Diabetic Ketoacidosis: A Beginners Guide | Zyla Health

 Being a diabetic, you might know that the cause of diabetes is related to insulin and if your blood sugar levels are on a higher side for a long time, it can impact your other organs especially kidneys, eyes and nervous system.

But everybody doesn’t know that lack of insulin can also cause Diabetic Ketoacidosis (DKA). It is a serious complication that occurs mostly in patients with Type 1 Diabetes.

It is caused by the production of an excess amount of “ketones” which causes the blood to become acidic. These ketones are produced because the body starts to break down fat for producing energy instead of glucose.

In this blog, we’re going to discuss everything that you need to know about Diabetic Ketoacidosis including its diagnosis, prevention and treatment.

What is Diabetic Ketoacidosis (DKA)?

Your body needs the energy to function. On the cellular level, the fuel for the energy is glucose which we get from the food that we eat. The glucose is transported from blood to body cells using a hormone called insulin.

In a diabetic body, insulin isn’t available or isn’t able to function. So, glucose absorption doesn’t happen. As a result, glucose starts floating in the blood causing ‘high levels of sugar in the blood (high sugar). Plus, the body cells do not get the required glucose for energy.

Watch this video by Zyla Health to understand Diabetic Ketoacidosis: Causes, Symptoms, Diagnosis, and Treatment.

So a diabetic body starts looking for another source of energy in the form of fats. However, when fats break down for energy, it produces a waste product i.e. an acid known as ketones. When it exceeds certain limits, it causes Diabetic Ketoacidosis.

The 3 ketone bodies formed are:

• Acetone
• Beta-hydroxy butane
• Acetoacetate

Let’s move on and discuss the causes and symptoms of Diabetic Ketoacidosis so that preventive measures or treatment can be taken on time.

Diabetic Ketoacidosis causes

As mentioned earlier, DKA is more commonly observed in patients with Type 1 diabetes rather than type 2 diabetes and here are some common Diabetic Ketoacidosis causes:

1. Uncontrolled diabetes
2. Missing meals or long gap between meals
3. Missing insulin dose
4. Patient on an insulin pump and non-functional insulin pump
5. High levels of stress.
6. Infection in the body that keeps coming back

To know how stress and diabetes are related, read our blog “Stress, meditation and diabetes”.

Diabetic Ketoacidosis symptoms

The symptoms of DKA spring up quickly. Sometimes, it can happen within 24 hours. If you’re seeing some of the following signs in a diabetic patient, you must see a doctor quickly.

1. Vomiting and pain in the abdomen: Ketones are acidic in nature. High levels of ketones make the blood acidic and as a result, causes vomiting. In some patients, it may also cause abdominal pain.
2. Dehydration, dry mouth (thirst) and frequent urination: With high levels of sugar and ketones, the body works extra to throw out excess glucose through urine. It results in the removal of too much water from the body.

In this case, the body absorbs water from cells to maintain water balance in the blood which causes cells to dehydrate. This in turn, makes the patient feel thirsty and tend to drink more water.

1. Rapid breathing or breathlessness: Whenever the blood becomes acidic, the lungs start inhaling air faster to get more oxygen. Since carbon dioxide causes an acidic state, breathing more oxygen can make it less acidic.
2. Fruity breath or acetone like smell from the mouth: With high levels of ketones, the breath smells like acetone (can be similar to nail paint remover) or pear-like.

Other severe complications can be developed such as increased heart rate (due to increased breathing) and confusion (due to lack of glucose in the brain).

If the cause of DKA is an infection, the patient may experience fever, chills, cough, and cold along with other symptoms.

What are the complications if it is left untreated?

If not treated at an early stage, DKA can be life-threatening as it can lead to:

1. Swelling in the brain: This can further lead to a severe complication known as diabetic coma.
2. Kidney Failure: With too much glucose in the blood, our body throws it out of the body through urine which leads to loss of sodium and potassium in the body and dehydration. Due to dehydration, blood flow to the kidney is decreased and leads to renal failure.
3. Heart Failure: Loss of sodium and potassium, dehydration, swelling and fast heartbeats put extra pressure on the heart and may cause cardiac arrest or heart attack.

