it before.But I'm happy, 2 kg less little by little

ruthbia said:
recover this thread of 2016 .
Right now I have ketacidosis, I don't know how because I am in an average of 100mg/dl, hemo of 6.0% (according to Diabox) and I ingest about 40g of HC but some more per day, and I have the circulating insulin well.
The fact is that the ketone strip gives me positive and with the medical strike I see myself hours and hours in the emergency room.
Any home remedy?

You will be in ketosis, ruth, not in ketoacidosis, which is different.Ketoacidosis occurs when there is hyperglycemia and lack of insulin, as in a diabetic debut or an important infection that cannot be controlled by increasing the dose of insulin (usually older and multipatological people).
When making low food in HC, you enter ketosis and if you measure the ketonic bodies, they get positive but in small quantity, having those controls, you are not in hyperglycemia and you put insulin, so it is impossible that you are in ketoacidosis,You would also be very symptomatic, so quiet.

The truth is that we never use ketone strips.We were only concerned with correcting if it was high and returning to normal control.
When he debuted he could start having her, the breath smelled like apple, we caught her with 260, but immediately controlled her with insulin, without reaching more.

I had ketoacidosis in my debut.The header nurse made me a strip in consultation and with my 13 and 365 glycase they sent me to hospital admission.
I free me porfalta de beds, hehe.

I think I have entered ketosis because I have been between 55-68 for several days without tracing coma what eats and with insulin minimal.Yes, like few hydrates but not so much as to ĺEleter to ketosis.
In three days I will go to the opposite, I already know.Upon 200 meaningless.

If you are losing weight you are in ketosis, yes or yes.It is the state that allows you to burn fat, if not, you would throw glucose and the Michelines would be intact;)
You do not have to be all the time, the body can enter and go out to convenience.That is good and is called metabolic flexibility.In fact, if you have so under sugar, it is because the body is squeezing glucose and, when it is no longer enough, go to fat.

ruthbia said:
I had ketoacidosis in my debut.The header nurse made me a strip in consultation and with my 13 and 365 glycase they sent me to hospital admission.
I free me porfalta de beds, hehe.

I think I have entered ketosis because I have been between 55-68 for several days without tracing coma what eats and with insulin minimal.Yes, like few hydrates but not so much as to ĺEleter to ketosis.
In three days I will go to the opposite, I already know.Upon 200 meaningless.

I entered with 11 years in ketacidosis with more than 600 after some papers, I had a bestial pancreatitis, I was in the ICU for a week and another in the plant, all decompensated and of course, normal, walking down the street.
It has also happened to me to be very low with the same insulin and eating things that I do not usually eat, it happened to me about 15 d, and now that I am ovulating, I have more resistance and I had to go up quickly, a littleRoll this not knowing why doing the same.

@Ruthbia normally shows when you enter ketosis as you say for breath, but this only happens the first times until the body obtains metabolic flexibility and not to everyone.Then it is normal for you not to find out (I do not find out).In addition to the breath you can have other symptoms that are usually due to the lack of minerals, so when you start keto diets or long fasts it is convenient to drink enough water with minerals (mineral, or mixed with seawater, with electrolytes ...).The symptoms is what they call ketch flu because they are similar to a flu but last a few days and not everyone has them.When you have metabolic flexibility you don't notice anything.Nor the breath because the body becomes very efficient in producing ketones and does not produce more as at the beginning.When they produce more they are expelled by breath and urine.Over time those that we are ketoadapted we give negative in ketones in urine although in blood they come out positive.
Do not worry if you are fine and your glucose are normal.It is also very normal to be with lower glucose and not have hypoglycemia symptoms.Your brain has ketones to feed and do not notice the lack of glucose.There are people who with 30 glucose are so calm being in Cetosis.
If I am eating few HC I do not notice hypos in 50, I sleep all night in 50 as if nothing.In times that I upload something else the HC already notice them when you get out of 60. It is better to lower slow to adjust than to try to overcome the hypos all the time because if you eat glucose it will take you out of ketosis and if you eat things with little HC it will not upload just.Still it is normal for not putting HC to keep you lower because your body does not generate glucose in excess (except exceptions such as intense sport and hormones) as happens when eating HC, which reaches a large amount to blood in a short time.

Thanks girls!
The bad thing about ketosis is that my hair falls.It already happened to me in 2021 when I made the diet for the first time.
I thought it was Covid because it coincided and it is one of the symptoms.Dermatologist sent me vitamins but I have already taken them (3 months) and nothing, this time they have not worked.
I want to lose weight, that as a 60g of HC I remain, more or imagine.I lost 9 kg in 2021 and eating from regime 1000cal I took 3, and I had left 5 kg without losing the previous time, so ... to strive a little touch.