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Article from Diabetes UK

24 Nov 2007 21:30 #284 by david
david created the topic: Article from Diabetes UK
Diabetic Ketoacidosis

In the short term, consistent high blood glucose levels can lead to a condition called diabetic ketoacidosis (DKA). This happens because of a lack of glucose entering the cells where it can be used as energy. The body begins to use stores of fat as an alternative source of energy, and this in turn produces an acidic by-product known as ketones.

Ketones are very harmful and the body will immediately try to get rid of them by excreting them in urine. Consequently, when ketones are present and blood glucose levels are rising, people often become increasingly thirsty as the body tries to flush them out. If the level of ketones in the body continues to rise, ketoacidosis develops (ketoacidosis means acidity of the blood, due to an excess of ketones in the body). Their harmful effect becomes more apparent, and nausea or vomiting may start. In addition, the skin may become dry, eyesight blurred and breathing deep and rapid.

Unfortunately, because of vomiting, the body becomes even more dehydrated and less efficient at flushing out the ketones, allowing levels to rise even faster. As the level of ketones rise, it may be possible to smell them on the breath - often described as smelling like pear drops or nail varnish. Eventually, if untreated, the level of ketones will continue to rise and, combined with high blood glucose levels, a coma will develop which can be fatal. However, at any of these intermediate stages, ketoacidosis can be treated and damage usually limited. Obviously, the sooner, the better.

Anyone who relies on insulin injections could develop ketoacidosis. This includes everyone with Type 1 diabetes and people with Type 2 who control their diabetes with insulin injections. In exceptionally rare cases, people controlling their diabetes with diet or tablets have been known to develop ketoacidosis when severely ill.

The high-risk time for developing ketoacidosis is when a person is unwell, as part of the body's response to illness and infection is to release more glucose into the bloodstream, and to stop insulin from working properly. This happens even if the person loses their appetite or goes off food altogether. During periods of illness, even if you are not eating, insulin is still needed and it is important never to stop taking your insulin. You should do more frequent blood glucose testing. Diabetes UK recommends that you test at least four times a day during periods of illness. Ask your care team for help if you are worried.

Ketones are easily detected by a simple urine test, using strips available on prescription. People with diabetes should test their urine for ketones if their blood glucose is high (usually over 15mmol/l) or if they have any symptoms of ketoacidosis. If an individual discovers high levels of ketones in their urine (the test strips will tell you if levels are high), and especially if their blood glucose levels are high, they should call their doctor or diabetes specialist nurse immediately, or go to their nearest casualty department.

The original article can be found at:
Link: Diabetes UK

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28 Nov 2007 05:58 #300 by TheFastDoctor
TheFastDoctor replied the topic: Re:Article from Diabetes UK
There's a lot of truth in this article, but it is UTTER NONSENSE to blankly state that \"ketones are harmful\".. they are after all the bulk of energy supply when the sugars run out! The fact that ketones are lost in the urine is coincidental, NOT a way of trying to get rid of a \"toxin\".

Only if there's a very high concentration of ketones, together with a high concentration of blood sugar, is the osmolar balance under threat. And this happens only in diabetics anyway. Yet with expert and experienced supervision, all classes of diabetics can fast succesfully and with excellent results. Most of my type 1 patients find a considerably reduced insulin need after a fast of even as short as 3-4 days.

NO ONE can lose (fat) weight without producing and using ketones.

Such a pity that a small part of truth can become so twisted and taken out of context to raise false alarms.

All my posts are "generic", based on my opinions and experiences only and are not intended to replace the advice of your own licensed medical practitioner.

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