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hyperglycemia crisis

Ivan Kruljac, Miroslav Ćaćić, Petra Ćaćić, Lora Stanka Kirigin Biloš, Davor Kust, Božidar Perić, Maja Filipović-Grčić, Gorana Mirošević, Vedran Ostojić, Mario Štefanović, Milan Vrkljan
Aims We compared characteristics of patients with hyperglycemic hyperosmolar state (HHS) and patients with severe hyperglycemia without the signs of hyperosmolarity and ketoacidosis; analyzed long-term all-cause mortality and potential prognostic factors. Methods The studied population included 261 749 adults. HHS was diagnosed in patients with plasma glucose >33.0 mmol/L, ketonuria <1+, and serum osmolarity >320 mmol/L. Patients with plasma glucose >33.0 mmol/L, ketonuria <1+ and serum osmolarity <320 mmol/L were considered as controls (nHHS)...
November 17, 2017: Experimental and Clinical Endocrinology & Diabetes
Katherine L Modzelewski, Denis V Rybin, Janice M Weinberg, Sara M Alexanian, Marie E McDonnell, Devin W Steenkamp
OBJECTIVE: Hyperglycemic crisis encompasses a group of diabetes emergencies characterized by insulin deficiency with high morbidity and mortality. Cocaine use is increasingly prevalent in the United States and may be associated with increased risk of diabetic ketoacidosis. The objective was to determine if active cocaine use at hospital admission could be considered a risk factor for development of hyperglycemic crisis. METHODS: A retrospective case-control analysis was performed on 950 inpatients with hyperglycemia at an urban academic hospital...
September 2017: Journal of Clinical & Translational Endocrinology
Days Oliveira Andrade, Sara Patrícia O Santos, Marcela Augusta S Pinhel, Flávia Mariana Valente, Marcela Cavichiolo Giannini, Michele Lima Gregório, Moacir Fernandes De Godoy, Dorotéia Rossi S Souza, José Fernando Vilela-Martin
Hypertensive crisis is a common clinical situation that presents a high rate of morbidity and mortality and it is characterized by symptomatic rise of blood pressure (BP), systolic (SBP) ≥ 180 mmHg and/or diastolic (DBP) ≥ 120 mmHg. It is classified as emergency (HE) or hypertensive urgency (HU). There is no description of laboratory findings in patients who present acute BP elevation. Thus, this study had the objective to assess the biochemical-metabolic parameters of patients with HC. We studied 74 normotensive individuals (NT), 74 controlled hypertensive patients (ContrHT), 50 subjects with HU, and 78 with HE for evaluating biochemical-metabolic parameters...
2017: Clinical and Experimental Hypertension: CHE
Horng-Yih Ou, Hung-Tsung Wu, Ching-Han Lin, Ye-Fong Du, Che-Yuan Hu, Hao-Chang Hung, Pansee Wu, Hung-Yuan Li, Shu-Huei Wang, Chih-Jen Chang
Context: High glucose generates reactive oxygen species (ROS) and contributes to glucotoxicity in hepatocytes, and hyperglycemia causes structural and functional damage to the liver. However, only a mild hepatic dysfunction was observed in subjects with hyperglycemic crisis, implying a factor exists to exert a hepatic protective effect. Hepassocin is a hepatokine that modulates the proliferation and metabolism of hepatocytes and also exerts protective activity in liver injury. However, its role in hyperglycemic crisis-induced hepatic dysfunction remains unknown...
July 1, 2017: Journal of Clinical Endocrinology and Metabolism
Junichi Ikeda, Kouei Muguruma, Takaaki Inoue, Teruhisa Nishida, Shigenari Kawakita, Takashi Murota, Haruyuki Ohsugi, Nae Takizawa, Hidefumi Kinoshita, Tadashi Matsuda, Amika Noda, Keita Utsunomiya
Adrenal corticotropin (ACTH) -independent macronodular adrenal hyperplasia (AIMAH) is a rare cause of Cushing's syndrome. Bilateral adrenalectomy is the treatment of choice, but lifetime steroid replacement is essential. Here we report a case of AIMAH whose hyperglycemia was improved following unilateral adrenalectomy. A 42-year-old woman with serious intellectual disability and intractable epilepsy presented with polydipsia. Casual blood glucose and hemoglobin A1c (HbA1c) were 322 mg/dl and 8.5%, respectively...
January 2017: Hinyokika Kiyo. Acta Urologica Japonica
Ivan Kruljac, Miroslav Ćaćić, Petra Ćaćić, Vedran Ostojić, Mario Štefanović, Aljoša Šikić, Milan Vrkljan
Patients with type 2 diabetes mellitus have impaired ketogenesis due to high serum insulin and low growth hormone levels. Evidence exists that ketone bodies might improve kidney and cardiac function. In theory, improved ketogenesis in diabetics may have positive effects. We aimed to assess the impact of diabetic ketosis on all-cause mortality in patients with type 2 diabetes mellitus presenting with hyperglycemic crisis. We analyzed 486 patients with diabetic ketosis and 486 age and sex-matched patients with non-ketotic hyperglycemia presenting to the emergency department...
