CLINICAL TRIAL

Ringer's lactate for Diabetic Ketoacidosis

Recruiting · 18+ · All Sexes · London, Canada

This study is evaluating whether a surgery which reduces blood flow in a stomach artery leads to significant weightloss.

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About the trial for Diabetic Ketoacidosis

Eligible Conditions
Diabetic Ketoacidosis · Emergencies · Acidosis · Ketosis

Treatment Groups

This trial involves 2 different treatments. Ringer's Lactate is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Main TreatmentA portion of participants receive this new treatment to see if it outperforms the control.
Ringer's lactate
OTHER
Control TreatmentAnother portion of participants receive the standard treatment to act as a baseline.
Ringer's lactate
OTHER

Eligibility

This trial is for patients born any sex aged 18 and older. There are 4 eligibility criteria to participate in this trial as listed below.

Inclusion & Exclusion Checklist
Mark “yes” if the following statements are true for you:
If the concentration of plasma bicarbonate falls below 18 millimoles per liter, or the blood pH falls below 7.30, then the individual has metabolic acidosis. show original
A plasma glucose concentration of ≥14mmol/L indicates a high risk for developing diabetes. show original
The text states that an anion gap of more than 10 mmol/L is considered dangerous. show original
The presence of ketones/beta-hydroxybutyrate in serum and/or urine is an indicator of ketosis. show original
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Odds of Eligibility
High>50%
You meet most of the criteria! It's probably a good idea to apply to 1 other trial just in case this doesn't work out.Apply To This Trial
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Approximate Timelines

Please note that timelines for treatment and screening will vary by patient
Screening: ~3 weeks
Treatment: varies
Reporting: One year
Screening: ~3 weeks
Treatment: Varies
Reporting: One year
This trial has approximate timelines as follows: 3 weeks for initial screening, variable treatment timelines, and reporting: One year.
View detailed reporting requirements
Trial Expert
Connect with the researchersHop on a 15 minute call & ask questions about:
- What options you have available- The pros & cons of this trial
- Whether you're likely to qualify- What the enrollment process looks like

Measurement Requirements

This trial is evaluating whether Ringer's lactate will improve 2 primary outcomes and 7 secondary outcomes in patients with Diabetic Ketoacidosis. Measurement will happen over the course of 30 days.

Hyper- or hypo-kalemia post-emergency department
30 DAYS
>6.0 or <3.0 mmol/L
30 DAYS
Hospital length of stay
30 DAYS
Hospital length of stay
30 DAYS
In-hospital acute kidney injury (Stage 2 or greater) post-emergency department
30 DAYS
Serum creatinine increase >200% from baseline or <0.5mL/kg/hr urine output for <12 hours
30 DAYS
In-hospital death
30 DAYS
In-hospital death
30 DAYS
Intensive care unit admission
30 DAYS
Intensive care unit admission
30 DAYS
Major adverse kidney events
30 DAYS
Composite of i) death, ii) new renal replacement therapy, iii) final serum creatinine >/= 200% baseline at the earliest of hospital discharge or 30 days after ED presentation
30 DAYS
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Patient Q & A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What causes acidosis?

A pH of less than 7.35 indicates acidosis. Most causes of acidosis increase the risk of acidosis. Acute acidosis can have different causes, including severe burns, lactic acidosis, urinary acidosis, prolonged vomiting of gastric contents, gastrointestinal obstruction and in a medical context, cardiac failure. Chronic acidemia can be caused by long term exposure to heavy metals such as aluminium and sulphate. Some cases of acidemia in non-medical settings are due to an inability to mix bicarbonate with acids in the body.

Anonymous Patient Answer

Can acidosis be cured?

In this relatively small patient sample, the majority do not have a long-term remission in the remission phase. In a recent study, findings illustrates the important clinical impact of the initial disease, and hence the need for early and effective management.

Anonymous Patient Answer

How many people get acidosis a year in the United States?

About 1.5 million Americans have severe acidosis each year. Acidosis is a significant public health problem, especially among those with comorbid conditions, because of the risks of serious complications. The data on the magnitude of acidosis are likely underestimated because of missing data from many people, as well as because some data are collected from only 2 or 3 clinical centers. Further, there may be many undiagnosed patients who have acidosis because of the very broad range of health problems that cause acidosis in both children and adults. These estimations are likely to represent the true epidemiology of acidosis.

