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https://www.readbyqxmd.com/read/29330587/posterior-reversible-encephalopathy-syndrome-with-spinal-cord-involvement-pres-sci-as-a-rare-complication-of-severe-diabetic-ketoacidosis-a-case-report-and-review-of-the-literature
#1
Jianfei Nao, Han Zhang, Si Wu, Xiaotian Zhang, Dongming Zheng
INTRODUCTION: In addition to diffuse brain oedema, diabetic ketoacidosis (DKA) can lead to ischaemic or haemorrhagic stroke, extrapontine myelinolysis, and sinovenous thrombosis. However, posterior reversible encephalopathy syndrome (PRES) and spinal cord oedema are rarely reported in patients with DKA. METHODS: We present a case of a 17-year-old-girl who developed headache, blurred vision, and paraplegia after her DKA was controlled. Sequential magnetic resonance (MR) scans of the brain and spinal cord were performed...
January 12, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29316133/diabetic-ketoacidosis-in-adult-patients-an-audit-of-factors-influencing-time-to-normalisation-of-metabolic-parameters
#2
Melissa H Lee, Genevieve L Calder, John D Santamaria, Richard J MacIsaac
BACKGROUND: Diabetic ketoacidosis (DKA) is an acute life-threatening metabolic complication of diabetes that imposes substantial burden on our healthcare system. There is a paucity of published data in Australia assessing factors influencing time to resolution of DKA and length of stay (LOS). AIMS: To identify factors that predict a slower time to resolution of DKA in adults with diabetes. METHODS: Retrospective audit of patients admitted to St Vincent's Hospital Melbourne between 2010 to 2014 coded with a diagnosis of 'Diabetic Ketoacidosis'...
January 8, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29295580/diabetic-ketoacidosis-severity-at-diagnosis-and-glycaemic-control-in-the-first-year-of-childhood-onset-type-1-diabetes-a-longitudinal-cohort-study
#3
Amal R Khanolkar, Rakesh Amin, David Taylor-Robinson, Russell M Viner, Justin Warner, Evelien F Gevers, Terence Stephenson
It is unclear whether diabetic ketoacidosis (DKA) severity at diagnosis affects the natural history of type 1 diabetes (T1D). We analysed associations between DKA severity at diagnosis and glycaemic control during the first year post-diagnosis. We followed 341 children with T1D, <19 years (64% non-white) attending paediatric diabetes clinics in East London. Data were extracted from routine medical registers. Subjects were categorized with normal, mild, moderate, or severe DKA. Linear mixed-effects modelling was used to assess differences in longitudinal HbA1c trajectories (glycaemic control) during 12 months post-diagnosis (1288 HbA1c data-points) based on DKA, adjusting for sex, age, ethnicity, SES (Socioeconomic Status) and treatment type...
December 25, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29258565/a-core-outcomes-set-for-clinical-trials-of-interventions-for-young-adults-with-type-1-diabetes-an-international-multi-perspective-delphi-consensus-study
#4
Molly Byrne, Anthony O'Connell, Aoife M Egan, Sean F Dinneen, Lisa Hynes, Mary Clare O'Hara, Richard I G Holt, Ingrid Willaing, Michael Vallis, Christel Hendrieckx, Imelda Coyne
BACKGROUND: Achieving consensus from a range of relevant stakeholders about an agreed set of core outcomes to be measured and reported as a minimum in clinical trials has the potential to enhance evidence synthesis and make findings more relevant and applicable. Intervention research to improve outcomes for young adults with type 1 diabetes (T1DM) is hampered by inconsistent use of outcome measures. This population frequently struggles to manage their condition and reports suboptimal clinical outcomes...
