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Hyperosmolar state

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https://www.readbyqxmd.com/read/28738911/sentinel-visits-in-emergency-department-patients-with-diabetes-mellitus-as-a-warning-sign-for-hyperglycemic-emergencies
#1
Justin W Yan, Katherine M Gushulak, Melanie P Columbus, Alexandra L Hamelin, George A Wells, Ian G Stiell
OBJECTIVES: Patients with poorly controlled diabetes mellitus may have a sentinel emergency department (ED) visit for a precipitating condition prior to presenting for a hyperglycemic emergency, such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). This study's objective was to describe the epidemiology and outcomes of patients with a sentinel ED visit prior to their hyperglycemic emergency visit. METHODS: This was a 1-year health records review of patients≥18 years old presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, DKA, or HHS...
July 25, 2017: CJEM
https://www.readbyqxmd.com/read/28734951/emergency-department-management-of-diabetic-ketoacidosis-and-hyperosmolar-hyperglycemic-state-national-survey-of-attitudes-and-practice
#2
Alexandra L Hamelin, Justin W Yan, Ian G Stiell
OBJECTIVES: In 2013, the Association, now Diabetes Canada, published national clinical practice guidelines for the effective management of diabetic ketoacidosis and hyperosmolar hyperglycemic states in adults. We sought to determine emergency physician compliance rates and attitudes toward these guidelines and to identify potential barriers to their use in Canadian emergency departments. METHODS: An online survey consisting of questions related to the awareness and use of the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada was distributed to 500 randomly selected members of the Canadian Association of Emergency Physicians...
July 19, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28710307/is-it-safe-to-acutely-discontinue-insulin-therapy-in-patients-with-chronic-hyperglycaemia-starting-glp-1r-agonists
#3
Julie Omolola Okiro, Catherine Mc Hugh, Abuelmagd Abdalla
We report two patients with chronic hyperglycaemia secondary to type 2 diabetes who developed severe vomiting on d. The first patient was diagnosed with a mixed picture of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) and the second, with DKA. They were on insulin therapy which was discontinued on commencing d because of inefficacy and weight gain. The HHS patient developed dehydration secondary to vomiting and had lactic acidosis but no other precipitant could be found in either case...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28702883/risk-factors-for-recurrent-emergency-department-visits-for-hyperglycemia-in-patients-with-diabetes-mellitus
#4
Justin W Yan, Katherine M Gushulak, Melanie P Columbus, Kristine van Aarsen, Alexandra L Hamelin, George A Wells, Ian G Stiell
BACKGROUND: Patients with poorly controlled diabetes mellitus may present repeatedly to the emergency department (ED) for management and treatment of hyperglycemic episodes, including diabetic ketoacidosis and hyperosmolar hyperglycemic state. The objective of this study was to identify risk factors that predict unplanned recurrent ED visits for hyperglycemia in patients with diabetes within 30 days of initial presentation. METHODS: We conducted a 1-year health records review of patients ≥18 years presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, diabetic ketoacidosis, or hyperosmolar hyperglycemic state...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28690939/central-diabetes-insipidus-and-hyperglycemic-hyperosmolar-state-following-accidental-carbon-monoxide-poisoning
#5
Zain Ul Abideen, Syed Nayer Mahmud, Amna Rasheed, Yusaf Farooq Qasim, Furqan Ali
Carbon monoxide poisoning is common and carries significant morbidity and mortality. The nervous system, particularly the brain, is frequently affected by it, owing to its high metabolic activity and oxygen requirements. Carbon monoxide damages the nervous system by both hypoxic and inflammatory mechanisms. Central diabetes insipidus is an extremely rare complication of carbon monoxide poisoning. Herein, we report the case of a young lady, who developed this complication and severe hypernatremia after accidental carbon monoxide poisoning...
June 3, 2017: Curēus
https://www.readbyqxmd.com/read/28685515/predetermined-anti-diabetic-drug-regimen-adjustments-during-ramadan-fasting-an-observational-study-of-safety
#6
Abdallah M Beano, Mohammad A Zmaili, Zaid H Gheith, Ahmad M Naser, Munther S Momani, Al Motassem F Yousef, Ayman A Zayed
BACKGROUND: Many Muslim type 2 diabetes mellitus (T2DM) patients choose to fast the month of Ramadan despite the possible adverse health effects brought about by the change in dietary habits, among other things. Clinical data regarding the safety of multi-drug regimens during fasting are particularly scarce. The aim of the study was to evaluate the safety of a drug protocol devised by the authors to accommodate Ramadan's dietary changes, involving dose adjustments of four anti-diabetic drug regimens in T2DM patients fasting Ramadan...
