(224) Diabetes: Diabetic ketoacidosis

[HB KIM]

DIABETIC KETOACIDOSIS

DEFINITION
Diabetic ketoacidosis (DKA) is a life-threatening complication in patients with untreated diabetes mellitus (chronic high blood sugar or hyperglycemia). Near complete deficiency of insulin and elevated levels of certain stress hormones combine to cause DKA. DKA is more common among Type I diabetics, but may also occur in Type II diabetics generally when physiologically stressed, such as during an infection. Patients with new, undiagnosed Type I diabetes frequently present to hospitals with DKA. DKA can also occur in a known diabetic who fails to take prescribed insulin. DKA was a major cause of death in Type I diabetics before insulin injections were available; untreated DKA has a high mortality rate.

SIGNS AND SYMPTOMS
-Sluggish, extreme tiredness.
-Fruity (Ketone) smell to breath/compare to nail polish remover, similar to peardrops.
-Extreme thirst, despite large fluid intake.
-Constant urination
-Extreme weight-loss.
-Oral Thrush may be present, or/ yeast infections that fail to go away
-Muscle wasting.
-Agitation / Irritation / Aggression / Confusion


PATTERNS AND FORMULAS

1. HEAT ENTERS PC
thirst, drinking lots of water, unclear mental status, delirious speech, ketone smell in breathing, red tongue, dry coating, thready rapid pulse

Shi Gao  30-45g
Zhi Mu  18g
Zhi Gan Cao  6g
Geng Mi  18g


2.  YIN DEFICIENCY LEADING WIND
thirst with drinking lots of water, copious urination, dry skin, increased wrinkles

Zhi Gan Cao  18g
Sheng Di Huang  18g
Bai Shao  18g
Mai Men Dong  15g
E Jiao  9g
Huo Ma Ren  9g
Mu Li  15g
Bie Jia  24g
Gui Ban  30g


3. EXTREME YIN DEFICIENCY
thirst, drinking lots of water, extreme fatigue, difficult breathing, unclear mental status, red tongue, dry coating, faint pulse

Ren Shen  9-15g
Mai Men Dong  9-12g
Wu Wei Zi  3-6g


4. EMPIRICAL FORMULA: Benefit Qi/Yin, Clear Heat
Huang Qi  20g
Sheng Di  15g
Shan Yao  15g
Xuan Shen  17.5g
Huang Qin  7.5g
Huang Lian  7.5g
Chuan Xiong  7.5g
Huang Bai  7.5g
Chi Shao  7.5g
Cang Zhu  10g
Zhi Zi  10g
Fu Ling  10g
Dang Gui  10g
Mu Li  25g