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https://www.readbyqxmd.com/read/28820963/ketone-body-acetoacetate-buffers-methylglyoxal-via-a-non-enzymatic-conversion-during-diabetic-and-dietary-ketosis
#1
Trine Salomón, Christian Sibbersen, Jakob Hansen, Dieter Britz, Mads Vandsted Svart, Thomas Schmidt Voss, Niels Møller, Niels Gregersen, Karl Anker Jørgensen, Johan Palmfeldt, Thomas Bjørnskov Poulsen, Mogens Johannsen
The α-oxoaldehyde methylglyoxal is a ubiquitous and highly reactive metabolite known to be involved in aging- and diabetes-related diseases. If not detoxified by the endogenous glyoxalase system, it exerts its detrimental effects primarily by reacting with biopolymers such as DNA and proteins. We now demonstrate that during ketosis, another metabolic route is operative via direct non-enzymatic aldol reaction between methylglyoxal and the ketone body acetoacetate, leading to 3-hydroxyhexane-2,5-dione. This novel metabolite is present at a concentration of 10%-20% of the methylglyoxal level in the blood of insulin-starved patients...
August 17, 2017: Cell Chemical Biology
https://www.readbyqxmd.com/read/28811858/effectiveness-of-ipragliflozin-for-reducing-hemoglobin-a1c-in-patients-with-a-shorter-type-2-diabetes-duration-interim-report-of-the-assign-k-study
#2
Kotaro Iemitsu, Takehiro Kawata, Takashi Iizuka, Masahiro Takihata, Masahiko Takai, Shigeru Nakajima, Nobuaki Minami, Shinichi Umezawa, Akira Kanamori, Hiroshi Takeda, Shogo Ito, Taisuke Kikuchi, Hikaru Amemiya, Mizuki Kaneshiro, Atsuko Mokubo, Tetsuo Takuma, Hideo Machimura, Keiji Tanaka, Taro Asakura, Akira Kubota, Sachio Aoyanagi, Kazuhiko Hoshino, Masashi Ishikawa, Yoko Matsuzawa, Mitsuo Obana, Nobuo Sasai, Hideaki Kaneshige, Fuyuki Minagawa, Tatsuya Saito, Kazuaki Shinoda, Masaaki Miyakawa, Yasushi Tanaka, Yasuo Terauchi, Ikuro Matsuba
BACKGROUND: Ipragliflozin is a selective sodium glucose co-transporter 2 inhibitor. The ASSIGN-K study is investigating the efficacy and safety of ipragliflozin for type 2 diabetes mellitus (T2DM) in the real-world clinical setting. METHODS: Japanese T2DM patients with inadequate glycemic control despite diet and exercise with/without pharmacotherapy were enrolled in an investigator-driven, multicenter, prospective, observational study examining the efficacy and safety of ipragliflozin treatment (50 mg/day for 52 weeks)...
September 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28737202/-euglycemic-ketosis-in-an-adolescent-with-type-1-diabetes-on-insulin-and-dapaglifozin-case-report
#3
Marcia Pereyra A, Cristhian Ramírez, Rossana Román
Dapagliflozin, an insulin-independent sodium-glucose cotransporter 2 inhibitor (SGLT2-I) induces glycosuria and reduces hyperglycemia in adults with type 2 diabetes. OBJECTIVE: To present an “euglycemic” diabetic ketosis in an adolescent with type 1 diabetes (T1D) receiving dapagliflozin, to alert about the risk of a drug not approved in children nor in T1D. CASE REPORT: A 17 years old adolescent with T1D during 9 years, was started on dapagliflozin 10 mg / day to reduce insulin dose and weight...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28710307/is-it-safe-to-acutely-discontinue-insulin-therapy-in-patients-with-chronic-hyperglycaemia-starting-glp-1r-agonists
#4
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/28685968/prevalence-of-and-risk-factors-for-diabetic-ketosis-in-chinese-diabetic-patients-with-a-random-blood-glucose-level-13-9-mmol-l-result-from-check-study
#5
Leili Gao, Yufeng Li, Dadong Fei, Li Ma, Shuchun Chen, Bo Feng, Qing Su, Linong Ji
BACKGROUND: To investigate the prevalence of diabetic ketosis (DK) and risk factors for it in Chinese diabetes patients with severe hyperglycemia. METHODS: This is a multicenter, cross-sectional study. Patients aged >16 years with diabetes mellitus and a random blood glucose level >13.9 mmol/L (>250 mg/dl) were recruited to the study. Blood ketones (β-hydroxybutyric acid) and urine ketones (acetoacetic acid) were measured and patients' demographic and clinical characteristics were collected...
