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diabetic ketoacidosis

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https://www.readbyqxmd.com/read/28107262/suspected-cerebral-edema-in-diabetic-ketoacidosis-is-there-still-a-role-for-head-ct-in-treatment-decisions
#1
Carmen L Soto-Rivera, Lisa A Asaro, Michael S D Agus, Danielle D DeCourcey
OBJECTIVES: Neurologic deterioration associated with cerebral edema in diabetic ketoacidosis is typically sudden in onset, progresses rapidly, and requires emergent treatment. The utility of brain imaging by head CT in decisions to treat for cerebral edema has not been previously studied. The objective of this study was to describe the characteristics of pediatric patients with diabetic ketoacidosis who develop altered mental status and evaluate the role of head CT in this cohort. DESIGN: Retrospective analysis of clinical, biochemical, and radiologic data...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28102030/impact-of-sodium-glucose-cotransporter-2-inhibitors-on-nonglycemic-outcomes-in-patients-with-type-2-diabetes
#2
Jennifer M Trujillo, Wesley A Nuffer
The efficacy of the sodium-glucose cotransporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin, and empagliflozin in reducing hyperglycemia in patients with type 2 diabetes is well documented. In addition, positive effects have been observed with these agents on nonglycemic variables, such as reductions in body weight and blood pressure, which may confer additional health benefits. SGLT2 inhibitors are also associated with evidence of renal-protecting benefits. Furthermore, during the landmark Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME) trial, a substantial reduction in major adverse cardiovascular outcomes was demonstrated with empagliflozin therapy...
January 19, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28101143/clinical-aspects-of-pancreatogenic-diabetes-secondary-to-hereditary-pancreatitis
#3
Marcio Garrison Dytz, Pedro Arthur Hamamoto Marcelino, Olga de Castro Santos, Lenita Zajdenverg, Flavia Lucia Conceição, Tânia Maria Ortiga-Carvalho, Melanie Rodacki
BACKGROUND: Hereditary pancreatitis is a rare inherited form of pancreatitis, characterized by recurrent episodes of acute pancreatitis with early onset and/or chronic pancreatitis, and presenting brittle diabetes, composed of episodes of nonketotic hyperglycemia and severe hypoglycemia. The existing literature regarding this form of diabetes is scarce. In this report, clinical features of pancreatogenic diabetes secondary to hereditary pancreatitis are presented along with recommendations for appropriate medical treatment...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28100606/predictive-hyperglycemia-and-hypoglycemia-minimization-in-home-evaluation-of-safety-feasibility-and-efficacy-in-overnight-glucose-control-in-type-1-diabetes
#4
Tamara Spaic, Marsha Driscoll, Dan Raghinaru, Bruce A Buckingham, Darrell M Wilson, Paula Clinton, H Peter Chase, David M Maahs, Gregory P Forlenza, Emily Jost, Irene Hramiak, Terri Paul, B Wayne Bequette, Faye Cameron, Roy W Beck, Craig Kollman, John W Lum, Trang T Ly
OBJECTIVE: The objective of this study was to determine the safety, feasibility, and efficacy of a predictive hyperglycemia and hypoglycemia minimization (PHHM) system compared with predictive low-glucose insulin suspension (PLGS) alone in overnight glucose control. RESEARCH DESIGN AND METHODS: A 42-night trial was conducted in 30 individuals with type 1 diabetes in the age range 15-45 years. Participants were randomly assigned each night to either PHHM or PLGS and were blinded to the assignment...
January 18, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28099783/ketosis-and-diabetic-ketoacidosis-in-response-to-sglt2-inhibitors-basic-mechanisms-and-therapeutic-perspectives
#5
REVIEW
Hongyu Qiu, Aleksandra Novikov, Volker Vallon
Inhibitors of the sodium-glucose cotransporter SGLT2 are a new class of anti-hyperglycemic 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
https://www.readbyqxmd.com/read/28098839/continuous-glucose-monitoring-enables-the-detection-of-losses-in-infusion-set-actuation-lisas
#6
Daniel P Howsmon, Faye Cameron, Nihat Baysal, Trang T Ly, Gregory P Forlenza, David M Maahs, Bruce A Buckingham, Juergen Hahn, B Wayne Bequette
Reliable continuous glucose monitoring (CGM) enables a variety of advanced technology for the treatment of type 1 diabetes. In addition to artificial pancreas algorithms that use CGM to automate continuous subcutaneous insulin infusion (CSII), CGM can also inform fault detection algorithms that alert patients to problems in CGM or CSII. Losses in infusion set actuation (LISAs) can adversely affect clinical outcomes, resulting in hyperglycemia due to impaired insulin delivery. Prolonged hyperglycemia may lead to diabetic ketoacidosis-a serious metabolic complication in type 1 diabetes...