December 19, 2017: Trials
https://www.readbyqxmd.com/read/29241389/euglycemic-diabetic-ketoacidosis-associated-with-sodium-glucose-cotransporter-type-2-inhibitors-in-patients-with-type-2-diabetes-mellitus-receiving-oral-therapy
#5
Ryan B Dull, Mikayla L Spangler, Emily L Knezevich, Britney M Lau
INTRODUCTION AND OBJECTIVE: Postmarketing reports and warnings of serious adverse events such as diabetic ketoacidosis (DKA) have raised concern regarding the safety of sodium-glucose cotransporter 2 inhibitors (SGLT2i). This report describes 2 cases of symptomatic SGLT2i-associated euglycemic DKA (euDKA) leading to hospitalization in patients with type 2 diabetes mellitus (DM) previously well controlled on oral medications. CASE REPORTS: Subject 1 is a 55-year-old female admitted with euDKA precipitated by infection and managed with intravenous insulin...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29230299/predictors-of-acute-gastrointestinal-bleeding-in-diabetic-ketoacidosis-a-retrospective-observational-study-in-minority-population
#6
Kanthi Rekha Badipatla, Preeti Jadhav, Sushma Vaddigiri, Bharat Bajantri, Amandeep Singh, Chaitanya Chandrala, Vijay S Are, Suresh Kumar Nayudu
Background: Diabetic ketoacidosis (DKA) is a common acute complication of diabetes mellitus requiring aggressive medical management. We attempted to study the incidence and various clinical and laboratory variables associated with acute gastrointestinal bleeding (AGIB) and acute upper AGIB (AUGIB) in patients with DKA. Methods: We conducted a retrospective chart review of all the patients admitted to our hospital with DKA between January 2010 and December 2015. We collected demographic, clinical, laboratory, endoscopy and hospitalization details using an electronic medical-record database...
November 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/29218226/hamman-s-syndrome-in-diabetic-ketoacidosis
#7
Alexandra Rose Pain, Josh Pomroy, Andrea Benjamin
Hamman's syndrome (spontaneous subcutaneous emphysema and pneumomediastinum) is a rare complication of diabetic ketoacidosis (DKA), with a multifactorial etiology. Awareness of this syndrome is important: it is likely underdiagnosed as the main symptom of shortness of breath is often attributed to Kussmaul's breathing and the findings on chest radiograph can be subtle and easily missed. It is also important to be aware of and consider Boerhaave's syndrome as a differential diagnosis, a more serious condition with a 40% mortality rate when diagnosis is delayed...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29217500/peripheral-neuropathy-as-a-complication-of-diabetic-ketoacidosis-in-a-child-with-newly-diagnosed-diabetes-type-1-case-report
#8
Marta Baszyńska-Wilk, Marta Wysocka-Mincewicz, Anna Świercz, Jolanta Świderska, Magdalena Marszał, Mieczysław Szalecki
BACKGROUND: Neurological complications of diabetic ketoacidosis are considered to be very serious clinical problem. The most common complication is cerebral edema. However this group includes also less common syndromes such as ischemic or hemorrhagic stroke, cerebral venous and sinus thrombosis or very rare peripheral neuropathy. CASE REPORT: We present a case of 9-year old girl with new onset type 1 diabetes, diabetic ketoacidosis, cerebral edema, multifocal vasogenic brain lesions and lower limbs peripheral paresis...
December 8, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29212386/efficacy-and-safety-of-sotagliflozin-in-treating-diabetes-type-1
#9
Marc S Rendell
INTRODUCTION: Sotagliflozin is the first dual SGLT1/SGLT2 inhibitor developed for use in diabetes. Sotagliflozin blocks SGLT2 in the kidneys and SGLT1 in the intestines resulting in reduced early phase glucose absorption and increased blood levels of GLP-1 and PYY. Urinary glucose excretion is lower than with other agents as a result of decreased glucose absorption. The primary development effort to date has been in Type 1 diabetes. AREAS COVERED: The published information on sotagliflozin is reviewed, along with the recent results of several pivotal Type 1 diabetes trials...
December 7, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29175806/the-distribution-of-different-types-of-diabetes-in-childhood-a-single-center-experience
#10
Belma Haliloğlu, Saygın Abali, Fuat Buğrul, Enes Çelik, Serpil Baş, Zeynep Atay, Tülay Güran, Serap Turan, Abdullah Bereket
OBJECTIVE: Type 1 diabetes (T1D) is the most common cause of diabetes in childhood but type 2 diabetes (T2D) and maturity onset diabetes of the young (MODY) are emerging and noteworthy causes of diabetes in youths. The aim of the study is to determine the distribution, trends and clinical features of the different types of diabetes in childhood in a tertiary single-center. METHODS: Children and adolescents aged 0-18 years who were diagnosed "diabetes/persistent hyperglycemia" between January 1999 and December 2016, were reviewed...
