Differential effects of fasting and dehydration in the pathogenesis of diabetic ketoacidosis

Burge, Mark R.; Garcı́a, Noemı́; Qualls, Clifford; Schade, David S.

doi:10.1053/meta.2001.20194

Cited by 57 publications

(57 citation statements)

References 14 publications

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“…There does seem to be some evidence of a link between habitual fluid intake and cancers of the bladder (Michaud et al, 1999), and colon (Shannon et al, 1996). Links with other disease states, including diabetes and cardiovascular disease have also been postulated, but the evidence is somewhat tenuous (Burge et al, 2001;Chan et al, 2002). It is also the case that individuals with a high fluid intake may be chronically hypohydrated if they also have a high water requirement, so water turnover may not be a good index of tissue hydration status (Shirreffs & Maughan, 1998).…”

Section: Hydration Status and Wellnessmentioning

confidence: 99%

Impact of mild dehydration on wellness and on exercise performance

2003

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Chronic mild dehydration is a common condition in some population groups, including especially the elderly and those who participate in physical activity in warm environments. Hypohydration is recognised as a precipitating factor in a number of acute medical conditions in the elderly, and there may be an association, although not necessarily a causal one, between a low habitual fluid intake and some cancers, cardiovascular disease and diabetes. There is some evidence of impairments of cognitive function at moderate levels of hypohydration, but even short periods of fluid restriction, leading to a loss of body mass of 1-2%, lead to reductions in the subjective perception of alertness and ability to concentrate and to increases in self-reported tiredness and headache. In exercise lasting more than a few minutes, hypohydration clearly impairs performance capacity, but muscle strength appears to be relatively unaffected.

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Section: Hydration Status and Wellnessmentioning

confidence: 99%

Impact of mild dehydration on wellness and on exercise performance

2003

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“…During these times of decreased caloric intake, patients with diabetes who continue taking sufficient amounts of insulin may maintain euglycemia, but are unable to stop the ketone body formation and can present with DKA with only mild elevations of blood glucose or even relative normoglycemia 2,6,7 . In cases of prolonged fasting, near total glycogen depletion contributes to the normoglycemia as metabolic acidosis continues to develop 8,9 .…”

Section: Discussionmentioning

confidence: 99%

Starvation-induced True Diabetic Euglycemic Ketoacidosis in Severe Depression

et al. 2008

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“…This type of euglycaemic, or lower than expected, hyperglycaemic ketoacidosis has previously been described. [34][35][36] In the cases described to date, blood glucose levels have not been consistently reported. The lowest reported level was 5 mmol/L and 13 cases have been reported with levels below 10 mmol/L.…”

Section: Pathophysiologymentioning

confidence: 99%

“…26,[29][30][31][32][33] Lower than expected hyperglycaemia in SGLT-2 inhibition associated with DKA may be a result of a combination of factors including partial treatment of DKA, fasting or carbohydrate avoidance, dehydration, alcohol consumption and glycosuria. 34,35 Presentation Presentation of DKA in these patients is usually typical with classical symptoms and high glucose levels. However, some reported cases have presented with lower than expected hyperglycaemia.…”

Section: Pathophysiologymentioning

confidence: 99%