July 7, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28668376/clinical-characteristics-beta-cell-dysfunction-and-treatment-outcomes-in-patients-with-a-%C3%AE-ketosis-prone-diabetes-kpd-the-first-identified-cohort-amongst-asian-indians
#6
Riddhi Das Gupta, Roshna Ramachandran, Praveen Gangadhara, Shajith Anoop, Surjitkumar H Singh, Anil Satyaraddi, Samantha Sathyakumar, H S Asha, Nihal Thomas
OBJECTIVE: Ketosis-prone diabetes (KPD), an atypical form of diabetes, has emerged as a heterogeneous syndrome in multiple ethnic groups. The objectives of this study were to look into the clinical characteristics of adult Asian Indian patients with recently diagnosed, antibody negative diabetes presenting with unprovoked ketoacidosis (A-β+ KPD) and to determine the natural course of recovery of beta-cell functions on serial follow-up over one year. RESEARCH DESIGN AND METHODS: Newly diagnosed adult diabetes patients (n=11) with suspected KPD (A-β+) were prospectively studied over a period of 1-year with serial evaluations of clinical, biochemical and beta-cell secretion characteristics...
June 23, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28664602/neurod1-deficient-diabetes-mody6-identification-of-the-first-cases-in-japanese-and-the-clinical-features
#7
Yukio Horikawa, Mayumi Enya, Hiroyo Mabe, Megumi Fukushima, Noriyuki Takubo, Masaaki Ohashi, Fuki Ikeda, Ken-Ichi Hashimoto, Hirotaka Watada, Jun Takeda
AIMS: Only a few families with neuronal differentiation 1 (NEUROD1)-deficient diabetes, currently designated as maturity-onset diabetes of the young 6 (MODY6), have been reported, but mostly in Caucasian, and no mutation has been identified by family-based screening in Japanese. Accordingly, the phenotypic details of the disease remain to be elucidated. METHODS: We examined a total of 275 subjects having diabetes suspected to be MODY who were negative for mutations in MODY1-5 referred from 155 medical institutions throughout Japan...
June 30, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28662684/atypical-blood-glucose-response-to-continuous-and-interval-exercise-in-a-person-with-type-1-diabetes-a-case-report
#8
Othmar Moser, Gerhard Tschakert, Alexander Mueller, Werner Groeschl, Thomas R Pieber, Gerd Koehler, Max L Eckstein, Richard M Bracken, Peter Hofmann
BACKGROUND: Therapy must be adapted for people with type 1 diabetes to avoid exercise-induced hypoglycemia caused by increased exercise-related glucose uptake into muscles. Therefore, to avoid hypoglycemia, the preexercise short-acting insulin dose must be reduced for safety reasons. We report a case of a man with long-lasting type 1 diabetes in whom no blood glucose decrease during different types of exercise with varying exercise intensities and modes was found, despite physiological hormone responses...
June 30, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28658838/hemi-chorea-in-a-patient-with-ketotic-hyperglycemia-an-unusual-presentation
#9
Pendela Venkata Satish, Kudaravalli Pujitha, Neha Agrawal, Thomas Mathew, Sudha Vidyasagar
Chorea has often been associated with lesions in the basal ganglia and in the sub thalamic nucleus. It is possible for a patient with chorea-ballismus to have hyperglycemia at the initial presentation. We hereby present a case of an 81-year-old female, who was on treatment for type 2 diabetes mellitus and presented to us with sub acute onset of abnormal movements of right side of the body. She had semi purposeful, rapid and jerky movements of right upper limb and lower limb along with abnormal tongue movements...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28604407/diabetic-ketoacidosis-heralding-type-1-diabetes-in-children
#10
Corinne I Alois, Denise Rizzolo
Despite advances in diabetes management, diabetic ketoacidosis (DKA) continues to be a leading cause of morbidity and mortality. Up to one-third of children may present with DKA as the original presentation of type 1 diabetes. These children develop clinical manifestations of DKA including hyperglycemia, acidosis, and ketosis. Clinicians must be able to identify those patients at risk, recognize common signs and symptoms, and start prompt management.
