Keetoacidosis: The Cause Of Infections In Diabetic T

H, who had come into the emergency department two days prior for diabetic ketoacidosis (DKA) and was diagnosed with type 1 diabetes. The Mayo Clinic explains that diabetic ketoacidosis occurs when the body cannot produce insulin. Insulin is the key that allows glucose to enter cells, and provide the cells with energy. Without glucose for energy, the body begins to breakdown fats that produce harmful substances known as ketones. DKA is characterized by hyperglycemia, metabolic acidosis and ketones in the urine, (2017). That had since resolved, so for the most part of the day me and the secondary nurse were providing diabetic education. She was educated on the use of the glucometer, how to give insulin injections, and symptoms of hypoglycemia, I felt confident in this education and was surprised by how much I remembered from previous lectures. I did not have time to provide teaching on diet, exercise induced hypoglycemia, or patient specific teaching based upon her report, because we switched our roles. I can see how education can get swept under the rug in practice when you are so busy throughout the day. Instead of saving education until the end of the day, when I become a new nurse I will make sure I am taking advantage of every patient encounter as an opportunity to educate. Later in the simulation, when I had transitioned roles, Ms. H experienced a hypoglycemic episode after receiving a dose of insulin and not consuming any of her breakfast. According to Silvestri, hypoglycemia is often caused by the following, too much insulin, too little food, or excessive activity (2014, p. 653). In Dr. Johanson’s lectures I learned that carbohydrates are the main source of energy for the body and are metabolized to form glucose for the body to use. When there is no consumption of carbohydrates, there is no glucose and this results in low blood glucose known as hypoglycemia. A type 1 diabetic lacks the ability to make insulin, which is the key that

Ketosis is the metabolic state that most of the body's energy supply comes from ketone bodies in the blood, contrasting to the state of glycolysis in which blood glucose provides most of the energy (Taubes, 2011, 140-141). Ketosis might be better known as acetone breath, a common symptom of progressing diabetes mellitus type. It is characterized by serum concentrations of ketone bodies, with low and stable levels of insulin and blood glucose. It is commonly generalized with hyper-ketonemia, which is an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis as the liver glycogen stores are depleted (Taubes, 2011, p.155). The ketone bodies used for energy are acetoacetate and beta-hydroxybutyrate, with that, the levels of ketone bodies are regulated mainly by glucagon and insulin (p.156). Most cells can then be used by both glucose and ketone bodies for fuel, and during ketosis, free fatty acids and glucose synthesis fuel the rest.

The blood glucose level has very limited range for humans to survive and stay healthy. Generally, people are able to remove excess glucose rapidly from the body but this is not the case when they are diagnosed with diabetes and insulin resistant situations. The lack of insulin resistance can also lead to a decrease in glycogen synthesis and storage as it usually converts glucose to energy for cell’s use (Jensen & et al. 2011). When insulin is produced under insulin resistance, the cells are incapable of using them effectively which then leads to high blood sugar level as ketones and ketoacids are produced as an alternative energy source for the body. The rise of ketoacid causes the blood pH acidic and the patient may also be diagnosed with ketoacidosis (Newton & Raskin 2004). There would also be less intake of lipid and more of stored triglycerides as the lipids are effected by the insulin. As the glucose levels increase, the muscle glucose uptake will decrease while the liver glucose production and blood fatty acid concentration will also increase within the body (Lichtenstein & Schwab 2000). Excess glucose within the blood are converted to fat which can lead to Diabetic Dyslipidaemia and furthermore to obesity, hypertension and

“Diabetes is a silent killer” (Demille 2005, p.5). It is a metabolic disorder that can result in impaired quality of life and serious complications. This study aims to understand the case of Mr. Skyler Hanson who is newly diagnosed with Diabetes Mellitus Type 1 that leads to diabetic ketoacidosis which was confirmed by the presence of moderate to high ketones in the urine and a high blood glucose level. It was noted that he has a history of fatigue, headache, abdominal pain, nausea and frequent urination. Furthermore, it was disclosed that he has difficulty in adjusting to his diagnosis and he occasionally missed administration of insulin dose when socialising. Subsequently, he was admitted in the Critical Care Unit for rehydration,

Diabetes Mellitus is a growing issue for health care providers internationally. The World Health organization estimated in 2013 there were 347 Million diabetics worldwide, predicting that Diabetes will be the 7th leading cause of death by 2030 (WHO, 2013). In both type 1 and type 2 diabetes Mellitus, factors such as poor compliance with diet and medication, infection, acute medical or surgical illness or trauma can lead to poor glycaemic control, precipitating a hyperglycaemic emergency such as Diabetic Ketoacidosis (DKA) (Scobie & Samaras, 2009). In Type 2 Diabetes, another equally dangerous

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

During one of my rotations, I was assigned a young adult patient who had run out of insulin and had been admitted to the hospital following a Diabetes Ketoacidosis (DKA) episode. I realized that my patient was probably torn between buying insulin and buying healthy food because her chart showed several admissions in the

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

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).