January 15, 2017: Sensors
https://www.readbyqxmd.com/read/28098426/dapagliflozin-in-patients-with-type-1-diabetes-a-post-hoc-analysis-of-the-effect-of-insulin-dose-adjustments-on-24-hour-continuously-monitored-mean-glucose-and-fasting-beta-hydroxybutyrate-levels-from-a-phase-iia-pilot-study
#7
Robert R Henry, Paresh Dandona, Jeremy Pettus, Sunder Mudaliar, John Xu, Lars Hansen
AIMS: To investigate the effects of total daily insulin dose (TDD) reductions on 24-hour continuously monitored mean glucose and fasting beta-hydroxybutyrate (a marker for diabetic ketosis/ketoacidosis [DKA]) using patient-level data from a 14-day, pilot study of dapagliflozin in type 1 diabetes. MATERIALS AND METHODS: Exploratory correlation analysis was performed post-hoc to determine the relationship between change in TDD and a) 24-hour mean glucose (by continuous glucose monitoring) and b) fasting beta-hydroxybutyrate, in 70 patients with type 1 diabetes receiving insulin and dapagliflozin (1-, 2...
January 18, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28090050/euglycemic-diabetic-ketoacidosis-with-persistent-diuresis-treated-with-canagliflozin
#8
Junichiro Adachi, Yuusuke Inaba, Chisato Maki
Diabetic ketoacidosis is characterized by hyperglycemia, anion-gap acidosis, and increased plasma ketones. After the resolution of hyperglycemia, persistent diuresis is rare. We herein report the case of a 27-year-old Asian woman with type 2 diabetes who was treated with a sodium-glucose cotransporter 2 (SGLT2) inhibitor (canagliflozin) who developed euglycemic diabetic ketoacidosis and persistent diuresis in the absence of hyperglycemia. Physicians should consider euglycemic diabetic ketoacidosis in the differential diagnosis of patients treated with SGLT2 inhibitors...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090049/thyroid-storm-precipitated-by-diabetic-ketoacidosis-and-influenza-a-a-case-report-and-literature-review
#9
Toshiyuki Ikeoka, Hiroaki Otsuka, Naruhiro Fujita, Yukiko Masuda, Shigeto Maeda, Ichiro Horie, Takao Ando, Norio Abiru, Atsushi Kawakami
A 46-year-old woman with a history of Graves' disease presented with the chief complaints of appetite loss, weight loss, fatigue, nausea, and sweating. She was diagnosed with diabetic ketoacidosis (DKA), thyroid storm, and influenza A. She was treated with an intravenous insulin drip, intravenous fluid therapy, intravenous hydrocortisone, oral potassium iodine, and oral methimazole. As methimazole-induced neutropenia was suspected, the patient underwent thyroidectomy. It is important to maintain awareness that thyroid storm and DKA can coexist...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28077344/detection-of-h-fabp-heart-type-fatty-acid-binding-protein-levels-in-diabetic-ketoacidosis-and-identification-of-early-cardiac-effects-of-ketoacidosis
#10
Fatma Hilal Yılmaz, Sevil Arı Yuca, Hüsamettin Vatansev, Emine Ayça Cimbek, Yaşar Şen, İsa Yılmaz, Fikret Akyürek, Derya Arslan, Derya Çimen, Alaadin Yorulmaz
OBJECTIVE: This is study aims to measure the level of serum heart-type fatty acid binding protein (h-FABP) in patients presenting with diabetic ketoacidosis (DKA) and diabetic ketosis (DK) and to determine its role in identifying early period cardiac ischemia. METHODS: This prospective study included 35 patients diagnosed with DKA, 20 patients diagnosed with DK, and 20 control subjects.The h-FABP, creatine kinase-MB (CK-MB), and troponin-I levels were studied in patients with DKA and DK as well as in the control group at the time of presentation...