January 2017: Endocrine
Shi-Jun Li, Tao Wang, Lin Wang, Zhan-Qi Pang, Ben Ma, Ya-Wen Li, Jian Yang, He Dong
Pheochromocytomas are neuroendocrine tumors, and its cardiac involvement may include transient myocardial dysfunction, acute coronary syndrome (ACS), and even ventricular arrhythmias.A patient was referred for evaluation of stuttering chest pain, and his electrocardiogram showed T-wave inversion over leads V1 to V4. Coronary angiography showed 90% stenosis in the mid-left anterior descending coronary artery (LAD), which was stented. Five days later, the patient had ventricular tachycardia, and severe hypertension, remarkable blood pressure fluctuation between 224/76 and 70/50 mm Hg...
April 2016: Medicine (Baltimore)
Vanessa A Fravel, William Van Bonn, Frances Gulland, Carlos Rios, Andreas Fahlman, James L Graham, Peter J Havel
The Marine Mammal Center (TMMC) cares for malnourished California sea lion (CSL) (Zalophus californianus) pups and yearlings every year. Hypoglycemia is a common consequence of malnutrition in young CSLs. Administering dextrose during a hypoglycemic crisis is vital to recovery. Traditional veterinary approaches to treat hypoglycemia pose therapeutic challenges in otariids, as vascular access and catheter maintenance can be difficult. The current approach to a hypoglycemic episode at TMMC is to administer dextrose intravenously (i...
March 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Daniel A Godoy, Réza Behrouz, Mario Di Napoli
PURPOSE OF REVIEW: Alterations of blood glucose levels are secondary insults with detrimental consequences for the injured brain. Here, we review various aspects of brain glucose metabolism and analyze the evidence on glycemic control during acute brain injury. RECENT FINDINGS: An essential component in the overall management of acute brain injury, especially during the acute phase, is maintaining adequate and appropriate control of serum glucose. This is one of the few physiological parameters that is modifiable...
April 2016: Current Opinion in Critical Care
Yaling Yi, Xingshen Sun, Katherine Gibson-Corley, Weiliang Xie, Bo Liang, Nan He, Scott R Tyler, Aliye Uc, Louis H Philipson, Kai Wang, Manami Hara, Katie Larson Ode, Andrew W Norris, John F Engelhardt
Cystic fibrosis (CF)-related diabetes in humans is intimately related to exocrine pancreatic insufficiency, yet little is known about how these 2 disease processes simultaneously evolve in CF. In this context, we examined CF ferrets during the evolution of exocrine pancreatic disease. At 1 month of age, CF ferrets experienced a glycemic crisis with spontaneous diabetic-level hyperglycemia. This occurred during a spike in pancreatic inflammation that was preceded by pancreatic fibrosis and loss of β-cell mass...
May 2016: Endocrinology
Lars W Andersen, Katherine M Berg, Sophia Montissol, Christopher Sulmonte, Julia Balkema, Michael N Cocchi, Richard E Wolfe, Ashok Balasubramanyam, Xiaowen Liu, Michael W Donnino
OBJECTIVES: The pyruvate dehydrogenase complex (PDH) is an essential enzyme in aerobic metabolism. Ketones are known to inhibit PDH activity, but the extent of this inhibition is unknown in patients with diabetic ketoacidosis (DKA). METHODS: We enrolled adult patients presenting to the emergency department in hyperglycemic crisis. Patients were classified as DKA or hyperglycemia without ketoacidosis based on laboratory criteria. Healthy controls were also enrolled...
June 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Veera Ganesh Yerra, Chayanika Gundu, Pragna Bachewal, Ashutosh Kumar
Autophagy is a dynamic process which plays an important role in cellular homeostasis through recycling of damaged proteins and organelles. Chronic hyperglycemia associated with diabetes is known to impair the cellular autophagic pathways to a varied extent in some of the diabetic complications. But the role of autophagy driven quality control of proteins and the cellular organelles has been understudied in diabetic complications including neuropathy (DN). The present article hypothesizes that enhancing autophagy in neuronal cells may help them to get rid of bioenergetic crisis, necrosis, apoptosis associated with DN...
January 2016: Medical Hypotheses
Ross Arena, Carl J Lavie, Marie-France Hivert, Mark A Williams, Paige D Briggs, Marco Guazzi
Unhealthy lifestyle characteristics (i.e., physical inactivity, excess body mass, poor diet, and smoking) as well as associated poor health metrics (i.e., dyslipidemia, hyperglycemia, and hypertension) are the primary reasons for the current non-communicable disease crisis. Compared to those with the poorest of lifestyles and associated health metrics, any movement toward improving lifestyle and associated health metrics improves health outcomes. To address the non-communicable disease crisis we must: 1) acknowledge that healthy lifestyle (HL) interventions are a potent medicine; and 2) move toward a healthcare system that embraces primordial as much as, if not more than, secondary prevention with a heavy focus on HL medicine...
