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https://www.readbyqxmd.com/read/28604407/diabetic-ketoacidosis-heralding-type-1-diabetes-in-children
#1
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.
June 9, 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
#2
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
#3
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
#4
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
#5
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...
May 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28458888/diabetic-ketoacidosis-a-challenging-diabetes-phenotype
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28377335/discovery-of-diabetes-in-the-elderly-what-diagnosis
#12
Pacifique Lévy, Laurence Pacot, Jean-Philippe Bastard, Camille Vatier
Type 1 diabetes accounts for 5 to 10% of all diabetes cases. It appears most often during childhood or adolescence. We report the case of a hypertensive overweight patient of 79 years who consulted for asthenia in context of polyuria-polydipsia syndrome in which blood glucose assay revealed a diabetes mellitus associated with ketosis. Despite the age, the body mass index and the history of the patient, type 1 diabetes diagnosis should be considered in this clinical presentation with brutal and symptomatic early...
April 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28303514/euglycemic-ketosis-in-patients-with-type-2-diabetes-on-sglt2-inhibitor-therapy-an-emerging-problem-and-solutions-offered-by-diabetes-technology
#13
A Pfützner, D Klonoff, L Heinemann, N Ejskjaer, J Pickup
Diabetic ketoacidosis is an infrequent but life-threatening acute complication of diabetes, affecting predominantly patients with type 1 diabetes, children, and pregnant women, where ketosis is usually associated with marked hyperglycemia. Recently, an increasing number of cases have been reported of euglycemic diabetic ketoacidosis in patients with type 2 diabetes receiving sodium-glucose cotransporter 2 inhibitor treatment in routine practice. There is a minor, but not negligible diabetic ketoacidosis risk associated with this drug class, which was not seen in randomized clinical trials...
April 2017: Endocrine
https://www.readbyqxmd.com/read/28294105/breath-acetone-as-a-potential-marker-in-clinical-practice
#14
Vera Ruzsanyi, Miklós Kalapos
In recent decades, two facts have changed the opinion of researchers about the function of acetone in humans. Firstly, it has turned out that acetone cannot be regarded as simply a waste product of metabolism, because there are several pathways in which acetone is produced or broken down. Secondly, methods have emerged making possible its detection in exhaled breath, thereby offering an attractive alternative to investigation of blood and urine samples. From a clinical point of view the measurement of breath acetone levels are important, but there are limitations to its wide application...
March 15, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28272658/early-stage-prurigo-pigmentosa-a-case-report
#15
Emel Onaygil, Abdullah Songur, Zekayi Kutlubay, Cuyan Demirkesen
Prurigo pigmentosa is a rare inflammatory dermatosis that primarily affects adolescents and young adults. Even though it is most commonly seen in Japanese women, other countries have reported cases with increasing frequency. It is characterized by erythematous papules and macules on the trunk, neck and chest that resolve leaving a reticulate hyperpigmentation. Some endogenous factors related with ketosis like fasting, diet, diabetes, pregnancy and exogenous agents like chrome, nickel, para-amino compounds have been accused of playing a role in etiology...
February 4, 2017: Türk Patoloji Dergisi
https://www.readbyqxmd.com/read/28257155/surgical-retrieval-of-a-guide-wire-lost-during-central-venous-catheterization-in-a-dog
#16
Jade M Hardy, Jennifer L Lansdowne, Carol A Himsel, Sean R Freer
OBJECTIVE: To report a case of successful surgical removal of a guide wire lost during central venous catheterization. CASE SUMMARY: A 28 kg, 4-year-old female neutered mixed breed dog presented to the primary care veterinarian with diabetic ketosis. During the process of central venous catheterization, the guide wire was accidently released and the entire length of the guide wire slipped into the jugular vein. Due to the absence of nearby interventional radiology facilities, surgical intervention was proposed...
May 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28255845/anti-pd-l1-atezolizumab-induced-autoimmune-diabetes-a-case-report-and-review-of-the-literature
#17
REVIEW
Laura Hickmott, Hugo De La Peña, Helen Turner, Fathelrahman Ahmed, Andrew Protheroe, Ashley Grossman, Avinash Gupta
Programmed cell death-1 and programmed death ligand 1 (PD-1/PD-L1) inhibitors trigger an immune-mediated anti-tumour response by promoting the activation of cytotoxic T lymphocytes. Although proven to be highly effective in the treatment of several malignancies they can induce significant immune-related adverse events (irAEs) including endocrinopathies, most commonly hypophysitis and thyroid dysfunction, and rarely autoimmune diabetes. Here we present the first case report of a patient with a primary diagnosis of urothelial cancer developing PD-L1 inhibitor-induced autoimmune diabetes...
April 2017: Targeted Oncology
https://www.readbyqxmd.com/read/28203360/blood-versus-urine-ketone-monitoring-in-a-pediatric-cohort-of-patients-with-type-1-diabetes-a-crossover-study
#18
Line Goffinet, Thierry Barrea, Véronique Beauloye, Philippe A Lysy
BACKGROUND: The aim of our study was to determine the influence of routine ketone monitoring on hyperglycemic events (HE) and ketosis in youngsters with type 1 diabetes (T1D). METHODS: Our single-site, controlled and randomized study was conducted on children and adolescents with T1D outside of remission phase. During two crossover periods of 6 months, patients (n = 22) experiencing HE tested ketones alternatively with a blood ketone meter or urine ketone test strips and gave their opinion on screening methods after completion of clinical trial...
January 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28105082/genetic-diagnosis-and-treatment-of-a-chinese-ketosis-prone-mody-3-family-with-depression
#19
Jun Tang, Chen-Yi Tang, Fang Wang, Yue Guo, Hao-Neng Tang, Ci-La Zhou, Shu-Wen Tan, Shi-Ping Liu, Zhi-Guang Zhou, Hou-De Zhou
BACKGROUND: To analyze the gene mutation and mental disorder of a Chinese ketosis-prone diabetes (KPD) family, and to make a precise diagnosis and give a treatment for them. METHODS: We studied a Chinese family with a clinical diagnosis of maturity-onset diabetes of the young (MODY). The clinical data and the blood samples were collected. The promotor and coding regions inclusive intron exon boundaries of the HNF1A, HNF4A were detected by polymerase chain reaction (PCR) and direct sequencing...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28099783/ketosis-and-diabetic-ketoacidosis-in-response-to-sglt2-inhibitors-basic-mechanisms-and-therapeutic-perspectives
#20
REVIEW
Hongyu Qiu, Aleksandra Novikov, Volker Vallon
Inhibitors of the sodium-glucose cotransporter SGLT2 are a new class of antihyperglycemic drugs that have been approved for the treatment of type 2 diabetes mellitus (T2DM). These drugs inhibit glucose reabsorption in the proximal tubules of the kidney thereby enhancing glucosuria and lowering blood glucose levels. Additional consequences and benefits include a reduction in body weight, uric acid levels, and blood pressure. Moreover, SGLT2 inhibition can have protective effects on the kidney and cardiovascular system in patients with T2DM and high cardiovascular risk...
January 18, 2017: Diabetes/metabolism Research and Reviews
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