January 12, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28074994/-normoglycemic-diabetic-ketoacidosis-in-pregnancy-report-of-one-case
#11
Margarita Rivas M, Pamela Belmar Z, Pilar Durruty A, Lilian Sanhueza M, Gloria López S
Normoglycemic diabetic ketoacidosis should be suspected in pregnant women presenting nausea, vomiting, abdominal pain and anorexia. We report a 39 years old woman with a 32 weeks pregnancy who sought emergency care due to hyperemesis. She was hospitalized with the following diagnoses: pregnancy hypertension syndrome, gestational diabetes, morbid obesity and poor prenatal control. The evaluation of the feto-placental unit showed perception of fetal movements, non-reactive non-stress baseline record and a biophysical profile of 6/8...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28070957/controlled-trial-of-hartmann-s-solution-versus-0-9-saline-for-diabetic-ketoacidosis
#12
Michael Yung, Georgia Letton, Steve Keeley
AIM: We aimed to determine whether using a balanced salt solution, Hartmann's solution (HS), in diabetic ketoacidosis (DKA) shortens the time to normalise acid-base status through the avoidance of hyperchloremic metabolic acidosis compared with 0.9% normal saline (NS). METHODS: We conducted a double-blind, randomised controlled trial comparing HS to NS as the initial intravenous fluid in children with DKA. Patients were stratified by severity (pH < 7.1) and known or new diabetes...
January 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28062431/disseminated-histoplasmosis-presenting-as-diabetic-keto-acidosis-in-an-immunocompetent-patient
#13
Negin Niknam, Prashant Malhotra, Angela Kim, Seth Koenig
Histoplasma capsulatum causes a spectrum of manifestations from asymptomatic to fatal disseminated disease. Disseminated histoplasmosis is mostly seen in endemic areas among immunocompromised patients such as those with AIDS. Here, we present a patient living in a non-endemic area with previously undiagnosed diabetes mellitus, who presented with septic shock and diabetic ketoacidosis (DKA), and was ultimately diagnosed with disseminated histoplasmosis. The patient rapidly recovered on administration of intravenous liposomal amphotericin followed by oral itraconazole...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28054280/successful-bypass-operation-for-esophageal-obstruction-after-acute-esophageal-necrosis-a-case-report
#14
Yayoi Sakatoku, Masahide Fukaya, Kazushi Miyata, Masato Nagino
BACKGROUND: Acute esophageal necrosis (AEN) is a rare clinical disorder. Esophageal stenosis or obstruction is one of severe complications, but there are a few reports about surgical treatments. In such a situation, it still remains controversial which to choose, esophagectomy or bypass operation. CASE PRESENTATION: A 61-year-old woman was admitted to the local hospital for septic shock with diabetic ketoacidosis due to necrotizing fasciitis of the right thigh. Three days later, she had hematemesis, and gastrointestinal endoscopy revealed black mucosal coloration throughout the entire esophagus...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28049242/factors-associated-with-the-presence-and-severity-of-diabetic-ketoacidosis-at-diagnosis-of-type-1-diabetes-in-korean-children-and-adolescents
#15
Hye Jin Lee, Hyeoh Won Yu, Hae Woon Jung, Young Ah Lee, Jae Hyun Kim, Hye Rim Chung, Jaeho Yoo, Eunyoung Kim, Jeesuk Yu, Choong Ho Shin, Sei Won Yang, Seong Yong Lee
The aim of this study was to identify the risk factors for presence and severity of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in Korean children and adolescents. A retrospective chart review of children and adolescents newly diagnosed with T1DM was conducted in seven secondary and tertiary centers in Korea. Eligible subjects were < 20 years of age and had records on the presence or absence of DKA at the time of T1DM diagnosis. DKA severity was categorized as mild, moderate, or severe...
