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https://www.readbyqxmd.com/read/28534682/diabetic-ketoacidosis-a-common-debut-of-diabetes-among-african-americans-with-type-2-diabetes
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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: Endocrinol Diabetes Nutr
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28393586/evaluation-of-glycated-albumin-ga-and-ga-hba1c-ratio-for-diagnosis-of-diabetes-and-glycemic-control-a-comprehensive-review
#12
Sara Yazdanpanah, Mohammad Rabiee, Mohammadreza Tahriri, Mojgan Abdolrahim, Asadollah Rajab, Hossein E Jazayeri, Lobat Tayebi
Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic high blood glucose concentrations (hyperglycemia). When it is left untreated or improperly managed, it can lead to acute complications including diabetic ketoacidosis and non-ketotic hyperosmolar coma. In addition, possible long-term complications include impotence, nerve damage, stroke, chronic kidney failure, cardiovascular disease, foot ulcers, and retinopathy. Historically, universal methods to measure glycemic control for the diagnosis of diabetes included fasting plasma glucose level (FPG), 2-h plasma glucose (2HP), and random plasma glucose...
April 10, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28381819/purulent-pericarditis-an-uncommon-presentation-of-a-common-organism
#13
Muhammad Kashif, Henish Raiyani, Masooma Niazi, Kamalakkannan Gayathri, Trupti Vakde
BACKGROUND In the modern antibiotic era, Streptococcus agalactiae infection of the endocardium and pericardial space is a rare occurrence. However, once the disease spreads it can lead to life-threatening illness despite advances in diagnostic and treatment modalities, partly because the symptoms and signs associated with pericarditis are frequently missing, and due to the rarity of the disease, diagnosis is often overlooked. We report an extremely rare case of purulent pericarditis caused by Streptococcus agalactiae...
April 6, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28376867/assessment-of-platelets-morphological-changes-and-serum-butyrylcholinesterase-activity-in-children-with-diabetic-ketoacidosis-a-case-control-study
#14
Suzan Omar Mousa, Samira Zein Sayed, Mahmoud Mohammed Moussa, Ahmed Hamdy Hassan
BACKGROUND: Many studies indicated that mean platelet volume (MPV) and platelet distribution width (PDW) may be valuable in the diagnosis and management of clinical disorders; also, serum butyrylcholinesterase activity (BChE) was suggested to be linked to systemic inflammation and oxidative stress. Limited studies measured these readily available markers in children with diabetic ketoacidosis (DKA). Our objectives were to measure MPV, PDW and BChE in children with DKA; and to assess if any of these markers reflects the severity of DKA...
April 4, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28372975/guidelines-for-management-of-diabetic-ketoacidosis-time-to-revise
#15
Ketan K Dhatariya, Guillermo E Umpierrez
No abstract text is available yet for this article.
May 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28372715/management-of-hyperglycemic-crises-diabetic-ketoacidosis-and-hyperglycemic-hyperosmolar-state
#16
REVIEW
Maya Fayfman, Francisco J Pasquel, Guillermo E Umpierrez
Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are the most serious and life-threatening hyperglycemic emergencies in diabetes. DKA is more common in young people with type 1 diabetes and HHS in adult and elderly patients with type 2 diabetes. Features of the 2 disorders with ketoacidosis and hyperosmolality may coexist. Both are characterized by insulinopenia and severe hyperglycemia. Early diagnosis and management are paramount. Treatment is aggressive rehydration, insulin therapy, electrolyte replacement, and treatment of underlying precipitating events...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28365561/are-the-results-from-the-2014-uk-national-survey-on-the-management-of-diabetic-ketoacidosis-applicable-to-individual-centres
#17
M Varadarajan, M Patel, N Kakkar, E Li Ping Wah-Pun Sin, D Maxey, I Nunney, K Dhatariya
BACKGROUND: In 2013 the Joint British Diabetes Societies published an update to their 2010 guideline on the management of diabetic ketoacidosis (DKA). In 2014 a national survey was conducted to assess the management of DKA across the UK using the JBDS or local guidelines. Hospitals were invited to submit data on 5 people presenting with DKA. These data were published in 2016. However, whether those national results were applicable to individual hospitals remains unknown. AIM: To assess the management of people presenting with DKA at a single hospital and compare the results with the national dataset...
March 19, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28364357/treatment-of-diabetic-ketoacidosis-dka-hyperglycemic-hyperosmolar-state-hhs-novel-advances-in-the-management-of-hyperglycemic-crises-uk-versus-usa
#18
REVIEW
Ketan K Dhatariya, Priyathama Vellanki
PURPOSE OF REVIEW: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies that cause high morbidity and mortality. Their treatment differs in the UK and USA. This review delineates the differences in diagnosis and treatment between the two countries. RECENT FINDINGS: Large-scale studies to determine optimal management of DKA and HHS are lacking. The diagnosis of DKA is based on disease severity in the USA, which differs from the UK...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28355170/comparing-practice-patterns-between-pediatric-and-general-emergency-medicine-physicians-a-scoping-review
#19
Nnenna O Chime, Jessica Katznelson, Sandeep Gangadharan, Barbara Walsh, Katie Lobner, Linda Brown, Marcie Gawel, Marc Auerbach
OBJECTIVE: Acutely ill infants and children presenting to the emergency department are treated by either physicians with pediatric emergency medicine (PEM) training or physicians without PEM training, a good proportion of which are general emergency medicine-trained physicians (GEDPs). This scoping review identified published literature comparing the care provided to infants and children (≤21 years of age) by PEM-trained physicians to that provided by GEDPs. METHODS: The search was conducted in 2 main steps as follows: (1) initial literature search to identify available literature with evolving feedback from the group while simultaneously deciding search concepts as well as inclusion and exclusion criteria and (2) modification of search concepts and conduction of search using finalized concepts as well as review and selection of articles for final analysis using set inclusion criteria...
April 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28345986/children-and-young-people-with-diabetes-recognition-and-management
#20
Hamish Hamilton, Grace Knudsen, Camelia Laura Vaina, Michelle Smith, Siba Prosad Paul
Diabetes mellitus (type 1) is an autoimmune condition leading to absolute insulin deficiency resulting in hyperglycaemia and its associated manifestations. It is the most common type of diabetes seen in children, characterised by the 4Ts (toilet, thinner, thirsty, tired). The signs and symptoms can sometimes be non-specific and a delay or missed diagnosis may be catastrophic to the health of the child. Children with an established diagnosis of diabetes often present to the health service with issues such as hypoglycaemia, hyperglycaemia, or diabetic ketoacidosis...
March 23, 2017: British Journal of Nursing: BJN
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