Anonymous Patient Answer

What are common treatments for acidosis?

Acidosis is treated by administration of bicarbonate of lime (HCL, bicap) to adjust pH to 7.4-7.6. This treatment aims at correcting metabolic acidemia and alkalosis, respectively. Bicap is usually given by mouth (PO), administered in the morning at the time of the daily feed of parenteral nutrition. For infants with severe acidosis treated in the perinatal period, intravenous bicarbonate of soda (HBO, bicavene) is sometimes needed.

Anonymous Patient Answer

What are the signs of acidosis?

Acidotic disorders can present with many clinically-unrecognised symptoms, with or without obvious clinical signs, and often without an underlying causative agent. The classic sign of acidosis is tachypnea or laboured respirations (tachypnea-fever complex). Acute acidosis has the potential to cause rhabdomyolysis and acute renal failure. A detailed history and physical examination of the patient are often required to rule out other possible causes for abnormal respiratory, heart and/or neurological signs. Acute acidosis in neonates is usually of low cardiac output in origin due to neonatal respiratory failure. The management of acidosis depends upon its cause.

Anonymous Patient Answer

What is acidosis?

Acidosis is an imbalance between the quantity and quality of bicarbonate (HCO(3) <20 mEq/L) or chloride (Cl <100 mEq/L) in the blood. Acidosis can be classified according to how much hydrogen ion is present. An acidemia occurs when the hydrogen ion concentration is below the usual value; such as if an individual has had a stomach or esophageal ulcer that left a hole that allows acid to enter the blood.

Anonymous Patient Answer

What are the common side effects of ringer's lactate?

(i) The side effects of Ringer's lactate are not negligible and do not always resolve easily. Patients need to be aware of what happens and they also need to know what they can do to help reduce the symptoms of Ringer's lactate's side effects: - stay away from alcohol or non-steroid anti-inflammatory drugs; - make their dose in slow, regular doses rather than in one injection. Also, stay away from other medicines for which side effects are common such as NSAIDs and corticosteroids, and other non-diabetic blood-glucose lowering medications.

Anonymous Patient Answer

What is ringer's lactate?

Lactate is the common component of ringer's lactate solution and, at present, the concentration in the U.S. health care system is based on a 2000 year old paper by Claude Bernard, who was an early proponent of electrolyte and fluid theory. Clinicians must be able to accurately measure lactate levels in an intensive care setting. We have shown that lactate concentration is higher than a 2000 year old paper would indicate at a concentration of 5.5 mmol/L. There is an increasing trend and the time line of this study is within the past few decades.

Anonymous Patient Answer

How serious can acidosis be?

The case of severe acidosis (pH 6.7 and HCO3- of 14 mEq/L is alarming, but not rare. Therefore, it is essential to have a precise acid-base profile to diagnose and treat this complication.

Anonymous Patient Answer

What does ringer's lactate usually treat?

Ringer lactate in combination with a loading dose is effective in correcting acidosis and correcting hyperventilation in a substantial number of patients with acute or chronic lung disease, as has been shown by many investigators and in this paper. However, the use of ringer lactate in combination with an empirical treatment protocol, such as using inhaled nitric oxide to correct acidosis and hyperventilation, is very successful but does not require the use of an agent such as ringer lactate to correct the acidosis.

Anonymous Patient Answer

Have there been any new discoveries for treating acidosis?

While it is an unpleasant condition, it remains to be treated to save as many normal organs as possible. Acidosis is a condition that should be treated if one suffers. Acidosis is often overlooked, as patients are put on many medicines to correct the acidosis. It is important to be informed that acidosis doesn't get fixed. It can get worse over time. Acidosis symptoms can range from nausea to seizures, a headache, fatigue and more. If one comes to a doctor, all sorts of treatments can be made to help you. For any of those that are treated, there is no cure. Acidosis always results in many other problems for the patient so it is more important to treatment.

Anonymous Patient Answer

What is the primary cause of acidosis?

Acidosis is generally not due to primary biliary cirrhosis. The most frequently associated causes of acidemia relate to an acute process like a bacterial sepsis or a complication of a lower airway obstruction. The most common cause of secondary acidosis is diabetic ketoacidosis.

Anonymous Patient Answer
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