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https://www.readbyqxmd.com/read/28448895/incidence-of-diabetic-ketoacidosis-among-patients-with-type-2-diabetes-mellitus-treated-with-sglt2-inhibitors-and-other-antihyperglycemic-agents
#1
Yiting Wang, Mehul Desai, Patrick B Ryan, Frank J DeFalco, Martijn J Schuemie, Paul E Stang, Jesse A Berlin, Zhong Yuan
AIMS: To estimate and compare incidence of diabetes ketoacidosis (DKA) among patients with type 2 diabetes who are newly treated with SGLT2 inhibitors (SGLT2i) versus non-SGLT2i antihyperglycemic agents (AHAs) in actual clinical practice. METHODS: A new-user cohort study design using a large insurance claims database in the US. DKA incidence was compared between new users of SGLT2i and new users of non-SGLT2i AHAs pair-matched on exposure propensity scores (EPS) using Cox regression models...
April 13, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28437153/diabetic-ketoacidosis-in-patients-with-type-2-diabetes-recently-commenced-on-sglt-2-inhibitors-an-ongoing-concern
#2
Mohamed Ahmed, Malachi J McKenna, Rachel K Crowley
OBJECTIVE: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are increasingly used as an adjunctive treatment for type 2 diabetes. We report the occurrence of diabetic ketoacidosis (DKA) in 3 patients with type 2 diabetes recently commenced on SGLT-2 inhibitors. METHODS: Clinical presentation, laboratory data, and treatment outcomes of all 3 cases are described. RESULTS: All 3 patients had documented history of longstanding type 2 diabetes...
April 2, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28435047/histological-and-cognitive-alterations-in-adult-diabetic-rats-following-an-episode-of-juvenile-diabetic-ketoacidosis-evidence-of-permanent-cerebral-injury
#3
Nicole Glaser, Jennifer Sasaki-Russell, Michael Cohen, Christopher Little, Martha O'Donnell, Jeffrey Sall
Evidence suggests that diabetic ketoacidosis (DKA) may cause subtle cognitive alterations in children but the mechanisms are poorly understood. Acute DKA is associated with reactive astrogliosis and microglial activation in a rat model. Whether these inflammatory changes permanently alter brain histology is unknown. We aimed to determine whether DKA results in permanent alterations in brain histology and whether these changes are associated with cognitive deficits in a rat model. We induced diabetes in juvenile rats with streptozotocin at 4 weeks of age...
April 20, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28414668/autoimmune-diabetes-presented-with-diabetic-ketoacidosis-induced-by-immunotherapy-in-an-adult-with-melanoma
#4
A A Alzenaidi, J Dendy, L Rejjal
INTRODUCTION: Immunotherapy has been approved for treatment of melanoma. Autoimmune endocrinopathies have been reported in trials involving immunotherapy but autoimmune diabetes has not been definitively linked to them. Here we describe a case of autoimmune diabetes presenting with DKA after receiving combined immunotherapy with anti-CTLA4 and anti-PD1 monoclonal antibodies. CASE: A 47year old gentleman with metastatic melanoma presented to our institution with confusion, abdominal pain and decreased oral intake...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412071/emergency-medicine-myths-cerebral-edema-in-pediatric-diabetic-ketoacidosis-and-intravenous-fluids
#5
Brit Long, Alex Koyfman
BACKGROUND: Pediatric diabetic ketoacidosis (DKA) is a disease associated with several complications that can be severe. One complication includes cerebral edema (CE), and patients may experience significant morbidity with this disease. OBJECTIVE: This review evaluates the myths concerning CE in pediatric DKA including mechanism, presentation of edema, clinical assessment of dehydration, and association with intravenous (i.v.) fluids. DISCUSSION: Multiple complications may occur in pediatric DKA...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28397942/flash-glucose-monitoring-system-may-benefit-children-and-adolescents-with-type-1-diabetes-during-fasting-at-ramadan
#6
Abdulmoein E Al-Agha, Shahd E Kafi, Abdullah M Zain Aldeen, Raghdah H Khadwardi
To assess the benefit of using the flash glucose monitoring system (FGMS) in children and adolescents with type 1 diabetes mellitus (T1DM) during Ramadan fasting. Methods: A prospective pilot study of 51 participants visited the pediatric diabetes clinic at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from between June until and July 2016. The FreeStyle® Libre™ FGMS (Abbott Diabetes Care, Alameda, CA, USA) was used. Hypoglycemia was defined as glucose values of less than 70 mg/dL, while hyperglycemia as glucose values of more than 150 mg/dL for all participants based on our institute's protocol...
