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Ketoacidosis

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https://www.readbyqxmd.com/read/28737266/nephrolithiasis-a-complication-of-pediatric-diabetic-ketoacidosis
#1
Sungeeta Agrawal, Robin Kremsdorf, Serife Uysal, Meghan E Fredette, Lisa Swartz Topor
OBJECTIVE: To determine the frequency of nephrolithiasis as a complication of diabetic ketoacidosis (DKA) in pediatrics. METHODS: We performed a retrospective chart review of patients with DKA admitted to a pediatric hospital between January 2009 and July 2016. We identified patients with nephrolithiasis during admission for DKA. RESULTS: We identified 395 episodes of DKA over 7.5 years. Nephrolithiasis developed as a complication of DKA in 3 of those admissions (0...
July 24, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28736981/ketoacidosis-and-sglt2-inhibitor-treatment-analysis-of-faers-data
#2
Jenny E Blau, Sri Harsha Tella, Simeon I Taylor, Kristina I Rother
BACKGROUND: Regulatory agencies have concluded that sodium glucose cotransporter 2 (SGLT2) inhibitors lead to ketoacidosis, but published literature on this point remains controversial. METHODS: We searched the FDA Adverse Event Reporting System (FAERS) for reports of acidosis in patients treated with canagliflozin, dapagliflozin, or empagliflozin (from the date of each drug's FDA approval until May 15, 2015). We compared the number of SGLT2 inhibitor-related reports to reports of acidosis in patients treated with the two most commonly used DPP4 inhibitors: sitagliptin and saxagliptin...
July 24, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28734951/emergency-department-management-of-diabetic-ketoacidosis-and-hyperosmolar-hyperglycemic-state-national-survey-of-attitudes-and-practice
#3
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/28733691/pancreatic-panniculitis-sans-pancreatitis-in-a-patient-with-diabetic-ketoacidosis
#4
Wei Liang Koh, Yong Kwang Tay, Victor Wl Ng
No abstract text is available yet for this article.
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28731823/maternal-fetal-outcomes-in-34-pregnant-women-with-type-1-diabetes-in-sensor-augmented-insulin-pump-therapy
#5
Ana María Gómez, Lisseth Fernanda Marín Carrillo, Carol M Arévalo Correa, Oscar Mauricio Muñoz Velandia, Martín Alonso Rondón Sepúlveda, Jaime Luis Silva Herrera, Diana Cristina Henao Carrillo
BACKGROUND: Pregnancy in women with type 1 diabetes (T1D) is associated with increased risk of maternal complications and neonatal morbidity and mortality. Optimizing glycemic control improves these outcomes. OBJECTIVE: To describe the experience of using sensor-augmented insulin pump therapy (SAPT) and SAPT + low-glucose suspension (LGS) on pregnant women with T1D, including neonatal and maternal outcomes. METHODS: A prospective observational study was conducted in women with T1D who started SAPT and SAPT + LGS before or during pregnancy at the San Ignacio University Hospital Diabetes Center in Bogotá, Colombia...
July 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28727175/the-cost-of-treating-diabetic-ketoacidosis-in-the-uk-a-national-survey-of-hospital-resource-use
#6
K K Dhatariya, C Skedgel, R Fordham
AIM: Diabetic ketoacidosis is a commonly encountered metabolic emergency. In 2014, a national survey was conducted looking at the management of diabetic ketoacidosis in adult patients across the UK. The survey reported the clinical management of individual patients as well as institutional factors that teams felt were important in helping to deliver that care. However, the costs of treating diabetic ketoacidosis were not reported. METHODS: We used a 'bottom up' approach to cost analysis to determine the total expense associated with treating diabetic ketoacidosis in a mixed population sample...
July 20, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28726122/beta-ketothiolase-deficiency-presenting-with-metabolic-stroke-after-a-normal-newborn-screen-in-two-individuals
#7
Monica H Wojcik, Klaas J Wierenga, Lance H Rodan, Inderneel Sahai, Sacha Ferdinandusse, Casie A Genetti, Meghan C Towne, Roy W A Peake, Philip M James, Alan H Beggs, Catherine A Brownstein, Gerard T Berry, Pankaj B Agrawal
Beta-ketothiolase (mitochondrial acetoacetyl-CoA thiolase) deficiency is a genetic disorder characterized by impaired isoleucine catabolism and ketone body utilization that predisposes to episodic ketoacidosis. It results from biallelic pathogenic variants in the ACAT1 gene, encoding mitochondrial beta-ketothiolase. We report two cases of beta-ketothiolase deficiency presenting with acute ketoacidosis and "metabolic stroke." The first patient presented at 28 months of age with metabolic acidosis and pallidal stroke in the setting of a febrile gastrointestinal illness...