Now that you know the basics of Diabetic Ketoacidosis, let’s see how it is diagnosed and what can be done to prevent and treat it…

How is Diabetic Ketoacidosis diagnosed?

Here are some ways to diagnose diabetic ketoacidosis quickly:

1. Urine test: When ketones in our blood rise, they are thrown out of the body through urine. Hence, a urine test will be able to detect the presence of ketones. If the urine report is showing “nil” that means it is a normal result.
2. Blood test: In a blood test, the amount of ketones are measured. Two common types of ketones produced by breaking down fats are “beta-hydroxy butane” and “acetoacetate”. If levels of these rises, their amount can be measured in the blood.

Normal blood ketone level is 0.21–2.81 mg/dl. More than this is high and it indicates management of diabetes and ketone levels.

The more the amount of ketones in the blood, the more severe is diabetic ketoacidosis.

1. Arterial blood gas: Arterial blood gas measures two components — blood pH & bicarbonate levels. In diabetic ketoacidosis, low bicarbonate levels and low pH (less than 7.3) is observed.
2. Electrolytes test: With extra glucose, our body throws it out through urine which leads to loss of sodium and potassium. Low sodium and potassium levels are used to confirm diabetic ketoacidosis.
3. Kidney function test: Due to dehydration, blood flow to the kidney is decreased and leads to acute renal failure which causes disturbed kidney function tests.

Insulin should be taken on time to manage blood sugar levels

Who is at risk?

Following conditions increase the risk to develop diabetic ketoacidosis:

1. Type 1 diabetes: Patients with Type 1 Diabetes are more prone to develop diabetic ketoacidosis than patients with Type 2 Diabetes due to no insulin production.
2. History of heart disease or a history of heart attack
3. Pancreatitis (inflammation in the pancreas) or disease of the pancreas as it further impacts insulin production
4. Stroke
5. Alcohol intake or drug abuse
6. Certain medications

Can one prevent Diabetic Ketoacidosis?

Despite all the risks and complications, diabetic ketoacidosis can be avoided with certain measures and by taking good care of yourself. It’s important that you follow your diabetes treatment plan and ask your diabetes treatment team for help when you need it.

Follow these guidelines in order to prevent DKA:

1. Take your diabetes medicines as prescribed by your doctor. Avoid skipping it.
2. Eat small meals every 2–3 hours to manage blood sugar levels. Avoid long meal gaps.
3. Avoid all fried, outside, processed and packaged food.
4. Drink 10–12 glasses of water throughout the day.
5. Adjust your insulin units as per your blood sugar levels and keep your doctor updated.
6. Measure your sugar levels at home with a glucometer at least 2–3 times a week.
7. Talk to your doctor once every three months for a medicinal review.
8. If you are suffering from an infection, measure your sugar levels and if they are consistently high, consult your doctor.
9. Get regular tests done to know the status of other diseases that may be caused by diabetes.
10. Follow a healthy lifestyle that includes modifications in your diet and physical activity.

Taking insulin at the right time is important for the management of diabetes

Diabetic Ketoacidosis treatment

Here are ways in which your doctor can choose diabetic ketoacidosis treatment for you, depending on the severity.

1. Fluid therapy: Since DKA causes water loss, it is important to maintain a good amount of water intake and hence, saline water is given through IV.
2. Management of blood sugar levels: Since DKA is caused by high sugar, insulin should be administered (when potassium levels rise above 3.3).
3. Potassium therapy: DKA causes hypokalemia which means low potassium levels and hence, potassium levels have to be maintained.
4. Bicarbonate therapy: DKA is associated with acidic blood, bicarbonate is given to restore the pH of the blood.

Eat healthy food without delaying or skipping, being physically active, taking medicines on time and lastly, managing stress levels will help in managing your blood sugar levels.

This, in turn, will help in preventing Diabetic Ketoacidosis and other complications of diabetes.

