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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/28593353/diabetic-ketoacidosis-and-diabetes-associated-with-antipsychotic-exposure-among-a-previously-diabetes-naive-population-with-schizophrenia-a-nationwide-nested-case-control-study
#2
Christoffer Polcwiartek, Kristian Kragholm, Christopher Rohde, Nasseh Hashemi, Torkel Vang, Jimmi Nielsen
AIMS/HYPOTHESIS: Diabetic ketoacidosis (DKA) is a potentially fatal metabolic emergency of both type 1 and type 2 diabetes. Although there is a reduced risk of type 1 diabetes in schizophrenia, the incidence of DKA is tenfold higher than that of the general population. Thus, we aimed to investigate associations between exposure to antipsychotic medication (within 3 months prior to event) and DKA, type 1 diabetes and type 2 diabetes. We also reported related, clinically relevant outcomes...
June 7, 2017: Diabetologia
https://www.readbyqxmd.com/read/28588004/long-term-follow-up-of-a-case-with-proprotein-convertase1-3-deficiency-transient-diabetes-mellitus-with-intervening-diabetic-ketoacidosis-during-growth-hormone-therapy
#3
Nazlı Gonc, Alev Ozon, Ayfer Alikasifoglu, Nurgun Kandemir
Proprotein convertase 1/3 deficiency is a very rare disease characterized by severe intractable diarrhea in the first years of life, followed by obesity and several hormonal deficiencies later. Diabetes mellitus requiring insulin treatment and diabetic ketoacidosis have not been reported before in this disorder. We herein present a girl with proprotein convertase 1/3 deficiency who has been followed from birth to 17 years of age. She developed deficiencies of all pituitary hormones over time as well diabetes mellitus while receiving growth hormone therapy...
June 7, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28587531/dapagliflozin-for-the-treatment-of-type-1-diabetes-mellitus
#4
Kalliopi Pafili, Efstratios Maltezos, Nikolaos Papanas
In 2017, the management of type 1 diabetes mellitus (T1DM) remains intriguing for the clinician, who has to balance between adequate glycemic control and untoward events related to insulin up-titration. Thus, agents that will complement insulin actions and reduce adverse effects are highly welcome. Areas covered: In this review, the authors summarize results from studies on the sodium glucose co-transporter 2 (SGLT2) inhibitor dapagliflozin in T1DM. Expert opinion: In T1DM, dapagliflozin is associated with significant antihyperglycemic and metabolic properties, which are achieved with reduction or stabilization of insulin dose and with a very low trend for hypoglycemia...
June 12, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28576796/management-of-diabetic-ketoacidosis-effect-of-a-quality-improvement-programme-and-its-long-term-follow-up
#5
Punith Kempegowda, Benjamin Coombs, Joht Singh Chandan, Jaffar Al-Sheikhli, Kasun Theivendran, Bhavana Shyamanur, Sandip Ghosh, Parth Narendran
No abstract text is available yet for this article.
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28571661/-evaluation-and-perioperative-management-of-patients-with-diabetes-mellitus-a-challenge-for-the-anesthesiologist
#6
REVIEW
João Paulo Jordão Pontes, Florentino Fernandes Mendes, Mateus Meira Vasconcelos, Nubia Rodrigues Batista
Diabetes mellitus (DM) is characterized by alteration in carbohydrate metabolism, leading to hyperglycemia and increased perioperative morbidity and mortality. It evolves with diverse and progressive physiological changes, and the anesthetic management requires attention regarding this pathology interference in multiple organ systems and their respective complications. Patient's history, physical examination, and complementary exams are important in the preoperative management, particularly glycosylated hemoglobin (HbA1c), which has a strong predictive value for complications associated with diabetes...
