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A 2004 statement by the European Society for Paediatric Endocrinology and the Lawson Wilkins Pediatric Endocrine Society (for children) uses slightly different cutoffs, where mild DKA is defined by pH 7.20–7.30 (bicarbonate 10–15 mmol/L), moderate DKA by pH 7.1–7.2 (bicarbonate 5–10) and severe DKA by pH<7.1 (bicarbonate below 5).
If the patient is known to have diabetes, the diagnosis of diabetic ketoacidosis is usually suspected from the appearance and a history of 1–2 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal a high blood sugar level and severe metabolic acidosis .
Type 2 diabetes is different in that it is usually caused by insulin resistance in the body in older patients leading to beta cell burnout over time, and is not prone to DKA. KPD is a condition that involves DKA like type 1, but occurs later in life and can regain beta cell function like type 2 diabetes.
Dementia of the Alzheimer's type, with early onset, with delirium: Included only in the DSM-IV. 290.12: Dementia of the Alzheimer's type, with early onset, with delusions: Included only in the DSM-IV. 290.13: Dementia of the Alzheimer's type, with early onset, with depressed mood: Included only in the DSM-IV. 294.10: Dementia of the Alzheimer's ...
[1] [2] Breath may also develop the smell of acetone as it is a volatile ketone that can be exhaled. Rapid deep breathing, or Kussmaul breathing, may be present to compensate for the metabolic acidosis. [1] Altered mental status is more common in diabetic than alcoholic ketoacidosis. [2]
Diabetic ketoacidosis (DKA) is one of the life-threatening severe complications of diabetes that demands immediate attention and intervention. [7] It is considered a medical emergency and can affect both patients with T1D (type 1 diabetes) and T2D (type 2 diabetes), but it is more common in T1D. [8]
Emil Kraepelin (1856–1926). The Kraepelinian dichotomy is the division of the major endogenous psychoses into the disease concepts of dementia praecox, which was reformulated as schizophrenia by Eugen Bleuler by 1908, [1] [2] and manic-depressive psychosis, which has now been reconceived as bipolar disorder. [3]
This state can be either physiologic or pathologic; physiologic ketotic hypoglycemia is a common cause of hypoglycemia in children, often in response to stressors such as infection or fasting. [1] Pathologic ketotic hypoglycemia is typically caused by metabolic defects, such as glycogen storage disorders .