April 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28389705/metabolic-effects-of-insulin-in-a-human-model-of-ketoacidosis-combining-exposure-to-lipopolysaccharide-and-insulin-deficiency-a-randomised-controlled-crossover-study-in-individuals-with-type-1-diabetes
#7
Mads V Svart, Nikolaj Rittig, Ulla Kampmann, Thomas S Voss, Niels Møller, Niels Jessen
AIMS/HYPOTHESIS: Diabetic ketoacidosis (DKA) is often caused by concomitant systemic inflammation and lack of insulin. Here we used an experimental human model to test whether and how metabolic responses to insulin are impaired in the early phases of DKA with a specific focus on skeletal muscle metabolism. METHODS: Nine individuals with type 1 diabetes from a previously published cohort were investigated twice at Aarhus University Hospital using a 120 min infusion of insulin (3...
April 7, 2017: Diabetologia
https://www.readbyqxmd.com/read/28376867/assessment-of-platelets-morphological-changes-and-serum-butyrylcholinesterase-activity-in-children-with-diabetic-ketoacidosis-a-case-control-study
#8
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/28372715/management-of-hyperglycemic-crises-diabetic-ketoacidosis-and-hyperglycemic-hyperosmolar-state
#9
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
#10
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
#11
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/28357144/-black-esophagus-or-gurvits-syndrome-a-rare-complication-of-diabetic-ketoacidosis
#12
Vivek Choksi, Kairavee Dave, Rulz Cantave, Sameer Shaharyar, Jeevan Joseph, Uday Shankar, Steven Kaplan, Hamid Feiz
Acute esophageal necrosis (AEN) also known as "black esophagus" or necrotizing esophagitis is a rare syndrome characterized by a striking diffuse patchy or circumferential black appearance of the esophageal mucosa that preferentially affects the distal esophagus and terminates at the gastroesophageal junction. Only 88 patients over a span of 40 years have received this diagnosis, and the prevalence of this disease ranges from 0.001 to 0.2% of cases in literature. It more commonly affects men (4 : 1 ratio) in the sixth decade of life...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28342328/reproductive-toxicity-of-%C3%AE-diketone-antibiotic-mixtures-to-zebrafish-danio-rerio
#13
Xuedong Wang, Yan Ma, Jinfeng Liu, Xiaohan Yin, Zhiheng Zhang, Caihong Wang, Yanyan Li, Huili Wang
So far, few data are available on the reproductive toxicological assessment of β-diketone antibiotics (DKAs), a class of ubiquitous pseudo-persistent pollutant, in zebrafish (Danio rerio). Herein, we reported the reproductive effects of DKAs by means of transcriptome analysis (F1-zebrafish), changes in a series of reproductive indices (F0-zebrafish) and histopathological observations. A total of 1170, 983 and 1399 genes were found to be differentially expressed when compared control vs. 6.25mg/L, control vs...
March 22, 2017: Ecotoxicology and Environmental Safety
https://www.readbyqxmd.com/read/28338247/impact-of-diabetic-ketoacidosis-management-in-the-medical-intensive-care-unit-after-order-set-implementation
#14
Benjamin Laliberte, Siu Yan Amy Yeung, Jeffrey P Gonzales
OBJECTIVE: To determine the rate of compliance to the 2006 and 2009 ADA DKA guidelines in the medical intensive care unit (MICU) at a large academic medical centre after the implementation of a computerised DKA order set and protocol. METHODS: Retrospective chart review of adult patients with DKA admitted to the MICU. Results of pre-order set (PRE) were compared to those of data post-order set (POST). The primary outcome was a composite administration of intravenous fluid resuscitation in the first 24 h, insulin bolus and initial insulin infusion rate...