May 29, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28570329/endocrine-emergencies-with-neurologic-manifestations
#7
Makoto Ishii
PURPOSE OF REVIEW: This article provides an overview of endocrine emergencies with potentially devastating neurologic manifestations that may be fatal if left untreated. Pituitary apoplexy, adrenal crisis, myxedema coma, thyroid storm, acute hypercalcemia and hypocalcemia, hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state), and acute hypoglycemia are discussed, with an emphasis on identifying the signs and symptoms as well as diagnosing and managing these clinical entities...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28557813/diabetic-ketoacidosis-as-an-immune-related-adverse-event-from-pembrolizumab-in-non-small-cell-lung-cancer
#8
Giulia C Leonardi, Geoffrey R Oxnard, Andrea Haas, Joshua P Lang, Jonathan S Williams, Mark M Awad
Programmed cell death protein 1 pathway inhibitors are now routinely administered to patients with non-small cell lung cancer, and prompt recognition of immune-related adverse events is critical to managing serious drug toxicities. Here, we describe a 66-year-old man with no known history of diabetes who presented with diabetic ketoacidosis after receiving 3 doses of pembrolizumab for lung adenocarcinoma. Autoimmune diabetes is a rare but potentially life-threatening complication of programmed cell death protein 1 inhibitors...
July 2017: Journal of Immunotherapy
https://www.readbyqxmd.com/read/28535688/sglt-2-inhibitors-is-there-a-role-in-type-1-diabetes-mellitus-management
#9
Nabila Ahmed-Sarwar, Angela K Nagel, Samantha Leistman, Kevin Heacock
OBJECTIVE: The purpose of this review is to identify and evaluate disease management of patients with type 1 diabetes mellitus (T1DM) who were treated with a sodium-glucose cotransporter 2 (SGLT-2) inhibitor as an adjunct to insulin therapy. DATA SOURCES: A PubMed (1969 to March 2017) and Ovid (1946 to March 2017) search was performed for articles published utilizing the following MESH terms: canagliflozin, empagliflozin, dapagliflozin, type 1 diabetes mellitus, insulin dependent diabetes, insulin, sodium-glucose transporter 2...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28534682/diabetic-ketoacidosis-a-common-debut-of-diabetes-among-african-americans-with-type-2-diabetes
#10
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/28520705/disparities-in-diabetes-deaths-among-children-and-adolescents-united-states-2000-2014
#11
Sharon Saydah, Giuseppina Imperatore, Yiling Cheng, Linda S Geiss, Ann Albright
Diabetes is a common chronic disease of childhood affecting approximately 200,000 children and adolescents in the United States (1). Children and adolescents with diabetes are at increased risk for death from acute complications of diabetes, including hypoglycemia and diabetic ketoacidosis (2,3); in 2012, CDC reported that during 1968-2009, diabetes mortality among U.S. persons aged ≤19 years declined by 61% (4). CDC observed disparities by race during 1979-2004, with black children and adolescents dying from diabetes at twice the rate of white children and adolescents (5)...
May 19, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#12
James Luke Godwin, Shuchie Jaggi, Imali Sirisena, Pankaj Sharda, Ajay D Rao, Ranee Mehra, Colleen Veloski
BACKGROUND: Advances in cancer immunotherapy have generated encouraging results in multiple malignancies refractory to standard chemotherapies. As the use of immune checkpoint inhibitors (ICI) proliferates, the incidence of autoimmune side effects associated with these agents, termed immune related adverse events (irAE), is expected to increase. The frequency of significant irAE in ICI treated patients is about 10-20% and early recognition is critical to prevent serious morbidity and even mortality...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28488182/successful-management-of-pregnancies-in-patients-with-inherited-disorders-of-ketone-body-metabolism
#13
Raashda Ainuddin Sulaiman, Maha Al-Nemer, Rubina Khan, Munirah Almasned, Bedour S Handoum, Zuhair N Al-Hassnan
Patients with succinyl-CoA:3-oxoacid CoA transferase (SCOT) deficiency and 3-hydroxy-3-methylglutaryl (HMG)-CoA lyase deficiency are at increased risk of developing metabolic acidosis and hypoglycemia during pregnancy, delivery, and postpartum period. This can be fatal if not treated appropriately. Pregnancy in such patients should be managed in a specialist center by a multidisciplinary team including metabolic physician, high-risk obstetrician, and metabolic dietician. We report two pregnancies in women with SCOT deficiency and HMG-CoA lyase deficiency, which were successfully managed at this tertiary care center...