July 20, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28721220/severe-diabetic-ketoacidosis-complicated-by-hypocapnic-seizure
#8
A Majid, B J Wheeler
In clinical practice, seizures independent of hypoglycemia are observed in patients with type 1 diabetes mellitus (T1DM) more frequently than expected by chance, suggesting a link. However, seizures during management of diabetic ketoacidosis (DKA) have generally been considered a bad prognostic factor, and usually associated with well-known biochemical or neurological complications. We present the case of a 17-year-old girl with known T1DM managed for severe DKA complicated by hypocapnic seizure. We review the literature on this rare occurrence as well as outline other possible differentials to consider when faced with the alarming combination of DKA and seizure...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28720552/autoimmune-limbic-encephalitis-associated-with-type-1-diabetes-mellitus
#9
Onur Akın, Aylin Kılınç Uğurlu, Emine Demet Akbaş, Esra Döğer, Yılmaz Akbaş, Aysun Bideci, Özge Yüce, Kıvılcım Gücüyener, Orhun Çamurdan, Neşe Karabacak, Peyami Cinaz
Glutamic acid decarboxylase (GAD) antibodies can participate in the pathogenesis of both type 1 diabetes mellitus (T1DM) and limbic encephalitis (LE). However, an association between T1DM and LE is very rare. We report a patient who was diagnosed with type 1 diabetes mellitus six months after encountering limbic encephalitis. A 16-year-old boy was admitted with behavioral changes, confusion, and headache. He was diagnosed with LE. Anti-GAD levels were high. He was treated with pulse methylprednisolone. During the steroid treatment, neurological symptoms improved but hyperglycemia occurred...
July 17, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28712629/the-prime-diabetes-model-novel-methods-for-estimating-long-term-clinical-and-cost-outcomes-in-type-1-diabetes-mellitus
#10
William J Valentine, Richard F Pollock, Rhodri Saunders, Jay Bae, Kirsi Norrbacka, Kristina Boye
BACKGROUND: Recent publications describing long-term follow-up from landmark trials and diabetes registries represent an opportunity to revisit modeling options in type 1 diabetes mellitus (T1DM). OBJECTIVES: To develop a new product-independent model capable of predicting long-term clinical and cost outcomes. METHODS: After a systematic literature review to identify clinical trial and registry data, a model was developed (the PRIME Diabetes Model) to simulate T1DM progression and complication onset...
July 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28711468/effect-of-initiating-use-of-an-insulin-pump-in-adults-with-type-1-diabetes-using-multiple-daily-insulin-injections-and-continuous-glucose-monitoring-diamond-a-multicentre-randomised-controlled-trial
#11
Roy W Beck, Tonya D Riddlesworth, Katrina J Ruedy, Craig Kollman, Andrew J Ahmann, Richard M Bergenstal, Anuj Bhargava, Bruce W Bode, Stacie Haller, Davida F Kruger, Janet B McGill, William Polonsky, David Price, Elena Toschi
BACKGROUND: The benefit of initiation of insulin pump therapy (continuous subcutaneous insulin infusion; CSII) in patients with type 1 diabetes using continuous glucose monitoring (CGM) has not been studied. We aimed to assess glycaemic outcomes when switching from multiple daily injections (MDI) to CSII in adults with type 1 diabetes using CGM. METHODS: In this multicentre, randomised controlled trial, 75 adults with type 1 diabetes in the CGM group of the DIAMOND trial were randomly assigned via the study website using a computer-generated sequence to continue MDI or switch to CSII, with continuation of CGM, for 28 weeks...
July 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28710307/is-it-safe-to-acutely-discontinue-insulin-therapy-in-patients-with-chronic-hyperglycaemia-starting-glp-1r-agonists
#12
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/28704103/postprandial-dosing-of-bolus-insulin-in-patients-with-type-1-diabetes-a-cross-sectional-study-using-data-from-the-t1d-exchange-registry
#13
Anne Peters, Michelle A Van Name, Brian Larsen Thorsted, Johanne Spanggaard Piltoft, William V Tamborlane
OBJECTIVE: To assess the prevalence and characteristics of patients with type 1 diabetes who dose bolus insulin postprandial (PostP) versus preprandial (PreP). METHODS: Data for this cross-sectional study were obtained from 21,533 participants in the T1D Exchange registry. Data were drawn from the enrollment questionnaire. Patients who dosed 'immediately before meal' or 'several minutes before meal' were classified as PreP. Patients who dosed 'during meal' or 'after meal' were classified as PostP...
