Ketoacidosis in diabetics also referred to as Diabetic Ketoacidosis (DKA) is a serious medical condition caused by abnormal increase in quantities of ketones in the body, as result of some unregulated biochemical circumstances. It is the combination factor of an excess of glucose in the bloodstream and abnormally high concentration of ketone bodies in the blood. Insulin is the main hormone in relation to ketoacidosis in diabetics.
In general we burn whatever food (carbohydrates, proteins, fats) we eat to produce energy. Anything extra is stored in different parts of the body. Glucose is the body’s major source of energy. Eventually all carbohydrates are broken down into glucose. Glucose is the only fuel that the brain can utilise, but it
DKA is presented with three major physiological disturbances which are hyperosmolality due to hyperglycemia, metabolic acidosis because of the buildup of ketoacids, and hypovalemia from osmotic diuresis. Diabetic ketoacidosis is caused by a profound deficiency of insulin, its most likely occur in people with type 1 diabetes, inadequate insulin dosage, poor self management, undiagnosed type 1 diabetes, illnesses and infections. In type 1
The food that we eat is one example of chemical energy, which is stored in the bonds of the molecules that make up food. When we eat the food, the large molecules are broken down into smaller molecules that can be used by the cells in the body. The process of breaking down the food and using it by our cells is called respiration. During this process the chemical energy is converted to heat, kinetic energy and other forms of chemical energy (like the one stored in the fat cells in our body).
At Yale New Haven on the medicine floor SLA 4, the nurse manager identified the need of education on both the hyperglycemia and diabetic ketoacidosis protocols. The nurses and doctors were not aware of the steps outlined in the protocol that needed to be followed. There have been several incidents across the hospital of orders not being correctly prescribed by physicians and nurses following through with these incorrect orders, therefore seriously effecting patient outcomes. Specifically on SLA 4 there was a recent incidence of a patient coming off of an
Diabetic ketoacidosis is a dangerous state - nutritional ketosis, on the other hand, is where the body is using ketones as a fuel source safely. For those who don't have diabetes, having insulin to ensure good blood sugar levels keeps ketones at safe levels which is achieved by reducing carbohydrate-intake to below 50
Classic symptoms of diabetes usually presented with newly diagnosed diabetics are: hyperglycaemia, polyuria, polydipsia, polyphagia, fatigue, blurred vision, headaches, and unexplained weight loss. Ketone bodies are found in the urine, this abnormal finding occurs when fatty acid by-products (acetones) are excreted in the urine. The ketones are present from a lack of the insulin hormone used to metabolize fats and carbohydrates. Diabetic ketoacidosis (DKA) is a life-threatening complication which results from minimal useful insulin hormone in the body, hypoglycaemia, or insufficient food intake (American Diabetes Association, 2008).
Only 35% of the subjects had diabetes but it was still concluded that the LCKD had significant improvements of glycaemia. Results were obtained by measuring fasting glucose and HbA1c. HbA1c improved and a decrease in diabetic medications also occurred. Similar results are reported in a therapeutic review on individuals with type II diabetes (). Hypoglycemia was not present because glucose was produced from the glycerol that was liberated via lipolysis and from glycogenic amino acids. Individuals who had close adherence to the LCKD were able to maintain their blood glucose levels and no longer needed insulin treatment. Studies found that higher circulating ketones in the blood concentration were associated with better glycemic control. Studies measuring HbA1c to show glycemic change showed a decrease from 7.3% to 6.3%, with improvements in insulin
Diabetic Ketoacidosis (DKA) is a serious disease with complications that may have fatal results in some cases. DKA is defined as an insulin deficiency that occurs when glucose fails to enter insulin into muscles such as: liver and adipose tissue. When there is an accumulation of ketones, it leads to metabolic acidosis which causes nausea and vomiting, as a result fluid and electrolytes are loss (Gibbs). There are many complications of diabetic ketoacidosis, some of the most prevalent are: Cerebral Edema, Hypolglycemia, and Acute Pancreatitis.
Diabetic ketoacidosis (DKA) DKA and hyperosmolar hyperglycemic syndrome (HHS) occurs in 20 % of the elderly who have not previously been diagnosed with diabetes. HHS is more often found in the elderly, being precipitated by an acute illness or drug therapy (Childs, Cypress, & Spollett, 2009). DKA and HHS, are both similar in the aspect for a decrease in the effective concentration of insulin in conjunction with the counter regulatory hormones glucagon, cortisol, growth hormone and epinephrine. However, DKA and HHS differed in the driving force, degree of insulin deficiency, serum glucose levels, pH, serum osmolality and duration of symptoms (Childs, Cypress, & Spollett, 2009).
