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Diabetic ketoacidosis

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https://www.readbyqxmd.com/read/27932047/disturbances-of-glucose-metabolism-associated-with-the-use-of-psychotropic-drugs-a-post-mortem-evaluation
#1
Cristian Palmiere, Marc Augsburger, Vincent Varlet
Treatment with atypical antipsychotic agents and tetracyclic antidepressants has been associated with impaired glycemic control. Reported complications have included new-onset diabetes mellitus, life-threatening diabetic ketoacidosis and, rarely, death. The study presented herein focuses on biochemical investigations of glucose metabolism in a series of medico-legal cases that revealed the presence of atypical antipsychotic agents (clozapine, olanzapine, quetiapine and risperidone) or mirtazapine at toxicology...
December 5, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27931088/sglt2-inhibitors-a-systematic-review-of-diabetic-ketoacidosis-and-related-risk-factors-in-the-primary-literature
#2
Kelly R Burke, Christine A Schumacher, Spencer E Harpe
STUDY OBJECTIVE: There is currently minimal information regarding risk factors for the development of sodium-glucose cotransporter-2 inhibitor (SGLT2i)-related diabetic ketoacidosis (DKA). We aim to identify individual patient characteristics associated with cases of SGLT2i-related DKA to better describe potential risk factors. DESIGN: Systematic review of primary literature. PATIENTS: 34 case reports of patients with Type 1 and Type 2 Diabetes Mellitus who developed DKA while receiving an SGLT2i...
December 8, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27930814/septic-ketoacidosis-a-potentially-lethal-entity-with-renal-tubular-epithelial-vacuolization
#3
Chong Zhou, Roger W Byard
Fatal ketoacidosis due to diabetes mellitus, alcoholism, and starvation may produce characteristic basal vacuolization of renal tubular epithelial cells (RTEC). Septic ketoacidosis has recently been recognized clinically as a distinct condition in which septicemia can lead to elevation of ketones and various anions unrelated to diabetes mellitus, alcoholism, or caloric deprivation. We report four lethal cases with significantly elevated vitreous ketones secondary to sepsis and/or severe localized infection in individuals with no history of diabetes mellitus, alcoholism, or starvation...
December 8, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27928503/metabolic-ketoacidosis-with-normal-blood-glucose-a-rare-complication-of-sodium-glucose-cotransporter-2-inhibitors
#4
Saad Ullah, Noman Khan, Hassan Zeb, Hassan Tahir
Ketoacidosis is a significant and often a life-threatening complication of diabetes mellitus seen mostly in type 1 diabetes mellitus as well as occasionally in type 2 diabetes mellitus. Diabetic ketoacidosis usually manifests with high blood glucose more than 250 mg/dL, but euglycemic diabetic ketoacidosis is defined as ketoacidosis associated with blood glucose level less than 250 mg/dL. Normal blood glucose in such patients results in significant delay in diagnosis and management of diabetic ketoacidosis, thus increasing mortality and morbidity...
2016: SAGE open medical case reports
https://www.readbyqxmd.com/read/27928184/ismp-adverse-drug-reactions-chronic-marijuana-use-associated-with-recurrent-diabetic-ketoacidosis-lamotrigine-induced-cataplexy-trimethoprim-sulfamethoxazole-induced-hyponatremia-ziprasidone-induced-sleepwalking-and-sleep-related-eating-metabolic-acidosis-associated
#5
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: mmancano@temple.edu). Your report will be published anonymously unless otherwise requested...
November 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27924173/predictors-of-recurrent-hospital-admission-for-patients-presenting-with-diabetic-ketoacidosis-and-hyperglycemic-hyperosmolar-state
#6
Annabel L Bradford, Courtney Champagne Crider, Xizheng Xu, Syed Hasan Naqvi
BACKGROUND: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are two serious, preventable complications of diabetes mellitus. Analysis of variables associated with recurrent DKA and HHS admission has the potential to improve patient outcomes by identifying possible areas for intervention. The aim of this study was to evaluate potential predictors of recurrent DKA or HHS admission. METHODS: This was a retrospective case-control study of 367 patients presenting during a 5-year period with DKA or HHS at a US tertiary academic medical center...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27920854/recurrent-urinary-tract-infections-in-an-adult-with-a-duplicated-renal-collecting-system
#7
Junaid Raja, Amir M Mohareb, Bilori Bilori
Because of advancements in fetal imaging, anatomic variants of the genitourinary tract are most often discovered in the antenatal period. As such, general internists are less likely to encounter adult patients with previously undiagnosed anatomic abnormalities of the renal collecting system, such as duplicated kidneys. These abnormalities put patients at risk for urinary obstruction and recurrent infections of the urinary tract. We report the case of a 40-year-old diabetic patient with a previously undiagnosed duplex kidney who had recurrent episodes of diabetic ketoacidosis triggered by urinary tract infections...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27918226/canagliflozin-use-in-type-i-diabetes-mellitus
#8
Robert Guthrie
Peters et al documented the appearance of diabetic ketoacidosis without significant elevation of serum glucose in patients treated with Canagliflozin. They solicited patient reports from their practice and from other colleagues' practices and identified nine patients, mainly with Type I Diabetes. Erondu et al evaluated the Canagliflozin development data base to describe the rate and appearance of ketoacidosis in the study patients. They found that in the research patients with Type 2 Diabetes, the rate of ketoacidosis in Canagliflozin patients was uncommon and similar to the reported rate in Type 2 patients not receiving Canagliflozin...