If you have high blood sugar levels, it is important for you to have proper diabetes treatment to improve your health and live a happy life. And Zyla provides you with exactly that.

Zyla offers holistic management of diabetes and its complications through a team of 50+ medical experts. We work on lifestyle management through nutrition, exercises and medicines review.

You can download the Zyla app now to start your health journey!

For more information, you can visit here

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Ageing & Bone Diseases

Skeletons in your closet is a well-known phrase. Just like you shouldn’t keep your thoughts bottled up to keep your mental health at its best, you should also take care of your bone health by regularly visiting your Orthopedician when you start ageing.

When we used to see the famous skeleton hanging in our biology lab, we never thought it serves so many purposes in our bodies.

Functions of Bones:

1. Provide a frame that supports our body on which muscles, tendons, and ligaments attach. It will be difficult to move if our body didn’t have bones. Just like Earthworms.
2. Protect vital organs of our body like, the skull protects the brain and our ribs guard the heart and lungs against external injury
3. Spongy bones present at the end of our long bones (arms and legs) contain bone marrow that produces our blood cells and platelets
4. They are made of a honeycomb-like structure that stores minerals like calcium and phosphorus
5. Bones also have a lesser-known function. They help us to maintain pH of the blood by releasing or absorbing alkaline (basic) minerals
6. They are a reservoir of calcium and can increase levels of calcium in the blood by releasing stored calcium or decrease its levels by absorbing it

How do Bones Function and Form?

Until we turn 30, our body ensures that an equal amount of old bones are being removed as the new ones are forming. After a certain age, when levels of sex hormones in males and females start decreasing, the formation of new bones gets slower. Lastly, the rate of removal of old bones is higher than the formation of new bones.

Factors affecting the decline in bone mass in combination with Aging:

1. Alternate levels of hormones
2. Nutrition: Consuming a low Calcium and Vitamin D diet
3. Lack of physical activity
4. Comorbid medical conditions like malnutrition, mineral disorders, and anaemia
5. Certain medicines such as steroids, and medicines used to treat female sterility
6. Female gender: When females reach menopause, estrogen levels in the body get low which increases bone resorption (breaking down old bones), and reduce forming new bones and overall, bone loss is sped up.
7. Smoking: It causes hormonal imbalances which cause the development of co-morbid conditions, and bone loss

The most common bone disease related to ageing is osteoporosis, followed by osteoarthritis, Rheumatoid Arthritis, and Osteomalacia. Due to bone loss, the bone becomes fragile which causes them to break easily, joints become painful and stiff, movement becomes slow or limited, and strength of muscles reduces. Also, the pattern of walking gets slower and shorter which causes difficulty in walking which causes tiredness on walking even for a small distance.

Prevention of Ageing-related Bone Diseases:

1. Consume a diet rich in calcium which includes yoghurt, green leafy vegetables, tofu, milk, and curd
2. Consume a diet rich in Vitamin D which includes eggs, mushrooms, and milk. Seafood such as tuna, oysters, and salmon is also abundant in Vitamin D
3. Perform regular physical activity
4. Get a regular bone mineral density test so that early intervention can take place
5. Get levels of calcium and Vitamin D checked and take supplements (under the physician’s advice) if you are deficient.

There are no symptoms associated with bone disease and hence, it goes unnoticed but it increases the risk of fracture which restricts movement and may result in various conditions, including Deep Vein Thrombosis.

Manage your health and reduce the chances of the development of health-related complications. Download the Zyla app (http://bit.ly/2BftxyE-defeatingdiabetes) for continuous monitoring and personalised care.

For more information, you can visit here

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How to manage Diabetes and Emotional Health | Zyla Health

Diabetes has long been a tough battle to fight for those affected by it. It changes a person’s life to a great extent. We know that it has many effects on a person’s physical health, but we need to know more about its effects on the emotional and mental well-being of a person.

More than 80 million people in India are suffering from diabetes and most of them often wonder, “how to manage diabetes?”. You can find a lot of things on searching and but less on how to cope up with it emotionally!

So in this blog, I decided to discuss some tips to manage diabetes, the emotional impacts of living with diabetes as well as the right way on how to manage your diabetes.