July 13, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28702883/risk-factors-for-recurrent-emergency-department-visits-for-hyperglycemia-in-patients-with-diabetes-mellitus
#14
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/28695457/the-role-of-laboratory-testing-in-differentiating-type-1-diabetes-from-type-2-diabetes-in-patients-undergoing-bariatric-surgery
#15
Scott J Pilla, Nisa M Maruthur, Michael A Schweitzer, Thomas H Magnuson, James J Potter, Jeanne M Clark, Clare J Lee
BACKGROUND: It may be difficult to distinguish between adults with type 1 diabetes and type 2 diabetes by clinical assessment. In patients undergoing bariatric surgery, it is critical to correctly classify diabetes subtype to prevent adverse perioperative outcomes including diabetic ketoacidosis. This study aimed to determine whether testing for C-peptide and islet cell antibodies during preoperative evaluation for bariatric surgery could improve the classification of type 1 versus type 2 diabetes compared to clinical assessment alone...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28695376/heterozygous-carriers-of-succinyl-coa-3-oxoacid-coa-transferase-deficiency-can-develop-severe-ketoacidosis
#16
Hideo Sasai, Yuka Aoyama, Hiroki Otsuka, Elsayed Abdelkreem, Yasuhiro Naiki, Mitsuru Kubota, Yuji Sekine, Masatsune Itoh, Mina Nakama, Hidenori Ohnishi, Ryoji Fujiki, Osamu Ohara, Toshiyuki Fukao
Succinyl-CoA:3-oxoacid CoA transferase (SCOT, gene symbol OXCT1) deficiency is an autosomal recessive disorder in ketone body utilization that results in severe recurrent ketoacidotic episodes in infancy, including neonatal periods. More than 30 patients with this disorder have been reported and to our knowledge, their heterozygous parents and siblings have had no apparent ketoacidotic episodes. Over 5 years (2008-2012), we investigated several patients that presented with severe ketoacidosis and identified a heterozygous OXCT1 mutation in four of these cases (Case1 p...
July 10, 2017: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/28690942/cardiac-arrhythmias-resulting-from-a-peripherally-inserted-central-catheter-two-cases-and-a-review-of-the-literature
#17
Jonathan Gapp, Mridula Krishnan, Felicia Ratnaraj, Robert P Schroell, Douglas Moore
We present two cases of patients being treated for diabetic ketoacidosis in the intensive care unit who experienced cardiac arrhythmia secondary to peripherally inserted central catheters (PICCs). In one instance, the patient became bradycardic and experienced related loss of consciousness, ultimately requiring cardiopulmonary resuscitation. In the second case, the patient experienced an episode of nonsustained ventricular tachycardia. We explore the various types of arrhythmias that have been reported secondary to central venous catheters, as well as factors that place patients at an increased risk for arrhythmia while undergoing PICC insertion...
June 3, 2017: Curēus
https://www.readbyqxmd.com/read/28689740/clinical-presentation-and-outcome-in-a-series-of-32-patients-with-2-methylacetoacetyl-coenzyme-a-thiolase-mat-deficiency
#18
Sarah Catharina Grünert, Robert Niklas Schmitt, Sonja Marina Schlatter, Corinne Gemperle-Britschgi, Mehmet Cihan Balcı, Volker Berg, Mahmut Çoker, Anibh M Das, Mübeccel Demirkol, Terry G J Derks, Gülden Gökçay, Sema Kalkan Uçar, Vassiliki Konstantopoulou, G Christoph Korenke, Amelie Sophia Lotz-Havla, Andrea Schlune, Christian Staufner, Christel Tran, Gepke Visser, Karl Otfried Schwab, Toshiyuki Fukao, Jörn Oliver Sass
2-methylacetoacetyl-coenzyme A thiolase (MAT) deficiency, also known as beta-ketothiolase deficiency, is an inborn error of ketone body utilization and isoleucine catabolism. It is caused by mutations in the ACAT1 gene and may present with metabolic ketoacidosis. In order to obtain a more comprehensive view on this disease, we have collected clinical and biochemical data as well as information on ACAT1 mutations of 32 patients from 12 metabolic centers in five countries. Patients were between 23months and 27years old, more than half of them were offspring of a consanguineous union...
June 27, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28687163/-latent-autoimmune-diabetes-in-adults-and-ketoacidosis-a-clinical-case
#19
P Vich Pérez, G Mora Navarro, A Espejo Gonzalez, M López Fernandez de Santos
No abstract text is available yet for this article.
July 4, 2017: Semergen
https://www.readbyqxmd.com/read/28685515/predetermined-anti-diabetic-drug-regimen-adjustments-during-ramadan-fasting-an-observational-study-of-safety
#20
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
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