June 2017: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28646357/management-of-hyperglycemia-and-diabetes-in-the-emergency-department
#7
REVIEW
Justin B Echouffo-Tcheugui, Rajesh Garg
PURPOSE OF REVIEW: Hyperglycemia in the emergency department (ED) is being recognized as a public health problem and presents a clinical challenge. This review critically summarizes available evidence on the burden, etiology, diagnosis, and practical management strategies for hyperglycemia in the ED. RECENT FINDINGS: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are hyperglycemic emergencies that commonly present to the ED. However, the most common form of hyperglycemia in ED is associated with non-hyperglycemic medical emergencies...
August 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28640151/a-case-report-of-hyperosmolar-hyperglycemic-state-in-a-7-year-old-child-an-unusual-presentation-of-first-appearance-of-type-1-diabetes-mellitus
#8
Young Min Cho, Byung Sung Park, Min Jae Kang
RATIONALE: A hyperosmolar hyperglycemic state (HHS) is a rare presentation of a hyperglycemic crisis in children with diabetes mellitus. As this condition can be fatal and has high morbidity, early recognition and proper management are necessary for a better outcome. Here, we report a rare case of HHS as the first presentation of type 1 diabetes mellitus (T1DM) in a 7-year-old girl. PATIENT CONCERNS: The patient was admitted due to polyuria and weight loss in the past few days...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28593362/hepatocyte-nuclear-factor-1%C3%AE-maturity-onset-diabetes-of-the-young-in-a-chinese-child-presenting-with-hyperglycemic-hyperosmolar-state
#9
Yue Luo, Zhijuan Dai, Liyi Li, Xiaoou Shan, Chaoming Wu
No abstract text is available yet for this article.
June 8, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28580075/role-of-vasopressin-in-current-anesthetic-practice
#10
REVIEW
Keun Suk Park, Kyung Yeon Yoo
Arginine vasopressin (AVP), also known as antidiuretic hormone, is a peptide endogenously secreted by the posterior pituitary in response to hyperosmolar plasma or systemic hypoperfusion states. When administered intravenously, it causes an intense peripheral vasoconstriction through stimulation of V1 receptors on the vascular smooth muscle. Patients in refractory shock associated with severe sepsis, cardiogenic or vasodilatory shock, or cardiopulmonary bypass have inappropriately low plasma levels of AVP ('relative vasopressin deficiency') and supersensitivity to exogenously-administered AVP...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28571661/-evaluation-and-perioperative-management-of-patients-with-diabetes-mellitus-a-challenge-for-the-anesthesiologist
#11
REVIEW
João Paulo Jordão Pontes, Florentino Fernandes Mendes, Mateus Meira Vasconcelos, Nubia Rodrigues Batista
Diabetes mellitus (DM) is characterized by alteration in carbohydrate metabolism, leading to hyperglycemia and increased perioperative morbidity and mortality. It evolves with diverse and progressive physiological changes, and the anesthetic management requires attention regarding this disease interference in multiple organ systems and their respective complications. Patient's history, physical examination, and complementary exams are important in the preoperative management, particularly glycosylated hemoglobin (HbA1c), which has a strong predictive value for complications associated with diabetes...
May 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28570329/endocrine-emergencies-with-neurologic-manifestations
#12
Makoto Ishii
PURPOSE OF REVIEW: This article provides an overview of endocrine emergencies with potentially devastating neurologic manifestations that may be fatal if left untreated. Pituitary apoplexy, adrenal crisis, myxedema coma, thyroid storm, acute hypercalcemia and hypocalcemia, hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state), and acute hypoglycemia are discussed, with an emphasis on identifying the signs and symptoms as well as diagnosing and managing these clinical entities...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28431304/-diabetic-striatopathy-and-ketoacidosis-report-of-two-cases-and-review-of-literature
#13
Liza Das, Rimesh Pal, Pinaki Dutta, Anil Bhansali
"Diabetic striatopathy" is characterized by dyskinesias with basal ganglia hyperintensities on neuroimaging. It is usually reported in elderly females with hyperglycemic hyperosmolar state and rare in patients with diabetic ketoacidosis. Here, we report two young males with diabetic ketoacidosis presenting as striatopathy, along with review of literature.
