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Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. [1] Signs and symptoms may include vomiting , abdominal pain , deep gasping breathing , increased urination , weakness, confusion and occasionally loss of consciousness . [ 1 ]
Moreover, certain medications prescribed for different conditions have the potential to cause HHS. [13] [15] As with DKA, urgent medical treatment is necessary, commonly beginning with fluid volume replacement. [8] On the whole, HHS is a medical emergency marked with hyperglycemia, hyperosmolarity, dehydration, and mild or no ketosis. [15]
The most common cause of ketoacidosis is a deficiency of insulin in type 1 diabetes or late-stage type 2 diabetes. This is called diabetic ketoacidosis and is characterized by hyperglycemia, dehydration and metabolic acidosis. Other electrolyte disturbances such as hyperkalemia and hyponatremia may also be present.
The first, and perhaps most perplexing, cause of dehydration in older adults is a lack of thirst. ... People with Alzheimer's disease or dementia are also at ... 37% of men and women age 65 and ...
The mainstay of physiologic ketotic hypoglycemia treatment typically includes management of the underlying cause, fluid resuscitation, and dietary supplementation of sugars and carbohydrates. [2] Alanine is a direct precursor in gluconeogenesis and can be used for treatment of ketotic hypoglycemia.
The major differential diagnosis is diabetic ketoacidosis (DKA). In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL). [6] Metabolic acidosis is absent or mild. [6] A temporary state of confusion (delirium) is also more common in HHS than DKA. HHS also tends to affect older people more.
In fasting adults, blood plasma glucose should not exceed 7 mmol/L or 126 mg/dL. Sustained higher levels of blood sugar cause damage to the blood vessels and to the organs they supply, leading to the complications of diabetes. [48] Chronic hyperglycemia can be measured via the HbA1c test. The definition of acute hyperglycemia varies by study ...
As oral rehydration is less painful, non-invasive, inexpensive, and easier to provide, it is the treatment of choice for mild dehydration. [45] Solutions used for intravenous rehydration may be isotonic,hypertonic, or hypotonic depending on the cause of dehydration as well as the sodium concentration in the blood. [46]