July 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28602849/etiopathological-differentiation-of-diabetes-mellitus-in-lean-young-adults
#11
N Kotwal, Vimal Upreti, K V S Hari Kumar, Amit Nachankar
OBJECTIVE: Classification of diabetes mellitus (DM) into type 1 or type 2 is difficult in lean, young individuals. We studied the β-cell function, insulin resistance (IR) and autoimmunity in young patients with recent onset DM. METHODS: In this cross-sectional study, we included patients (age below 35 years) with recent onset DM (<6 months) and normal body weight for evaluation. The detailed clinical examination was done to identify markers of IR. Autoimmune DM was diagnosed using glutamic acid decarboxylase 65 (GAD65), insulin autoantibody (IAA) and islet cell antibody (ICA)...
June 3, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28589154/prolonged-ketosis-in-a-patient-with-euglycemic-diabetic-ketoacidosis-secondary-to-dapagliflozin
#12
Shreya Pujara, Adriana Ioachimescu
Since the approval of sodium-glucose cotransporter 2 (SGLT2) inhibitors by the US Food and Drug Administration for type 2 diabetes, there have been several reports of euglycemic diabetic ketoacidosis in patients using this class of medication. We present a case of euglycemic diabetic ketoacidosis where ketonemia and glucosuria persisted well beyond the expected effect of dapagliflozin. Our patient is a 50-year-old woman with type 2 diabetes since age 35 who was taking metformin and dapagliflozin. She presented with fatigue, constipation, and 3 days of reduced oral intake...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28552612/efficacy-and-safety-of-incretin-based-drugs-in-patients-with-type-1-diabetes-mellitus-a-systematic-review-and-meta-analysis
#13
Wen Wang, Yun Gao, Dawei Chen, Chun Wang, Xiaobing Feng, Xingwu Ran
AIMS: In patients with type 2 diabetes, incretin-based therapies can improve glucose control without increased weight gain or hypoglycemia. Incretin-based drugs added to insulin therapy in type 1 diabetes (T1DM) have also been tried in many studies. However, the results were controversial. We thus performed a meta-analysis to assess the efficacy and safety of incretin-based therapies in patients with T1DM. METHODS: We systematically searched Medline, EMBASE, and Cochrane Central Register of Controlled Trials for relevant studies published before August 25, 2016...
July 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28534682/diabetic-ketoacidosis-a-common-debut-of-diabetes-among-african-americans-with-type-2-diabetes
#14
Priyathama Vellanki, Guillermo E Umpierrez
OBJECTIVE: More than half of African Americans (AA) with a new diagnosis of diabetic ketoacidosis have clinical and metabolic features of type 2 diabetes during follow-up. This particular presentation of diabetes has been termed as ketosis-prone type 2 diabetes (KPDM) or atypical diabetes. METHODS: We review the epidemiology, diagnosis, pathophysiology, and acute and long-term management of AA with KPDM and compare these similarities to patients with type 2 diabetes...
August 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28458888/diabetic-ketoacidosis-a-challenging-diabetes-phenotype
#15
Cliona Small, Aoife M Egan, El Muntasir Elhadi, Michael W O'Reilly, Aine Cunningham, Francis M Finucane
SUMMARY: We describe three patients presenting with diabetic ketoacidosis secondary to ketosis prone type 2, rather than type 1 diabetes. All patients were treated according to a standard DKA protocol, but were subsequently able to come off insulin therapy while maintaining good glycaemic control. Ketosis-prone type 2 diabetes (KPD) presenting with DKA has not been described previously in Irish patients. The absence of islet autoimmunity and evidence of endogenous beta cell function after resolution of DKA are well-established markers of KPD, but are not readily available in the acute setting...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28457031/prepubertal-childhood-onset-type-2-diabetes-mellitus-four-case-reports
#16
Anandakumar Amutha, Ranjit Unnikrishnan, Ranjit Mohan Anjana, Viswanathan Mohan
BACKGROUND: The prevalence of childhood onset type 2 diabetes (T2D) is increasing, but prepubertal T2D is still unusual. METHODS: We report four cases of T2D with onset at or below 10 years of age registered at a tertiary diabetes centre in southern India.T2D was diagnosed based on the absence of ketosis, good beta cell reserve as shown by the C peptide assay, absence of GAD antibodies and pancreatic calculi, and response to oral hypoglycemic agents. RESULTS: All four patients were female, obese and had acanthosis nigricans...
