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diabetic ketoacidosis

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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/28690942/cardiac-arrhythmias-resulting-from-a-peripherally-inserted-central-catheter-two-cases-and-a-review-of-the-literature
#7
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/28687163/-latent-autoimmune-diabetes-in-adults-and-ketoacidosis-a-clinical-case
#8
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
#9
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
https://www.readbyqxmd.com/read/28681964/a-shared-comparison-of-diabetes-mellitus-and-neurodegenerative-disorders
#10
Mahmoud Morsi, Ahmed Maher, Ahmed Metwally, Omnia Abo-Elmagd, Dina Johar, Larry Bernstein
Diabetes Mellitus (DM) is one of the most common diseases in the world population, associated with obesity, pancreatic endocrine changes, cardiovascular disease, renal glomerular disease, cerebrovascular disease, peripheral neuropathy, neurodegenerative disease, retinal disease, sleep apnea, some of which are bundled into the metabolic syndrome. The main characteristic of this disease is hyperglycemia, and often with albuminuria. Nevertheless, the classic features, with ketoacidosis in the extreme, are only a first layer of description of this condition...
July 6, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28680774/diabetic-ketoacidosis-an-emergency-medicine-simulation-scenario
#11
Reuben Addison, Tate Skinner, Felix Zhou, Michael Parsons
Simulation provides a safe environment where learning is enhanced through the deliberate practice of skills and controlled management of a variety of clinical encounters. This is particularly important for core cases and low-frequency, high-stakes procedures and encounters. Competency-based medical education has seen widespread adoption in the field along with ongoing work in the areas of undergraduate and postgraduate training. Similarly, effective professional development activities stand to benefit greatly from a more stringent integration of simulation and competency-based approaches...
May 29, 2017: Curēus
https://www.readbyqxmd.com/read/28674636/diabetes-during-pregnancy-influence-of-body-mass-index-on-composite-morbidity
#12
Amy E O'Neil Dudley, Zachary B Jenner, Hector Mendez-Figueroa, Viviana S Ellis, Suneet P Chauhan
Objective  This study aims to compare composite maternal and neonatal morbidities (MM, NM) among pregnant women with diabetes mellitus whose body mass index (BMI) at delivery was < 30 (group 1), 30.0 to 39.9 (group 2), and ≥ 40 kg/m (2) (group 3). We hypothesized that increased BMI class at delivery would be associated with worsening maternal and neonatal outcomes. Methods  This is a retrospective cohort study. MM was defined as: chorioamnionitis, wound infection, eclampsia, diabetic ketoacidosis, hypoglycemia admission, third/fourth degree laceration, and/or death...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28674356/atypical-ketoacidosis-and-protracted-hyperglycosuria-after-treatment-with-ipragliflozin-an-sglt2-inhibitor
#13
Masaaki Miyauchi, Masao Toyoda, Masafumi Fukagawa
We herein present the case of a 21-year-old diabetic obese woman who developed ketoacidosis following the administration of ipragliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor. At the time of admission, although her serum glucose level was only 175 mg/dL, laboratory tests showed ketoacidosis. Interestingly, hyperglycosuria persisted, even after the discontinuation of ipragliflozin. This is the first report of non-hyperglycemic ketoacidosis that might have been caused by protracted hyperglycosuria after the discontinuation of ipragliflozin...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28670136/sodium-glucose-cotransporter-2-inhibition-and-acidosis-in-patients-with-type-2-diabetes-a-review-of-us-fda-data-and-possible-conclusions
#14
John A D'Elia, Alissa R Segal, George P Bayliss, Larry A Weinrauch
OBJECTIVE: To evaluate whether adverse event reports to the US Food and Drug Administration on incidents of ketoacidosis from use of sodium glucose cotransport inhibitors (SGLT2 inhibitors) provide insight into ways this new class of drugs is being prescribed with other antihyperglycemic agents; to examine possible mechanisms to explain ketoacidosis. DESIGN AND METHODS: Reports of adverse events concerned to SGLT2 inhibitors, namely, empagliflozin, dapagliflozin, and canagliflozin were obtained under the Freedom of Information Act for 5 years ending in August 31, 2015...
2017: International Journal of Nephrology and Renovascular Disease
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
#15
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/28667128/diabetic-ketoacidosis-at-diagnosis-of-type-1-diabetes-predicts-poor-long-term-glycemic-control
#16
Lindsey M Duca, Bing Wang, Marian Rewers, Arleta Rewers
OBJECTIVE: This study tested the hypothesis that diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in children predicts poor long-term glycemic control independently of established risk factors. RESEARCH DESIGN AND METHODS: This was a prospective cohort study of 3,364 Colorado residents diagnosed with type 1 diabetes before 18 years of age, in 1998-2012, and monitored for up to 15 years. Of those, 1,297 (39%) had DKA at diagnosis (blood glucose >250 mg/dL, and venous pH <7...
June 30, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28664545/adherence-to-a-pediatric-diabetic-ketoacidosis-protocol-in-children-presenting-to-a-tertiary-care-hospital
#17
Rebecca Ronsley, Nazrul Islam, Claire Ronsley, Daniel L Metzger, Constadina Panagiotopoulos
OBJECTIVE: To review adherence to a provincial diabetic ketoacidosis (DKA) protocol and to assess factors associated with intravenous fluid administration and the length time on an insulin infusion. METHODS: A retrospective chart review was conducted of all DKA admissions to British Columbia Children's Hospital (BCCH) during September 2008 to December 2013. Data collection included diabetes history, estimation of dehydration, insulin and fluid infusion rates, and frequency of laboratory investigations...
June 30, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28662890/diabetic-ketoacidosis-in-patients-under-treatment-with-sodium-glucose-cotransporter-type-2-inhibitors
#18
José Antonio López Medina, Carmen Hernández García, Javier Espíldora Hernández
No abstract text is available yet for this article.
June 26, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28659865/review-of-evidence-for-adult-diabetic-ketoacidosis-management-protocols
#19
REVIEW
Tara T T Tran, Anthony Pease, Anna J Wood, Jeffrey D Zajac, Johan Mårtensson, Rinaldo Bellomo, Elif I I Ekinci
BACKGROUND: Diabetic ketoacidosis (DKA) is an endocrine emergency with associated risk of morbidity and mortality. Despite this, DKA management lacks strong evidence due to the absence of large randomised controlled trials (RCTs). OBJECTIVE: To review existing studies investigating inpatient DKA management in adults, focusing on intravenous (IV) fluids; insulin administration; potassium, bicarbonate, and phosphate replacement; and DKA management protocols and impact of DKA resolution rates on outcomes...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28655966/euglycemic-diabetic-ketoacidosis-by-sodium-glucose-co-transporter-inhibitors-real-but-preventable-concern
#20
Monish S Raut, Arun Maheshwari
No abstract text is available yet for this article.
June 2017: Indian Journal of Anaesthesia
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