May 10, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28464767/heterogeneity-of-type-1-diabetes-the-effect-of-ethnicity
#14
Mustafa Tosur, Maria Jose Redondo
BACKGROUND: Most of the current understanding of type 1 diabetes (T1D) etiology and pathogenesis stemmed from studies conducted in majoritarily Non-Hispanic White (NHW) populations. However, evidence is emerging that unique mechanisms of disease may contribute to the development of T1D in individuals of Hispanic ethnicity. OBJECTIVE: We reviewed the currently available literature on genetic, immunologic, metabolic and clinical characteristics of T1D in Hispanic as compared with NHW individuals...
May 1, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28458895/case-of-diabetic-ketoacidosis-as-an-initial-presentation-of-cushing-s-syndrome
#15
Runa Acharya, Udaya M Kabadi
SUMMARY: Diabetic ketoacidosis (DKA) is commonly encountered in clinical practice. The current case is a unique and rare presentation of DKA as the initial manifestation of Cushing's disease secondary to ACTH-secreting pituitary adenoma. Appropriate management as elaborated in the article led to total remission of diabetes as well as the Cushing's disease. LEARNING POINTS: DKA is a serious and potentially life-threatening metabolic complication of diabetes mellitus...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28458888/diabetic-ketoacidosis-a-challenging-diabetes-phenotype
#16
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/28449590/continuous-glucose-monitoring-in-older-adults-with-type-1-and-type-2-diabetes-using-multiple-daily-injections-of-insulin-results-from-the-diamond-trial
#17
Katrina J Ruedy, Christopher G Parkin, Tonya D Riddlesworth, Claudia Graham
OBJECTIVE: The objective was to determine the effectiveness of real-time continuous glucose monitoring (CGM) in adults ≥ 60 years of age with type 1 (T1D) or type 2 (T2D) diabetes using multiple daily insulin injections (MDI). METHODS: A multicenter, randomized trial was conducted in the United States and Canada in which 116 individuals ≥60 years (mean 67 ± 5 years) with T1D (n = 34) or T2D (n = 82) using MDI therapy were randomly assigned to either CGM (Dexcom™ G4 Platinum CGM System® with software 505; n = 63) or continued management with self-monitoring blood glucose (SMBG; n = 53)...
April 1, 2017: Journal of Diabetes Science and Technology
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
#18
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/28400862/an-audit-of-clinical-practice-in-a-single-centre-in-kuwait-management-of-children-on-continuous-subcutaneous-insulin-infusion-and-cardiovascular-risk-factors-screening
#19
Dina Omar, Hala Alsanae, Mona Al Khawari, Majedah Abdulrasoul, Zahraa Rahme, Faisal Al Refaei, Kazem Behbehani, Azza Shaltout
OBJECTIVES: To audit the current clinical practice of continuous subcutaneous insulin infusion (CSII) for the treatment of type 1 diabetes mellitus (T1D) in children and adolescents attending a single centre in Kuwait. METHODS: A one year retrospective audit was performed in children and adolescents with T1D on CSII, who attended the paediatric diabetes clinic, Dasman Diabetes Institute during 2012. The primary outcome measure was glycaemic control as evidenced by glycated haemoglobin (HbA1c) level and the secondary outcome measures were the frequency of monitoring of the risk for microvascular complications and occurrence of acute complications and adverse events...
2017: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/28400692/severe-hypertriglyceridemia-causing-pancreatitis-in-a-child-with-new-onset-type-i-diabetes-mellitus-presenting-with-diabetic-ketoacidosis
#20
Pradeep Kumar Sharma, Maneesh Kumar, Dinesh Kumar Yadav
The triad of pancreatitis, hypertriglyceridemia, and diabetic ketoacidosis and its treatment has not been extensively discussed in the pediatric literature. We report a 4-year-old child with severe hypertriglyceridemia, pancreatitis, and diabetic ketoacidosis. Hypertriglyceridemia and pancreatitis with diabetic ketoacidosis can be successfully managed with insulin and hydration therapy in children. Early recognition of this triad is important as insulin requirements, recovery duration, and prognosis can be altered...
March 2017: Indian Journal of Critical Care Medicine
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