December 5, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27913012/hyperglycemic-high-anion-gap-metabolic-acidosis-in-patients-receiving-sglt-2-inhibitors-for-diabetes-management
#9
Juliette Sandifer Kum-Nji, Aidar R Gosmanov, Helmut Steinberg, Samuel Dagogo-Jack
Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are a class of antidiabetic medications that improve glycemic control via inhibiting the reabsorption of filtered glucose and are approved for use in type 2 diabetes (T2DM). These drugs have recently been associated with euglycemic diabetic ketoacidosis (DKA). An increasing number of cases of SGLT-2i-associated DKA have occurred in patients with T2DM. Herein, we describe five episodes of hyperglycemic DKA in four type 2 diabetes patients receiving SGLT-2i therapy...
November 9, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27912129/incidence-of-complications-in-young-onset-diabetes-comparing-type-2-with-type-1-the-young-diab-study
#10
Anandakumar Amutha, Ranjit Mohan Anjana, Ulagamathesan Venkatesan, Harish Ranjani, Ranjit Unnikrishnan, K M Venkat Narayan, Viswanathan Mohan, Mohammed K Ali
BACKGROUND: There is little data on the incidence of diabetes complications in young onset type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in non European populations. METHODS: From a tertiary diabetes centre, Chennai, India, we recruited 108 T1DM (defined by abrupt onset of symptoms or diabetic ketoacidosis, absent insulin reserve requiring insulin treatment) and 90 T2DM participants (defined by absence of ketosis, good beta-cell reserve, and good response to oral agents) who were diagnosed between the ages of 10 and 25years, and without any evidence of diabetes complications at diagnosis...
November 17, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27908315/-life-threatening-ketoacidosis-in-a-25-year-old-woman-treated-with-sodium-glucose-cotransporter-2-inhibitor
#11
Mats Jacob Hermansson Lindberg, Frans Brandt Kristensen, Alev Yildiz
We report a case of atypical ketoacidosis in a patient treated with a sodium-glucose cotransporter- (SGLT) 2 inhibitor. The 25-year-old woman, who one year earlier had been prescribed dapagliflozin for presumed Type 2 diabetes, came to the emergency department in a state of severe ketoacidosis, pH 6.85, and a plasma glucose level of 14.3 mmol/l. She received standard treatment and recovered. We discuss the increasing evidence for atypical ketoacidosis being a serious side effect of the SGLT2 inhibitors.
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27905403/infusion-with-human-bone-marrow-derived-mesenchymal-stem-cells-improves-%C3%AE-cell-function-in-patients-and-non-obese-mice-with-severe-diabetes
#12
Lirong Li, Hui Hui, Xiaolei Jia, Jie Zhang, Ying Liu, Qianyue Xu, Dalong Zhu
Mesenchymal stem cells (MSCs) transplantation is a promising therapeutic strategy for type 1 diabetes (T1D). However, little is known on whether MSC transplantation can benefit T1D patients with ketoacidosis and its potential actions. Here, we show that infusion with bone marrow MSCs preserves β-cell function in some T1D patients with ketoacidosis by decreasing exogenous insulin requirement and increasing plasma C-peptide levels up to 1-2 years. MSC transplantation increased plasma and islet insulin contents in non-obese diabetic (NOD) mice with severe diabetes...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27899870/cognition-and-type-1-diabetes-in-children-and-adolescents
#13
Allison Cato, Tamara Hershey
IN BRIEF In children and adolescents with type 1 diabetes, exposure to glycemic extremes (severe hypoglycemia, chronic hyperglycemia, and diabetic ketoacidosis) overlaps with the time period of most active brain and cognitive development, leading to concerns that these children are at risk for cognitive side effects. This article summarizes the existing literature examining the impact of glycemic extremes on cognitive function and brain structure in youth with type 1 diabetes and points out areas for future research...