But first things first. Let’s know a little bit about diabetes

What is Diabetes?

Diabetes Mellitus is a chronic, metabolic disease caused by an increase in the level of sugar (glucose) in the blood. It causes severe damage to the heart, eyes, kidneys and nerves over a long period of time.

Living with diabetes affects not only the body but also the mind. Physicians are mainly concerned with the physical aspects of the disease and even though they are important, mental health is equally essential.

Being a diabetic, you should not neglect your emotional and mental well-being but learn to control your diabetes. Keep reading to find answers to all your questions about how to manage diabetes and your emotional health.

Dealing with finding out that you have Diabetes

The first major blow you get is when you find out that you have high blood sugar levels for quite some time, resulting in being diagnosed as a diabetic. This news could cause a wide range of unpleasant emotions because you might feel that there is no going back from it.

You might wonder, “How to manage diabetes?”, “How to control diabetes?” or majorly, “How to cure diabetes?”

For a personalised treatment under the guidance of experienced doctors, you can download Zyla app. See more details on our website- Zyla.in

At the time of diagnosis, you undergo a series of feelings that have been studied and seem to form a pattern. The following stages of emotions are experienced:

• Denial

Upon receiving news such as being diagnosed with diabetes, the first emotion that you experience is denial. You may oppose believing in the diagnosis at first and take it lightly. An important factor for denial could be the fact that you do not feel any major physical symptoms or complications at that time. This denial prevents you from taking the disease seriously and seeking proper treatment with necessary lifestyle changes right from the beginning.

• Anger

Once you cannot deny your current condition, you start feeling frustrated and angry towards the disease. You start hating your own selves for having developed this condition and overthink why this happened to you.

The negative emotional reaction to diabetes further worsens the condition.

• Guilt

From anger and irritation, you get into a feeling of guilt i.e. a feeling that arises when you think that you have done something wrong to your body. These feelings often arise when you have many responsibilities.

You feel guilty about not taking care of your health before and how this development would affect your ability to manage your responsibilities.

You get worried about the people around you and how diabetes would affect the entire family.

• Sorrow/ depression

With time, the guilt feeling changes to a feeling of loss and sadness. There might be an increase in symptoms like fatigue, loss of appetite, loss of interest in daily activities and changes in sleep pattern.

This is the stage of sorrow or depression wherein you feel sad about your condition. Without searching for ways of how to manage your diabetes, you fall prey to sadness. This may last a while and affect your mental well-being deeply.

• Acceptance

The last and final stage is that of acceptance. It may take up to a year or more for you to accept your diagnosis completely.

It’s important for you to have patience, emotional support from others, a proper understanding of it and how to manage diabetes to finally arrive at this stage.

Once you have accepted your current situation, you can move ahead and take the necessary steps on how to manage your diabetes and make the best of your life even with diabetes.

You may feel confused, sad and upset about it and it’s normal. It is hard to escape these emotions. But letting go of these feelings after a while would be a healthy thing for both your mind and body.

There are several ways to cope with these emotions. Here’s what you can do to ease them:

• Gain information

Learning about your condition i.e. learning about how you can manage your diabetes and being prepared with the right information will give you power over the disease. You will look at solutions rather than problems.

• Plan your days

Planning and following a healthy routine can do wonders for your emotional health. Every task done right will make you feel in control. Eating healthy food, exercising and some other productive activities will help you get a better mindset.

• Journaling

Maintaining a diary is a great coping mechanism. It will help you organise your thoughts and release your negative emotions to find a positive reaction to them.

• Socialise

Talking to your friends, family or even a therapist will help you cope. Having a chronic condition like diabetes can make you feel alone and out of place but it’s not the end of the world. Talk to the people you love and thus you can try to control your diabetes!