Diabetic Ketoacidosis (DKA) is a disease state, most often seen in individuals with Type I Diabetes. While it most often results from uncontrolled insulin levels, young children can often present in diabetic ketoacidosis as the initial presentation of undiagnosed type I Diabetes. The major symptoms of Type I Diabetes, polydipsia, polyphagia, and polyuria, are often subtle and can be normal in growing children (Urden, Stacy & Lough, 2014; Wilson, 2012). Unless alert to the symptoms of Diabetes they can often be overlooked until severe enough to warrant immediate medical attention.
Diabetic Ketoacidosis, also known as DKA, is one of the leading complications related to hyperglycemia in a patient who has Type 1 Diabetes. According to the CDC, “In 2014, 168,000 patients were discharged from the hospital due to DKA”. (INSERT IN TEXT CITATION FROM CDC WEBSITE). Diabetic Ketoacidosis is a combination of elevated blood sugar, ketosis, metabolic acidosis, dehydration and electrolyte imbalance. DKA is considered a life-threatening emergency. It is important as the nurse to be able to recognize the signs and symptoms and intervene early.
Diabetic ketoacidosis is a complication for some patients with insulin-dependent diabetes mellitus as well as for non-insulin dependent. It is treated commonly in the intensive care unit (ICU), even though clinical data from many studies support management in regular (medical/surgical) wards, avoiding expensive critical care unit costs and preventing bed crisis in these higher level of care units for sicker patients. Once the patient is treated, adequate follow up and education is mandatory. Noncompliance remains the primary concern for repeated admissions.
If we do not use all of the sugar (glucose) that the body has received, the extra stuff is stored to be used later in the liver and muscles and eventually, if we still don't use it all, it stores it in our fat banks. Some of us have "fat banks" on our thighs and but, while others of us have them in the belly, arms chest etc. We can't change where our body stores this extra "energy" but we can change how much it stores.
The body uses carbohydrates directly from the monosaccharide glucose. Glucose is in the blood and extracellular fluids (lymph) and can be made from glycogen. Glycogen is stored in the liver and muscles and in smaller amounts in the other organs and tissues of the body. Energy is derived from glucose by the splitting of the glucose molecules into smaller compounds and oxidizing these to form water, which frees quite a large amount of
I am Barbara Ligons your nurse and I will be assisting Dr. Gupta in caring for your daughter Ellen. When Ellen came into the emergency room she was barely conscious. She complained about excessive vomiting, frequent urination, excessive thirst, seeing double, headaches, and feeling really tired for the last two days. From these observations Dr.Gupta suspects a serious diabetic complication called ketoacidosis. Ellen has complained of weight loss of 15lbs in the last month and I do see in her file she has a history of headaches, depression and urinary tract infections which is where bacteria are found in the urine. After reviewing her records I also observed that the last surgeries she has had was the removal of her
One of the most common causes of weight loss is diabetes, this can range from a couple of pounds to two-three stone. Weight loss is usually due to the increased metabolism and breakdown of muscle and fat due to insulin deficiency. Fluid depletion can also cause weight loss from both Polydipsia and Polyuria. When an individual presents with these features it is important for them to be picked up quickly otherwise Ketoacidosis can occur which may be fatal. Ketones are made up of acetone and two organic acids- beta-hydroxybutyric acid and acetoacetic acid. The liver and other cells can only process limited amounts of fatty acids, lipids and ketones at any given time, any excess of keytones is then secreted into the blood causing ketoacidosis. The binding of ketoacids and bicarbonate buffers within the blood, leading to an eventual decrease of PH in the blood due to decreased levels of serum bicarbonate (Gould and Dyer, 2011: 551). As dehydration occurs within the kidneys the demand on glomerular filtration decreases and so to does the excretion of acids leading to decompensated metabolic acidosis. Diabetic ketoacidosis or hyperosmolar coma are mostly due to the hyperosmolarity of the blood, secondary to hyperglycemia and the result of this can be fatal if not treated within a short period of time Less obvious presentation includes tiredness and weakness which is very common in uncontrolled diabetes. Alongside these presenting features comes visual blurring and fungal