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[IP] Re: Question regarding DKA

>From Peter Chase's book:

Q: Why does someone feel sick when the ketones are moderate or large in the
urine or >0.6 mmol/L in the blood?
A: There are at least three parts to the answer to this question:
1. The bodys acid-base (pH) balance is finely tuned (a bit on the basic
side at 7.35-7.45). Acids and bases are difficult to explain. Examples of a
base and an acid are: soap is an alkaline (base) material and tomatoes are
acidic. Ketones (which are acids) make the body fluids more acidic as they
start to build up. As the body becomes more acidic, many of the bodys
functions can no longer work as they should. If left untreated, death will
eventually follow.
2. The second reason a person feels ill is because of a potassium and sodium
imbalance. They are important body salts, and are lost with ketones going
out in the urine. Potassium is important for the movement of the intestine
(moving food through). If too much potassium is lost, this movement
decreases or stops. When this happens, an upset stomach and vomiting can
occur. We often recommend orange juice (high in potassium) and apple juice
in addition to water when someone has urine or blood ketones. Drinking lots
of liquids helps to keep good hydration and to flush out the ketones.
3. Poor hydration would be the third reason for feeling ill. Usually
frequent urination due to high blood and urine sugar happen together with
urine ketones. This can lead to dehydration. Our bodies are 60% water. If
even 10% of body weight is lost as water, it is possible to be very sick.
Fluids can also be lost in large amounts with the flu (vomiting and
diarrhea). If fluid is being lost in large amounts from both the kidneys
(frequent urination) and from vomiting and/or diarrhea, dehydration can
occur even more rapidly. Children under the age of five, can become
dehydrated in less than four hours. They are more likely to require IV
treatment sooner than older children.

Barbara, Mum of Claire 9
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