February 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28044993/higher-than-conventional-subcutaneous-regular-insulin-doses-following-diabetic-ketoacidosis-are-associated-with-better-short-term-glycemic-control-in-children-and-adolescents
#16
Özlem Bağ, Selma Tunç, Özlem Nalbantoğlu, Çiğdem Ecevit, Aysel Öztürk, Behzat Özkan, Korcan Demir
OBJECTIVE: While some guidelines recommend 0.5-1.0 units/kg/d of subcutaneous insulin following resolution of diabetic ketoacidosis (DKA), up to 2 units/kg/d of insulin is used in various centers. The aim of this study is to evaluate the effect of initial insulin dosage on glycemic control in first 48 hours of subcutaneous regular insulin therapy after DKA. METHODS: Hospital records of patients with DKA in the last 3 years [n=76, median (25th - 75th percentile) age=10...
December 30, 2016: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28043933/clinical-biochemical-and-histopathology-features-of-patients-with-glycogenic-hepatopathy
#17
Saurabh Mukewar, Ayush Sharma, Kandace Lackore, Felicity Enders, Michael Torbenson, Patrick S Kamath, Lewis R Roberts, Yogish C Kudva
BACKGROUND & AIMS: Glycogenic hepatopathy, a syndrome characterized by hepatomegaly and increased liver transaminases in patients with type-1 diabetes, has not been well characterized in adults. We describe the clinical, biochemical, and histo-pathology profile of a cohort of patients with glycogenic hepatopathy. We also examined differences between patients with type-1 diabetes with vs without glycogenic hepatopathy. METHODS: We performed a case-control study of patients with type-1 diabetes diagnosed with glycogenic hepatopathy and patients with type-1 diabetes without glycogenic hepatopathy (controls)...
December 30, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28034690/impact-of-diabetic-ketoacidosis-on-thyroid-function-tests-in-type-1-diabetes-mellitus-patients
#18
Homeira Rashidi, Seyed Bahman Ghaderian, Seyed Mahmoud Latifi, Forogh Hoseini
The aim of current study was to evaluate the function of thyroid during diabetic acidosis, just after the treatment and two weeks after the treatment. This was the analytic study. The study subjects included 20 patients, aged 18-36 years old, with type1 diabetes and diabetic ketoacidosis. All subjects were evaluated for thyroid function tests such as triiodothyronine (T3), thyroxine (T4), T3 resin uptake (T3RU), free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH), before treatment. After completing DKA treatment and two weeks after discharge, the thyroid function tests were repeated on the subjects and the results were analyzed using paired T-test, ANOVA or repeated measure and Pearson correlation tests...
December 14, 2016: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28031780/double-diabetes-in-saudi-arabia-a-new-entity-or-an-underestimated-condition
#19
Rim Braham, Aus Alzaid, Asirvatham Alwin Robert, Muhammad Mujammami, Rania Ahmad Ahmad, Monther Zitouni, Samia Hasan Sobki, Mohamed Abdulaziz Al Dawish
AIM: To determine the clinical and biological characteristics of double diabetes (DD) among young people in Saudi Arabia. METHODS: This was a retrospective descriptive chart review study including 312 young newly diagnosed diabetic patients (aged 12-20 years), whom were admitted over a five year period (January 2009 to December 2013). Family history of diabetes mellitus (DM) (first degree), physical body mass index (BMI), acanthosis nigricans, history of auto-immune disease and laboratory information for glycosylated hemoglobin, basal C peptide level and diabetes autoantibody response (anti-GAD, anti-IA2 and anti-ICA) were collected from medical report...
December 15, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/28018682/bent-metal-in-a-bone-a-rare-complication-of-an-emergent-procedure-or-a-deficiency-in-skill-set
#20
Mridula Krishnan, Katherine Lester, Amber Johnson, Kaye Bardeloza, Peter Edemekong, Ilya Berim
Intraosseous (IO) access is an important consideration in patients with difficult intravenous (IV) access in emergent situations. IO access in adults has become more popular due to the ease of placement and high success rates. The most common sites of access include the proximal tibia and the humeral head. The complications associated are rare but can be catastrophic: subsequent amputation of a limb has been described in the literature. We report a 25-year-old female presenting with diabetic ketoacidosis (DKA) in whom emergent IO access was complicated by needle bending inside the humerus...
2016: Case Reports in Critical Care
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