February 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28437153/diabetic-ketoacidosis-in-patients-with-type-2-diabetes-recently-commenced-on-sglt-2-inhibitors-an-ongoing-concern
#17
LETTER
Mohamed Ahmed, Malachi J McKenna, Rachel K Crowley
OBJECTIVE: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are increasingly used as an adjunctive treatment for type 2 diabetes. We report the occurrence of diabetic ketoacidosis (DKA) in 3 patients with type 2 diabetes recently commenced on SGLT-2 inhibitors. METHODS: Clinical presentation, laboratory data, and treatment outcomes of all 3 cases are described. RESULTS: All 3 patients had documented history of longstanding type 2 diabetes...
April 2, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28433617/induced-and-controlled-dietary-ketosis-as-a-regulator-of-obesity-and-metabolic-syndrome-pathologies
#18
Madeline K Gibas, Kelly J Gibas
A worsening epidemic of diabetes and its precursor, metabolic syndrome (MetS) is engulfing America. A healthy individual, with proper glucose regulation has an ability to switch between burning fat and carbohydrates. It has been suggested that signaling errors within this homeostatic system, characterized by impaired switching of substrate oxidation from glucose to fat in response to insulin, can contribute to the etiology of metabolic syndrome and occurs before the development of type II diabetes. Glucose regulation with restored insulin sensitivity facilitated through clinically regulated, benign dietary ketosis (BDK), may significantly reduce, regulate and reverse the adverse pathologies common to MetS and obesity...
March 28, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28418115/aggravation-of-diabetes-and-incompletely-deficient-insulin-secretion-in-a-case-with-type-1-diabetes-resistant-hla-drb1-15-02-treated-with-nivolumab
#19
Kimio Matsumura, Kaoru Nagasawa, Yoichi Oshima, Shouta Kikuno, Kyohei Hayashi, Akihiro Nishimura, Minoru Okubo, Hironori Uruga, Kazuma Kishi, Tetsuro Kobayashi, Yasumichi Mori
Anti-programmed cell death-1 (PD-1) antibody therapy induces various adverse effects especially in endocrine systems. Several cases of acute onset insulin-dependent diabetes after anti-PD-1 antibody therapy have been reported. Many of these cases have a susceptible HLA genotype for type 1 diabetes possibly suggesting that human leukocyte antigen (HLA) might be involved in the onset of diabetes with anti PD-1 therapy. We describe an atypical case of hyperglycemia after anti PD-1 antibody administration. A 68-year-old Japanese man with pancreatic diabetes and steroid diabetes was administered nivolumab three times for chemoresistant adenocarcinoma of the lung...
April 18, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28417874/effectiveness-of-minimed-640g-with-smartguard%C3%A2-system-for-prevention-of-hypoglycemia-in-pediatric-patients-with-type-1-diabetes-mellitus
#20
Beatriz Villafuerte Quispe, María Martín Frías, M Belén Roldán Martín, Rosa Yelmo Valverde, M Ángeles Álvarez Gómez, Raquel Barrio Castellanos
INTRODUCTION/AIMS: Treatment with the MiniMed 640G-SmartGuard(®) system (640G-SG, sensor-augmented insulin pump system with low predicted glucose suspension feature) has been shown to decrease risk of hypoglycemia without altering metabolic control in patients with T1DM. The study purpose was to assess the impact of 640G-SG on hipoglycemia frequency and on metabolic control in a pediatric population with T1DM. PATIENTS/METHODS: A retrospective study on 21 children treated with 640G-SG...
April 2017: Endocrinología, diabetes y nutrición
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