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.

The patient in this study was repeatedly seen in the unexpected emergency department so they local hospital. These trips to the hospital caused several hospital admissions for verified diabetic ketoacidosis. These admissions were inevitably the result of voluntarily not using any dosages of her insulin, to which she at some point confessed.

Diabetic Ketoacidosis, also known as DKA or Diabetic acidosis, is an acute, major, and potentially life-threatening complication in people with diabetes. It can also lead to diabetic coma or even death if a person passed out for a long time. It happens more commonly in people with type I diabetes, aka diabetes insipidus, but it can also occur in people with type II diabetes, aka diabetes mellitus. It is also more common in African, African-American, and Hispanic people. Diabetic ketoacidosis occurs in 4.6-8.0 per 1000 people with type I diabetes annually. It occurs when your body has too much levels of blood acids called ketones. High level of ketones can poison the human body. The condition develops when a body is unable to get the sugar the body needs because the it is not producing enough insulin. Insulin plays a vital part in the metabolism of the body, it helps glucose enter the cells. If the body does not have sufficient insulin, the body starts to break down fats and muscles as fuel instead. This can lead to a buildup of ketones in the bloodstream, causing chemical imbalance called diabetic ketoacidosis if left untreated. Diabetic ketoacidosis is sometimes the first sign of type 1 diabetes in people who have never been diagnosed before. For people who have already been diagnosed with type 1 diabetes, a serious illness, surgery, infection, or not using insulin the proper way can lead to DKA. Diabetic ketoacidosis is a medical emergency that needs to be addressed

I enjoyed reading your discussion post about diabetes ketoacidosis (DKA). Working in an emergency room we unfortunately see many patients that are in DKA or have poor control of his or her glucose level and insulin administration. As you stated it is vital to treat the underlining condition that is causing the patient’s blood glucose to be elevated and causing the patient to go into DKA. Treating the underlying condition in turn will help treat the DKA; however it is still vital to give the patient fluids and insulin as well. The fluids will help to keep the patient from being dehydrated as well as decrease to blood glucose level. The insulin can be given either subcutaneous or intravenous depending on how elevated the glucose level is. In addition, the patient may be placed on an insulin drip to help decrease the blood glucose level. As you stated there are many electrolyte disturbance that are present in DKA, which is one of the reasons to give intravenous fluids to help correct it. Potassium is found to be elevated when the patient is in diabetic ketoacidosis, so there would be no need to replace this electrolyte, the health care provider would want to decrease this electrolyte level (Gillespie & Campbell, 2002, p. 14). The

Diabetic ketoacidosis is a potentially life threatening complication found patient who have diabetes mellitus.. Most often DKA, is the first presenting symptom in undiagnosed diabetics, illness in diabetics, and/or poor compliance with insulin therapy. Diabetic Ketoacidosis Is an event marked by shortage of insulin production, thus the body breaks down fat into ketone bodies to compensate for needed energy production. The lack of insulin is compensated with increased glucagon levels from the liver, osmotic diuresis occurs in which high glucose levels are excreted thought the kidneys leading to polyuria, dehydration, and polydipsia. The ketone bodies cause the body to become acidotic, the bicarbonate buffering system become overworked and hyperventilation (Kussmaul respirations), this allows carbon dioxide to be released. This is when symptoms become apparent, most often the patient will have vomiting, confusion, polyphagia, polydipsia, polyuria, hyperventilation, abdominal pain, fruity breath and occasionally coma. DKA is diagnosed by blood and urine test. The blood test will show an elevated Hemoglobin A1c; metabolic acidosis: plasma pH under 7.35, plasma bicarbonate under 15 mEq/L, elevated blood sugar above 250 mg/dL, abnormal sodium, chloride levels, hyperkalemia. Urine test will show elevated ketones, and glucose.

The most common symptoms of diabetes mellitus are chronic elevated blood glucose level. Glycosuria is a condition in which the kidneys excrete increased glucose as they are unable to reabsorb the excess amount. This leads to fluid and electrolyte excretion which leads to electrolyte imbalance and dehydration. Loss of glucose leads to increase in the use of fats and protein for the energy, which leads to accumulation of ketone bodies in the blood which leads to ketoacidosis (could be fatal).