November 24, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29174707/brugada-phenocopy-associated-with-diabetic-ketoacidosis-in-two-pediatric-patients
#11
Ryan E Alanzalon, Jonathan R Burris, Jeffrey M Vinocur
Two patients without cardiac history demonstrated type 1 Brugada pattern during hospitalization for diabetic ketoacidosis (DKA). Both patients had normalization of their ECGs after treatment of marked electrolyte abnormalities and metabolic acidosis. In this report, we describe two cases of Brugada phenocopy associated with DKA in children.
October 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29170817/postmortem-1h-mrs-detection-of-ketone-bodies-and-glucose-in-diabetic-ketoacidosis
#12
Jakob Heimer, Dominic Gascho, Vasiliki Chatzaraki, Damaris Fröhlich Knaute, Vera Sterzik, Rosa Maria Martinez, Michael J Thali, Niklaus Zoelch
Diabetic ketoacidosis (DKA) is a metabolic complication of diabetes mellitus that takes a lethal course if untreated. In this way relevant to forensic medicine, secure diagnosis of DKA usually involves the evidence of elevated levels of glucose and the ketone bodies acetone, acetoacetate, and β-hydroxybutyrate in corpse fluids. We conducted a postmortem hydrogen proton magnetic resonance spectroscopy (1H-MRS) in a case of lethal DKA. Distinctive resonances of all three ketone bodies as well as glucose were visible in spectra of cerebrospinal fluid, vitreous humor, and white matter...
November 23, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29162582/standardizing-clinically-meaningful-outcome-measures-beyond-hba1c-for-type-1-diabetes-a-consensus-report-of-the-american-association-of-clinical-endocrinologists-the-american-association-of-diabetes-educators-the-american-diabetes-association-the-endocrine
#13
REVIEW
Gina Agiostratidou, Henry Anhalt, Dana Ball, Lawrence Blonde, Evgenia Gourgari, Karen N Harriman, Aaron J Kowalski, Paul Madden, Alicia H McAuliffe-Fogarty, Molly McElwee-Malloy, Anne Peters, Sripriya Raman, Kent Reifschneider, Karen Rubin, Stuart A Weinzimer
OBJECTIVE: To identify and define clinically meaningful type 1 diabetes outcomes beyond hemoglobin A1c (HbA1c) based upon a review of the evidence, consensus from clinical experts, and input from researchers, people with type 1 diabetes, and industry. Priority outcomes include hypoglycemia, hyperglycemia, time in range, diabetic ketoacidosis (DKA), and patient-reported outcomes (PROs). While priority outcomes for type 1 and type 2 diabetes may overlap, type 1 diabetes was the focus of this work...
December 2017: Diabetes Care
https://www.readbyqxmd.com/read/29157798/euglycemic-diabetic-ketoacidosis-secondary-to-dapagliflozin-use-a-case-report
#14
Felicity Brown, Tamara McColl
BACKGROUND: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a novel class of oral antihyperglycemic agents. They are associated with rare cases of euglycemic diabetic ketoacidosis (DKA), which presents a diagnostic challenge in the emergency department (ED) and potentially severe consequences if missed. CASE REPORT: A 53-year-old man with type 2 diabetes mellitus and a recent Roux-en-Y gastric bypass surgery presented to the ED with nausea, vomiting, and generalized abdominal pain...
November 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29157581/sleep-in-children-with-type-1-diabetes-and-their-parents-in-the-t1d-exchange
#15
Sarah S Jaser, Nicole C Foster, Bryce A Nelson, Julie M Kittelsrud, Linda A DiMeglio, Maryanne Quinn, Steven M Willi, Jill H Simmons
OBJECTIVES: Sleep has physiological and behavioral impacts on diabetes outcomes, yet little is known about the impact of sleep disturbances in children with type 1 diabetes. The current study sought to characterize sleep in children with type 1 diabetes and in their parents and to examine the associations between child sleep, glycemic control and adherence, parent sleep and well-being, parental fear of hypoglycemia, and nocturnal caregiving behavior. METHODS: Surveys were emailed to parents of 2- to 12-year-old participants in the Type 1 Diabetes (T1D) Exchange clinic registry...