April 9, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28372715/management-of-hyperglycemic-crises-diabetic-ketoacidosis-and-hyperglycemic-hyperosmolar-state
#14
REVIEW
Maya Fayfman, Francisco J Pasquel, Guillermo E Umpierrez
Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are the most serious and life-threatening hyperglycemic emergencies in diabetes. DKA is more common in young people with type 1 diabetes and HHS in adult and elderly patients with type 2 diabetes. Features of the 2 disorders with ketoacidosis and hyperosmolality may coexist. Both are characterized by insulinopenia and severe hyperglycemia. Early diagnosis and management are paramount. Treatment is aggressive rehydration, insulin therapy, electrolyte replacement, and treatment of underlying precipitating events...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28364357/treatment-of-diabetic-ketoacidosis-dka-hyperglycemic-hyperosmolar-state-hhs-novel-advances-in-the-management-of-hyperglycemic-crises-uk-versus-usa
#15
REVIEW
Ketan K Dhatariya, Priyathama Vellanki
PURPOSE OF REVIEW: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies that cause high morbidity and mortality. Their treatment differs in the UK and USA. This review delineates the differences in diagnosis and treatment between the two countries. RECENT FINDINGS: Large-scale studies to determine optimal management of DKA and HHS are lacking. The diagnosis of DKA is based on disease severity in the USA, which differs from the UK...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28326628/incidence-recurrence-and-cost-of-hyperglycaemic-crises-requiring-emergency-treatment-in-andalusia-spain
#16
R J Barranco, F Gomez-Peralta, C Abreu, M Delgado-Rodriguez, A Moreno-Carazo, F Romero, M A de la Cal, J M Barranco, F J Pasquel, G E Umpierrez
AIMS: Hyperglycaemic crises (diabetic ketoacidosis and hyperosmolar hyperglycaemic state) are medical emergencies in people with diabetes. We aimed to determine their incidence, recurrence and economic impact. METHODS: An observational study of hyperglycaemic crises cases using the database maintained by the out-of-hospital emergency service, the Healthcare Emergency Public Service (EPES) during 2012. The EPES provides emergency medical services to the total population of Andalusia, Spain (8...
March 22, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28324468/ascariasis-and-hyperosmolar-hyperglycemic-state-a-surprising-ultrasound-finding-in-the-emergency-department
#17
Giles N Cattermole, Jean-Paul Nzabandora
BACKGROUND: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS. CASE PRESENTATION: A 26-year-old Rwandan man was admitted to the emergency department in coma, with a glycemia of 600 mg/dl. He was resuscitated with fluids, intubated and ventilated, and treated with insulin and antibiotics...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28255151/abdominal-wall-necrotising-fasciitis-a-rare-but-devastating-complication-of-the-percutaneous-endoscopic-gastrostomy-procedure
#18
M R Mohd Said, R Abdul Rani, R A Raja Ali, C S Ngiu
Percutaneous Endoscopic Gastrostomy (PEG) tubes were often offered to patients requiring long term enteral feeding. Even though the procedure is relatively safe, it is associated with various complications such as peritonitis or even death.1 We presented a case of a 54-year-old gentleman with underlying ischemic stroke and pus discharges from a recently inserted PEG tube. Computed Topography (CT) scan confirmed abdominal wall necrotising fasciitis complicated with hyperosmolar hyperglycaemia state (HHS) and later succumbed after 48 hours of admission...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28145211/-fatal-cerebral-oedema-during-the-treatment-of-diabetic-ketoacidosis-in-an-adult-male
#19
T J A Dekker, J A Janson, E J Hoorn, Y W J Sijpkens
Diabetic ketoacidosis is relatively common, but the optimal treatment of this condition is still controversial. Cerebral oedema is a rare, but potentially fatal complication. We present the case of an adult patient who presented with de novo diabetic ketoacidosis that was complicated by cerebral oedema during treatment. In this article we discuss factors that may have played a role in the development of this complication. A prolonged hyperosmolar state in diabetic ketoacidosis may increase the risk of cerebral oedema as a result of cerebral compensatory mechanisms...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28112005/hemichorea-caused-by-nonketotic-hyperosmolar-state-a-case-report-and-review-of-the-literature
#20
Hafiz Khuram Raza, Jia Jing, Guiyun Cui, Xiaoqian Liang, Fang Hua, Zunsheng Zhang, Hai Tang, Hongjuan Shi, Hao Chen
Our report involves a case of hemichorea caused by the nonketotic hyperosmolar state. We have analyzed the clinical data and relevant features of a patient who presented herself to the Affiliated Hospital of Xuzhou Medical University. The patient had unilateral involuntary movements for 1 month. We discovered that her blood glucose levels were very high. The patient underwent computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA), indicating right basal ganglia lesion...
March 2017: Somatosensory & Motor Research
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