Vegetarian and Vegan Diets in Type 2 Diabetes Management - Research Paper Example

Download file to see previous pages Emphasis was placed on clinical manifestations of diabetic ketoacidosis, its diagnosis, and treatment. Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus that can be life-threatening if not treated properly. Once thought to occur only in patients with type 1 diabetes, diabetic ketoacidosis has also been observed in patients with type 2 diabetes under certain conditions. The basic underlying mechanism for diabetic ketoacidosis is insulin deficiency coupled with elevated levels of counterregulatory hormones, such as glucagon, cortisol, catecholamines, and growth hormone. Diabetic ketoacidosis can be the initial presentation of diabetes mellitus or precipitated in known patients with diabetes mellitus by many factors, most commonly infection.

The management of diabetic ketoacidosis involves careful clinical evaluation, correction of metabolic abnormalities, identification and treatment of precipitating and co-morbid conditions, appropriate long-term treatment of diabetes, and plans to prevent a recurrence. Many cases of DKA can be prevented by better access to medical care, proper education, and effective communication with a health care provider during intercurrent illness. The provision of guidelines will also reduce mortality. Resources need to be redirected towards prevention by funding better access to care and educational programs.

Abstract
DIABETIC KETOACIDOSIS AND THE HYPERGLYCEMIC hyperosmolar state are the most serious complications of diabetic decompensation and remain associated with excess mortality. Insulin deficiency is the main underlying abnormality. Associated with elevated levels of counterregulatory hormones, insulin deficiency can trigger hepatic glucose production and reduced glucose uptake, resulting in hyperglycemia, and can also stimulate lipolysis and ketogenesis, resulting in ketoacidosis. Both hyperglycemia and hyperketonemia will induce osmotic diuresis, which leads to dehydration. Clinical diagnosis is based on the finding of dehydration along with high capillary glucose levels with or without ketones in the urine or plasma. The diagnosis is confirmed by the blood pH, serum bicarbonate level, and serum osmolality. Treatment consists of adequate correction of dehydration, hyperglycemia, ketoacidosis, and electrolyte deficits.

Diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state (HHS) appear as 2 extremes in the spectrum of diabetic decompensation.1 They remain the most serious acute metabolic complications of diabetes mellitus and are still associated with excess mortality. Because the approach to the diagnosis and treatment of these hyperglycemic crises are similar, we have opted to address them together. ...Download file to see next pages Read More