Talk to our experts on mental health and learn how to manage your diabetes by downloading our Zyla app. See more details on our website- Zyla.in

Emotional journey throughout Diabetes

Along with the physical effects of diabetes, you can suffer from certain feelings like anxiety, depression, and diabetes distress. Let’s talk about it:

• Anxiety

Diabetes or no diabetes, we live in a state of fear and worry. But if this fear and anxiety affect our work, relationships, and daily life then it is a cause of concern. Especially if you’re diabetic, you may worry extra about your condition in addition to the everyday struggles.

Certain symptoms like constant worrying, feeling nervous, inability to relax, increased heartbeat, sweating, trembling, chest tightness, and upset stomach, lasting for more than 2 weeks can indicate a problem of anxiety. It should be addressed and treated immediately to control your diabetes.

• Depression

Everyone feels sad once in a while but depression is a serious condition with the constant feeling of hopelessness and fatigue. If you’ve been feeling the sadness harder than ever for more than 2 weeks, you might be depressed. Start working on it.

• Diabetes distress

This medical term has been created recently by some doctors specifically for diabetics to refer to a condition when you’re tired of dealing with your diabetic state along with life’s other responsibilities.

It’s only natural to feel this way because diabetes comes with several more responsibilities in your daily life.

Diabetic distress is something more than just worry. It’s when you’re feeling all the anxiety, depression, frustration, stress and other emotions all at once.

Want to know more about how stress, diabetes and meditation are related? Read our blog — Stress, meditation and diabetes.

How to improve your emotional health and control your diabetes?

Emotional health MUST NOT be neglected at any cost. As much as your physical health is important in diabetes, emotional health is as essential.

You should address any and all emotions you’re feeling and seek help at the earliest and focus on how to manage your diabetes. To take better care of yourself emotionally, you can try the following:

• Maintain healthy habits

A healthy body is better known to handle stress. Develop and maintain healthy habits like eating healthy meals, avoiding caffeine, nicotine and alcohol.

It may seem difficult at first to turn around your lifestyle but the trick is to do it step by step.

Setting small goals for each day can encourage you to make this shift. For example, cut down from 4 to 3 cups of tea in a day and then eventually to 2. You may even be able to quit it in a matter of time.

• Regular exercise

A simple walk in the park, gym, yoga or even dancing are some ways you can release those “feel-good” hormones in your body.

Physical activity for 30–45 minutes a day not only makes you feel good but also increases the insulin sensitivity in your body and helps you control your diabetes.

If you don’t have much time to exercise, give a quick read to our blog, “Simple home exercise routine for a healthier you” for easy movements to add to your everyday regime.

• Adequate sleep

Sleep can solve a lot more problems than you think. Having a nightly routine and getting proper sleep will help you feel refreshed. It re-energizes your body and mind to face a new day head-on.

• Setting goals

Be mindful of your present condition and set the bar accordingly. Setting unrealistic goals can lead to a feeling of disappointment which has a negative impact on your state of mind.

So set achievable and realistic goals and do not hesitate to ask for help if you need it.

• Mindfulness

Meditation and deep breathing can be great ways to soothe your mind. Practising meditation or deep breathing for 15 minutes a day can have a beneficial effect on your mental health.

• Reward yourself

Don’t forget to treat yourself every now and then for achieving your goals, or just for the fun of it. Trust me, you deserve it.

• Therapy

Although diabetes affects one person physically, mentally it can affect the family as a whole. Family therapy could be a good option to get through a difficult time together.

• Join support groups

Talking and discussing your feelings with other people going through the same thing may help you find a positive outlook and be strong. It is good to share your feelings with a bunch of people who may be going through the same things.

• Be grateful

Try to count your blessings and be thankful for all that you have, and not what you don’t.

You are not alone! Many people are experiencing highs and lows in their blood sugar levels and find it difficult to cope with the disease emotionally. As important as physical health is, maintaining your emotional health should be a priority too.

There is help available for anyone who needs it. Following the advice given above and just keep going to find the good in life, even without sugar, may help in the long run. Remember, it may seem hard but diabetes is NOT the end.

At Zyla, we have a team of Doctors, nutritionists, psychologists and physiotherapists who provide personalised care and treatment to improve your diabetes and overall health.

Start your health journey today by downloading our Zyla app.

If you know more about, this visit here

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