2016: Expert Review of Cardiovascular Therapy
Moritoki Egi
Current criteria used for the diagnosis of diabetic mellitus are (1) HbA(1c) level > 6.5% (National Glycohemoglobin Standardization Program certified methods), (2) fasting glucose concentration > 126 mg x dl(-1) (7.0 mmol x l(-1)), (3) 2-h plasma glucose concentration > 200 mg x dl(-1) (11.1 mmol x l(-1)) during an oral glucose tolerance test, or (4) classic symptoms of hyperglycemia or hyperglycemic crisis with a random plasma glucose concentration > 200 mg x dl(-1) (11.1 mmol x l(-1)). It is reported that 15-20% of perioperative patients were with the presence of diabetic mellitus...
September 2015: Masui. the Japanese Journal of Anesthesiology
Ya-Hui Chen, Chien-Hsing Lee, Tai-Hao Hsu, Hui-Chen Lo
Type 2 Diabetes mellitus (T2DM), a disease with impaired glucose, protein and lipid metabolism, low-grade chronic inflammation, and immune dysfunction, is a global public health crisis. We previously demonstrated that Grifola frondosa has bioactivities in improving glycemic responses in diabetic rats. Herein, we investigated the immunomodulatory effects of the submerged-culture mycelia and broth of G. frondosa on the peripheral blood cells (PBL) and splenocytes. Male Wistar rats were administered with saline (normal rats) or streptozotocin plus nicotinamide (T2DM rats) and were intragastrically administered with placebo, fermented mycelia, broth, or mycelia plus broth (1 g kg-1 day-1) for two weeks...
2015: International Journal of Medicinal Mushrooms
Pragya Tiwari
Diabetes highlights a growing epidemic imposing serious social economic crisis to the countries around the globe. Despite scientific breakthroughs, better healthcare facilities, and improved literacy rate, the disease continues to burden several sections, especially middle and low income countries. The present trends indicate the rise in premature death, posing a major threat to global development. Scientific and technological advances have witnessed the development of newer generation of drugs like sulphonylureas, biguanides, alpha glucosidase inhibitors, and thiazolidinediones with significant efficacy in reducing hyperglycemia...
2015: Journal of Diabetes Research
Tetsuya Mizokami, Takuko Fukui, Hirofumi Imoto, Hiroki Fujii, Yuichi Sato, Kiyohide Nunoi, Ken Okamura
Two unrelated women were hospitalized for thyrotoxic crisis complicated by multiple organ failure. Both patients were treated with antithyroid drugs and hydrocortisone, as well as insulin for hyperglycemia, and underwent mechanical ventilation with sedation. Flaccid quadriplegia became apparent after each patient completely recovered their level of consciousness once sedation was discontinued on days 6 and 15, respectively. Three to six months of rehabilitation was required for the muscle strength to fully improve in both cases...
2015: Internal Medicine
Ankur Sharma, Rajeshwari Subramaniam, Mahesh Misra, Bandi Joshiraj, Gopi Krishnan, Prerna Varma, Shyam Kishore
Cushing syndrome may rarely present with life-threatening hypercortisolism, manifested by hypertension, hypokalemia, hyperglycemia, and edema. If medical treatment proves ineffective in ameliorating the symptoms, emergent rescue adrenalectomy may be the only way to relieve the crisis. We describe the anesthetic management of a patient with an ectopic adrenocorticotropic hormone-secreting tumor, whose condition was rapidly deteriorating due to severe cortisol excess, and emergent adrenalectomy was the only available therapeutic modality...
January 15, 2015: A & A Case Reports
Kathryn Farni, David A Shoham, Guichan Cao, Amy H Luke, Jennifer Layden, Richard S Cooper, Lara R Dugas
The prevalence of pre-diabetes (PD) among US adults has increased substantially over the past two decades. By current estimates, over 34% of US adults fall in the PD category, 84% of whom meet the American Diabetes Association's criteria for impaired fasting glucose (IFG). Low physical activity (PA) and/or sedentary behavior are key drivers of hyperglycemia. We examined the relationship between PD and objectively measured PA in NHANES 2003-2006 of 20,470 individuals, including 7,501 individuals between 20 and 65 yrs...
2014: PeerJ
Puskar Shyam Chowdhury, Prasant Nayak, Srinivasan Gurumurthy, Deepak David
Adrenocortical carcinoma (ACC) co-secreting aldosterone and cortisol is extremely rare. We report the case of a 37-yearold female who presented with paresis and facial puffiness. Evaluation revealed hypertension, hyperglycemia, severe hypokalemia and hyperaldosteronemia with elevated plasma aldosterone to renin ratio (ARR). Urinary free cortisol estimation showed elevated levels. Computed tomography scan revealed a right adrenal mass. Radical adrenalectomy specimen revealed ACC (T3N1). Post-operatively, the patient became normotensive and euglycemic with normalization of urinary cortisol and ARR...
July 2014: Indian Journal of Urology: IJU: Journal of the Urological Society of India
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