cetoacidosis

Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that are increasingly used in cancer treatments. As experience in the use of immunotherapy increases, more is known about its safety profile and immune-mediated adverse effects. Among them is diabetic ketoacidosis (DKA), a rare but serious fatal complication of treatment. In this paper we describe the cases of three patients who presented with episodes of DKA during treatment with ICIs, two of which manifested with fulminant forms, leading to an acute course with initially normal glycosylated hemoglobin values...

OBJECTIVE: Diabetic ketoacidosis (DKA) is a serious complication that usually occurs at diagnosis of type 1 diabetes mellitus (T1D). However, the prevalence of DKA at diagnosis of T1D is heterogeneous in different regions of the world. The aim of this study was to determine the prevalence of DKA at diagnosis of T1D in Asturias. METHODS: This study included all patients under nineteen years of age diagnosed with T1D in Asturias between 2011 and 2020. Retrospective review of medical records was performed to analyse DKA and other characteristics at diagnosis...

Fungal sinusitis is a pathology that can occur in patients with diabetes mellitus and be associated with a hyperglycemic crisis. It is an aggressive entity with local complications that include involvement of the orbit or the central nervous system, and vascular involvement. Despite surgical and antifungal treatment, mortality raises up to 75%. We report the case of a female patient with a diagnosis of diabetic ketoacidosis and signs of unilateral ophthalmoplegia, which led to the study with magnetic resonance imaging of the central nervous system, finding signs of sinusitis, meningitis, and cerebritis...

INTRODUCTION: The evolution of the incidence of type 1 diabetes (T1D) in all groups is controversial. Our objective is to study the incidence from 2009 to 2020, based on the Type 1 Diabetes Registry of Navarra, and to analyze the clinical presentation as diabetic ketoacidosis (DKA), and HbA1c at onset. MATERIALS AND METHODS: Descriptive study of all cases diagnosed as T1D and included in the Population Registry of T1D of Navarra in the period 1/1/2009 to 12/31/2020...

INTRODUCTION: ß-pancreatic cells are susceptible to SARS-CoV-2 infection and replication; this could lead to infection-related diabetes or precipitate the onset of type 1 diabetes. This study aimed to determine the severity at diagnosis, analyzing clinical and epidemiological features at debut in children under 16 years of age in the context of the SARS-CoV-2 pandemic. MATERIAL AND METHODS: A retrospective observational multicenter study was carried out in 7 hospitals of the public health network located in the south of our community...

INTRODUCTION: The aim of this study is to determine whether during the year 2020, coinciding with the COVID-19 pandemic, there has been an increase in the incidence of diabetes mellitus in children compared to the previous 2 years. It is also to find out if lockdowns and the difficulty providing face-to-face care in the health system have led to children showing more severe symptoms at the time of diagnosis. MATERIAL AND METHODS: Retrospective observational multicenter study of the province of Tarragona where data is collected from new diagnoses of type 1 diabetes mellitus in patients under the age of 15 during the year 2020 and compared with years 2018 and 2019...

INTRODUCTION: Diabetic ketoacidosis (DKA) is a life-threatening complication characterized by hyperglycemia, metabolic acidosis, and ketonemia. Although the time to resolution of DKA has been estimated at 12 to 18 hours, the factors that could prolong it have not been fully studied. METHODS: Retrospective study of medical records of adult patients admitted to the general ward with a diagnosis of DKA. They were classified according to severity as mild, moderate and severe...

INTRODUCTION: The association of COVID-19 with diabetes mellitus is bidirectional. In one direction, diabetes mellitus is associated with an increased risk of severe COVID-19. In the opposite direction, in patients with COVID-19 new-onset diabetes mellitus, severe diabetic ketoacidosis and severe metabolic complications have been described. CLINICAL CASE: This report describes two patients with diabetes mellitus who came to our hospital with ketoacidosis resulting from new-onset diabetes mellitus...

Spinal muscular atrophy is an uncommon cause of ketoacidosis, where there is a decrease in muscle mass, an abnormal metabolism of glucose and fatty acids, and changes in neuroendocrine function. These conditions favor the accumulation of keto acids and the development of metabolic acidosis. We report a 26-year-old female, with a history of spinal muscular atrophy type III, consulting for abdominal pain and vomiting lasting one week. She was admitted to the emergency service somnolent and poorly perfused. She had a pH of 6...

BACKGROUND: Acute pancreatitis in children is an uncommon, little known, poorly defined disease and thus is rarely considered in diagnosis of pediatric abdominal pain. It is rare but is being recognized more frequently, and differs from the disease in the adult both in etiology and therapeutic approach. CLINICAL MATERIAL: Fifty children with acute pancreatitis were managed. Their history and postoperative course were analyzed in a retrospective study. RESULTS: The clinical presentation was unremarkable; all patients had abdominal pain, specially in epigastrium, and vomiting was the only other clinical sign exhibited by > 80%...

We present a retrospective study based on 50 diabetic patients with acute abdominal diseases. Usually, clinical features were not typical, without defining signs of acute abdomen, despite frequent severe anatomo-pathological forms (6 of 12 acute appendicitis were gangrenous, with generalised or localised peritonitis; 15 of 22 acute colecystitis were gangrenous). In diabetic patients, with metabolic disorders and cetoacidosis, positive diagnosis and the decision of laparotomy are difficult problems, often delated, with a negative influence on the evolutions and prognosis of these patients...

INTRODUCTION AND OBJECTIVES: Diabetic Pregnancy Prognosis in Seventies is it better in Eighties because of Patient Education? METHODOLOGY: Retrospectively, since 1980 to 1989, in Women in status to breed, Diabetic Pregnancy was screened in our Department. W.H.O.'s (1980) Diabetes Mellitus Criterias, PEDERSEN's Criterias, White's Classification were used. Studied Parameters were etiologic factors (age, type, Diabetes oldness and control), former and present Evolution of Pregnancies (term and pregnancy's product)...

The case of a 15 year old white man, diabetic in cetoacidosis, with a orbit-rhino-cerebral phycomycosis is reported. The illness had an acute onset and the treatment was iniciated early with Amphotericin-B and unilateral osteotomy of maxillary and ethmoidal sinus. With this treatment the patient did well with residuals of ophtalmoplegia and amaurosis on the right. Interesting investigation aspects are the occluded internal carotid on the same side of the affected orbit and the CAT-SCAN finding of moderated ventricular dilatation (two months after hospital admission)...

Fifty nine insulin dependant diabetics were hospitalised for a trial withdrawal of insulin: 17 patients rapidly showed signs of lack of insulin, 18 did not develop cetoacidosis but could not be stabilised on diet and oral hypoglycemic agents, 24 were stabilised without insulin. A statistical study (multifactorial analysis of correlations, plotting of ROC graphs) validated the classification of these diabetics into 3 groups. It also showed that in patients with hypoglycemia, the values of C-protein, and after intravenous injection of tolbutamide, were good predictive factors for insulin-dependance: all patients with basal C-protein less than 1,9 ng/ml could not be stabilised without insulin; when the basal C-protein greater than or equal to 1,9 ng/ml and the amplitude of response at the 5th min was greater than or equal to 0,4 ng/ml, the diabetes could be stabilised by diet and oral hypoglycemic agents in 90 p...