November 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29127768/diabetic-ketoacidosis-hyperuricemia-and-encephalopathy-intractable-to-regular-dose-insulin
#16
Jillian Gregory, Sonali Basu
BACKGROUND: Diabetic ketoacidosis (DKA) in children less than 1 year of age is a rare occurrence. Typical presentation includes a prodrome of weight loss and polyuria with subsequent presentation to medical care when acidosis becomes symptomatic. CASE PRESENTATION: We describe an unusual case of a previously healthy infant with a 3 days' history of constipation, presenting acutely with abdominal pain, lethargy, and dehydration. On initial evaluation, our patient had profound encephalopathy, with marked tachypnea and work of breathing...
November 11, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29111277/resolution-of-ketoacidosis-in-children-with-new-onset-diabetes-evaluation-of-various-definitions
#17
Julia E von Oettingen, Erinn T Rhodes, Joseph I Wolfsdorf
AIMS: Data are sparse concerning use of serum electrolyte parameters as compared to venous blood gas (VBG) measurements to monitor acid-base status during treatment of diabetic ketoacidosis (DKA). We explored the utility of various parameters to define DKA resolution by investigating the relationship of venous pH (vpH), anion gap (AG), serum bicarbonate (HCO3), and glucose concentration during management of DKA in children with new onset diabetes mellitus (NODM). METHODS: We included all patients with NODM presenting with DKA to Boston Children's Hospital from 10/1/07-7/1/13...
October 27, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29109609/end-stage-renal-disease-increases-rates-of-adverse-glucose-events-when-treating-diabetic-ketoacidosis-or-hyperosmolar-hyperglycemic-state
#18
Caitlin M Schaapveld-Davis, Ana L Negrete, Joanna Q Hudson, Jagannath Saikumar, Christopher K Finch, Mehmet Kocak, Pan Hu, Megan A Van Berkel
IN BRIEF Treatment guidelines for diabetic emergencies are well described in patients with normal to moderately impaired kidney function. However, management of patients with end-stage renal disease (ESRD) is an ongoing challenge. This article describes a retrospective study comparing the rates of adverse glucose events (defined as hypoglycemia or a decrease in glucose >200 mg/dL/h) between patients with ESRD and those with normal kidney function who were admitted with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)...
October 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29105262/evaluation-of-novorapid-infusion-as-a-treatment-option-in-the-management-of-diabetic-ketoacidosis
#19
Raylene Kwok, Shoshana Sztal-Mazer, Ria E Hopkins, Susan G Poole, Louise Grannell, John Coutsouvelis, Duncan J Topliss
This study evaluates the clinical efficacy and safety of NovoRapid (insulin aspart) compared to Actrapid™ (human neutral insulin) for diabetic ketoacidosis (DKA). In this retrospective study involving 40 patients, no statistically significant differences were observed between biochemical variables, infusion duration or complications in patients treated with insulin aspart or human neutral insulin. These results support the use of insulin aspart as an effective and safe alternative to human neutral insulin in DKA...
November 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29101821/pharmacodynamics-and-pharmacokinetics-of-insulin-aspart-assessed-by-use-of-the-isoglycemic-clamp-method-in-healthy-cats
#20
H N Pipe-Martin, J M Fletcher, C Gilor, M A Mitchell
The objective of this study was to determine the pharmacodynamics (PD) and pharmacokinetics (PK) of insulin aspart in healthy cats following intramuscular (IM) and subcutaneous (SC) injection. Eight healthy, purpose-bred cats were used in a randomized, crossover study design. Each cat had 2 isoglycemic clamps performed, one after receiving 0.25 IU/kg of insulin aspart by IM injection and one after receiving the same dose by SC injection. The two isoglycemic clamps were performed on different days, at least 48 h apart...
September 21, 2017: Domestic Animal Endocrinology
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