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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] A person's breath may develop a specific "fruity" smell. [1]
Emergency treatment can come into effect within hours in case of diabetic hyperosmolar syndrome. Treatment involves intravenous fluids to replenish hydration-reducing plasma, intravenous insulin to lower blood sugar levels, and intravenous potassium and sodium to replace the lost electrolytes which are essential for cell function, as insulin will force some electrolytes into the cell.
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.
A confirmed diagnosis has seven elements: 1) a decreased effective serum osmolality – <275 mOsm/kg of water; 2) urinary sodium concentration high – over 40 mEq/L with adequate dietary salt intake; 3) no recent diuretic usage; 4) no signs of ECF volume depletion or excess; 5) no signs of decreased arterial blood volume – cirrhosis ...
The DKA is diagnosed by the urine analysis which will reveal significant levels of ketone bodies (which have exceeded their renal threshold blood levels to appear in the urine, often before other overt symptoms). And also venous blood investigation for electrolytes, glucose, and acid-base status.
Signs and symptoms of diabetic ketoacidosis may include: [citation needed] Ketoacidosis; Kussmaul hyperventilation (deep, rapid breathing) Confusion or a decreased level of consciousness; Dehydration due to glycosuria and osmotic diuresis; Increased thirst 'Fruity' smelling breath odor; Sweet sensation that is felt into the mouth without a reason
In fact, there’s one nutrient that Dr. Weil says post-menopausal women need less of: iron. “After menopause, women no longer bleed every month with their periods, so their iron levels are higher.
A low serum osmolality will suppress the release of ADH, resulting in decreased water reabsorption and more concentrated plasma. Syndrome of inappropriate ADH secretion occurs when excessive release of antidiuretic hormone results in inappropriately elevated urine osmolality (>100 mOsmol/L) relative to the blood plasma, leading to hyponatraemia.