November 2016: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/27896902/substantial-reduction-in-hospital-stay-of-children-and-adolescents-with-diabetic-ketoacidosis-after-implementation-of-clinical-practice-guidelines-in-a-university-hospital-in-saudi-arabia
#14
Abdulrahman Al Nemri, Yasser Sami Amer, Hala Gasim, Mohamed Elfaki Osman, Ayman Aleyadhy, Hessah Al Otaibi, Shaikh Mohammed Iqbal, Nasir Abdullah Aljurayyan, Asaad M Assiri, Amir Babiker, Sarar Mohamed
RATIONALE, AIMS AND OBJECTIVES: We aimed to determine the effect of Clinical Practice Guideline (CPG) implementation on length of hospital stay of children and adolescents with diabetic ketoacidosis (DKA). METHODS: This was a 6-year (2008-2014) case-control retrospective study conducted at King Khalid University Hospital, Riyadh, that compared patients with DKA managed using CPG with those treated before CPG implementation. RESULTS: There were 63 episodes of DKA in 41 patients managed using CPG compared with 40 episodes in 33 patients treated before implementation of CPG...
November 29, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27896145/interprofessional-multiple-step-simulation-course-improves-pediatric-resident-and-nursing-staff-management-of-pediatric-patients-with-diabetic-ketoacidosis
#15
Linnea M Larson-Williams, Amber Q Youngblood, Dawn Taylor Peterson, J Lynn Zinkan, Marjorie L White, Hussein Abdul-Latif, Leen Matalka, Stephen N Epps, Nancy M Tofil
AIM: To investigate the use of a multidisciplinary, longitudinal simulation to educate pediatric residents and nurses on management of pediatric diabetic ketoacidosis. METHODS: A multidisciplinary, multiple step simulation course was developed by faculty and staff using a modified Delphi method from the Pediatric Simulation Center and pediatric endocrinology department. Effectiveness of the simulation for the residents was measured with a pre- and post-test and a reference group not exposed to simulation...
November 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27887926/geographic-clustering-of-acute-complications-and-sociodemographic-factors-in-adults-with-type-1-diabetes
#16
Sonia Butalia, Alka B Patel, Jeffrey A Johnson, William A Ghali, Doreen M Rabi
OBJECTIVES: To assess the geographic distribution of acute complications in patients with type 1 diabetes in a large urban centre; and to assess the association between acute complications and community-level sociodemographic factors. METHODS: Adults (aged ≥18 years old) with type 1 diabetes and acute complications were identified between 2004 and 2008 by using a diabetes centre clinical database or discharge abstracts for acute complications (diabetic ketoacidosis or hypoglycemia)...
November 23, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27881588/glucocorticoids-did-not-reverse-type-1-diabetes-mellitus-secondary-to-pembrolizumab-in-a-patient-with-metastatic-melanoma
#17
Jasna Aleksova, Peter K H Lau, Georgia Soldatos, Grant McArthur
Immune checkpoint inhibitors offer patients with advanced melanoma substantial improvements in survival. Unlike chemotherapy, immune checkpoint inhibitors such as ipilimumab and pembrolizumab cause unique immune-related adverse events (irAEs), including the development of endocrinopathies. We report a case of a man aged 60 years who developed diabetic ketoacidosis (DKA) following the use of pembrolizumab for the treatment of metastatic melanoma. He received four cycles of ipilimumab, before proceeding to pembrolizumab...
November 23, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27875539/secular-trends-in-admissions-and-mortality-rates-from-diabetes-mellitus-in-the-central-belt-of-ghana-a-31-year-review
#18
Osei Sarfo-Kantanka, Fred Stephen Sarfo, Eunice Oparebea Ansah, Benjamin Eghan, Nana Kwame Ayisi-Boateng, Emmanuel Acheamfour-Akowuah
INTRODUCTION: Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa...
2016: PloS One
https://www.readbyqxmd.com/read/27871165/acute-pancreatitis-complicated-with-diabetic-ketoacidosis-in-a-young-adult-without-hypertriglyceridemia-a-case-report
#19
Jung Hyun Kim, Myung Jin Oh
Systemic complications related to acute pancreatitis include acute respiratory distress syndrome, multiple organ dysfunction syndrome, disseminated intravascular coagulation, hypocalcemia, hyperglycemia, and insulin dependent diabetes or diabetic ketoacidosis. In practice, the development of diabetic ketoacidosis induced by acute pancreatitis is rare and generally associated with hypertriglyceridemia. However, herein we report a case of a 34-year-old female without hypertriglyceridemia, who was diagnosed with acute pancreatitis complicated with diabetic ketoacidosis...
November 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27867961/cardio-renal-protection-with-empagliflozin
#20
Richard J MacIsaac, George Jerums, Elif I Ekinci
Cardiovascular (CV) and kidney disease are common and significant complications in people with type 2 diabetes (T2DM). CV disease is the leading cause of death, morbidly and hospitalisations for people with T2DM. Furthermore, diabetic kidney disease is a major risk factor for CV disease and is the main reason why patients need renal replacement therapy. In this perspective, we highlight the results of the recent landmark EMPA-REG OUTCOME trial which has shown that empagliflozin, a member of the sodium-glucose co-transporter 2 (SGLT-2) inhibitor class of glucose lowering medications, reduces death from CV causes, hospitalisation for heart failure and progression to end stage kidney disease in patients with T2DM and established CV disease...
October 2016: Annals of Translational Medicine
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