March 24, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28337685/type-iii-hypersensitivity-reaction-to-subcutaneous-insulin-preparations-in-a-type-1-diabetic
#15
Benjamin R Murray, Jolene R Jewell, Kyle J Jackson, Olabunmi Agboola, Brianna R Alexander, Poonam Sharma
Management of type 1 diabetes in patients who have insulin hypersensitivity is a clinical challenge and places patients at risk for recurrent diabetic ketoacidosis (DKA). Hypersensitivity reactions can be due to the patient's response to the insulin molecule itself or one of the injection's non-insulin components. It is therefore crucial for clinicians to quickly recognize the type of hypersensitivity reaction that is occurring and identify potentially immunogenic additives for the purpose of directing therapy as various insulin preparations have differing ingredients...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28321786/adherence-to-pediatric-diabetic-ketoacidosis-guidelines-by-community-emergency-departments-providers
#16
Janine E Zee-Cheng, Emily C Webber, Samer Abu-Sultaneh
BACKGROUND: Diabetic ketoacidosis (DKA) is a common presentation of type I diabetes mellitus to the emergency departments. Most children with DKA are initially managed in community emergency departments where providers may not have easy access to educational resources or pediatric-specific guidelines and protocols that are readily available at pediatric academic medical centers. The aim of this study is to evaluate adherence of community emergency departments in the state of Indiana to the pediatric DKA guidelines...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28314598/design-and-synthesis-of-hybrids-of-diarylpyrimidines-and-diketo-acids-as-hiv-1-inhibitors
#17
Ping Xue, Huan-Huan Lu, Yuan-Yuan Zhu, Xiu-Lian Ju, Christophe Pannecouque, Xiao-Jiao Zheng, Gen-Yan Liu, Xiu-Lan Zhang, Shuang-Xi Gu
Based on the strategy of molecular hybridization, diketo acid fragment as a classical phamacophore of integrase inhibitors was introduced to reverse transcriptase inhibitors diarylpyrimidines to design a series of diarylpyrimidine-diketo acid hybrids (DAPY-DKAs). The target molecules 10b and 11b showed inhibitory activities against WT HIV-1 with EC50 values of 0.18μM and 0.14μM, respectively. And the results of molecular docking demonstrated the potential binding mode and revealed that the DKA moiety and its ester could both be tolerated in the nonnucleoside binding site (NNBS) of HIV-1 RT...
March 7, 2017: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28304323/diabetic-ketoacidosis-complicating-pregnancy
#18
S N Bryant, C L Herrera, D B Nelson, F G Cunningham
BACKGROUND: Although diabetic ketoacidosis (DKA) in pregnancy can result in significant adverse consequences for both mother and fetus, the response to treatment, time course of recovery, and perinatal outcomes have not been well studied in pregnancy. OBJECTIVE: We examined the precipitating factors, laboratory abnormalities, treatment strategies, and clinical recovery in pregnancies complicated by DKA. STUDY DESIGN: This is a retrospective cohort study of pregnancies complicated by DKA between October 1999 and June 2015...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28288246/acute-kidney-injury-in-children-with-type-1-diabetes-hospitalized-for-diabetic-ketoacidosis
#19
Brenden E Hursh, Rebecca Ronsley, Nazrul Islam, Cherry Mammen, Constadina Panagiotopoulos
Importance: Acute kidney injury (AKI) in children is associated with poor short-term and long-term health outcomes; however, the frequency of AKI in children hospitalized for diabetic ketoacidosis (DKA) has not been previously examined. Objectives: To determine the proportion of children hospitalized for DKA who develop AKI and to identify the associated clinical and biochemical markers of AKI. Design, Setting, and Participants: This medical record review of all DKA admissions from September 1, 2008, through December 31, 2013, was conducted at British Columbia Children's Hospital, the tertiary pediatric hospital in British Columbia, Canada...
March 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28276776/brain-injury-with-diabetes-mellitus-evidence-mechanisms-and-treatment-implications
#20
REVIEW
Sherifa A Hamed
Diabetes mellitus is a risk for brain injury. Brain injury is associated with acute and chronic hyperglycaemia, insulin resistance, hyperinsulinemia, diabetic ketoacidosis (DKA) and hypoglycaemic events in diabetic patients. Hyperglycemia is a cause of cognitive deterioration, low intelligent quotient, neurodegeneration, brain aging, brain atrophy and dementia. Areas covered: The current review highlights the experimental, clinical, neuroimaging and neuropathological evidence of brain injury induced by diabetes and its associated metabolic derangements...
April 2017: Expert Review of Clinical Pharmacology
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