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https://www.readbyqxmd.com/read/29781681/the-management-of-diabetic-ketoacidosis-at-a-rural-regional-hospital-in-kwazulu-natal
#1
Nontobeko F M Ndebele, Mergan Naidoo
BACKGROUND:  Diabetic ketoacidosis (DKA) is a biochemical triad of hyperglycaemia, ketoacidosis and ketonaemia and one of the potentially life-threatening acute metabolic complications of diabetes mellitus. This study aimed at describing the clinical profile of patients presenting with DKA to a busy rural regional hospital in KwaZulu-Natal. METHODS:  A retrospective review of clinical notes of patients presenting with DKA to the Emergency Department was performed over a 10-month period...
March 22, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29774417/first-report-on-the-nationwide-incidence-of-type-1-diabetes-and-ketoacidosis-at-onset-in-children-in-serbia-a-multicenter-study
#2
Rade Vukovic, Maja D Jesic, Ivana Vorgucin, Sandra Stankovic, Nevena Folic, Tatjana Milenkovic, Silvija Sajic, Dragan Katanic, Sasa Zivic, Slavica Markovic, Ivan Soldatovic
Data regarding incidence of type 1 diabetes (T1DM), as well as data on frequency and severity of diabetic ketoacidosis (DKA) at the time of T1DM diagnosis is of paramount importance for national and regional healthcare planning. The aim of present multicenter study was to provide the first report regarding nationwide annual incidence rates for T1DM in youth in Serbia, as well as prevalence of DKA at the time of diagnosis. Data on all pediatric patients with newly diagnosed T1DM was retrospectively collected from all 15 regional centers for pediatric diabetes in Serbia during the period 2007-2017...
May 17, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29773640/health-care-utilization-and-burden-of-diabetic-ketoacidosis-in-the-u-s-over-the-past-decade-a-nationwide-analysis
#3
Dimpi Desai, Dhruv Mehta, Priyanka Mathias, Gopal Menon, Ulrich K Schubart
OBJECTIVE: Diabetes is one of the most common chronic diseases and a leading cause of morbidity and mortality in the U.S. Although our ability to treat diabetes and its associated complications has significantly improved, presentation with uncontrolled diabetes leading to ketoacidosis remains a significant problem. RESEARCH DESIGN AND METHODS: We aimed to determine the incidence and costs of hospital admissions associated with diabetic ketoacidosis (DKA). We reviewed the National Inpatient Sample Database for all hospitalizations in which DKA (ICD-9 codes 250...
May 17, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29770221/risperidone-induced-type-2-diabetes-presenting-with-diabetic-ketoacidosis
#4
Clarissa Ern Hui Fang, Mohammed Faraz Rafey, Aine Cunningham, Sean F Dinneen, Francis M Finucane
A 28-year-old male presented with 2 days of vomiting and abdominal pain, preceded by 2 weeks of thirst, polyuria and polydipsia. He had recently started risperidone for obsessive-compulsive disorder. He reported a high dietary sugar intake and had a strong family history of type 2 diabetes mellitus (T2DM). On admission, he was tachycardic, tachypnoeic and drowsy with a Glasgow Coma Scale (GCS) of 10/15. We noted axillary acanthosis nigricans and obesity (BMI 33.2 kg/m2 ). Dipstick urinalysis showed ketonuria and glycosuria...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29765612/crystal-structures-of-lymphocytic-choriomeningitis-virus-endonuclease-domain-complexed-with-diketo-acid-ligands
#5
Magali Saez-Ayala, Elsie Laban Yekwa, Mauro Carcelli, Bruno Canard, Karine Alvarez, François Ferron
The Arenaviridae family, together with the Bunyaviridae and Orthomyxoviridae families, is one of the three negative-stranded RNA viral families that encode an endonuclease in their genome. The endonuclease domain is at the N-terminus of the L protein, a multifunctional protein that includes the RNA-dependent RNA polymerase. The synthesis of mRNA in arenaviruses is a process that is primed by capped nucleotides that are 'stolen' from the cellular mRNA by the endonuclease domain in cooperation with other domains of the L protein...
March 1, 2018: IUCrJ
https://www.readbyqxmd.com/read/29756707/impact-of-the-hyperchloremic-component-of-metabolic-acidosis-on-the-patient-s-hydration-status-and-the-treatment-of-diabetic-ketoacidosis
#6
Ismael Toledo, Raquel Wainsztein, Carla Mannucci, Mabel Ferraro, Juan Ferreira, Alejandro Balestracci
INTRODUCTION: Diabetic ketoacidosis (DKA) is characterized by metabolic acidosis (MA) with a high anion gap (AG), although, occasionally, it can present with hyperchloremia. It has been postulated that the early presence of hyperchloremia could reflect a better hydration status; however, its prevalence and impact on DKA treatment remain unknown. determine the prevalence of the hyperchloremic component in MA prior to treatment and to assess whether it is associated with a better hydration status and a shorter recovery time from DKA compared to patients with high AG only...
June 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29741925/glycemic-control-in-adult-type-1-diabetes-patients-with-insulin-glargine-insulin-detemir-or-continuous-subcutaneous-insulin-infusion-in-daily-practice
#7
Päivi Rautiainen, Hilkka Tirkkonen, Tiina Laatikainen
BACKGROUNDS: This study aims to compare glycemic control of persons with type 1 diabetes using multiple daily injections (MDI) with insulin glargine versus insulin detemir or with continuous subcutaneous insulin infusion (CSII) in daily practice. SUBJECTS AND METHODS: All adult individuals with type 1 diabetes (n = 1053) were identified from the electronic patient database in North Karelia, Finland. The persons' individual data for insulin treatment, diabetic ketoacidosis (DKA), and hemoglobin A1c (HbA1c) measurements during the year 2014 were obtained from medical records...
May 9, 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29731109/plasma-glucose-to-glycated-hemoglobin-ratio-method-of-differentiating-fulminant-type-1-diabetes-from-diabetic-ketoacidosis
#8
Lan Liu, Wenjuan Jia, Yixing Wu, Ruike Liu, Chunping Zeng, Yuanyuan Hu, Jie Shen
OBJECTIVES: In fulminant type 1 diabetes mellitus (fT1DM), plasma glucose (PG) levels are strongly increased, unlike glycated hemoglobin (HbA1C ) levels, resulting in a sharply increased PG/HbA1C ratio. We investigated the PG/HbA1C ratio in fT1DM and tested the accuracy of cutoff points to easily and efficiently differentiate fT1DM from diabetic ketoacidosis (DKA). METHODS: We report 41 cases of fT1DM in which PG/HbA1C ratio was studied as a novel clinical parameter to predict fT1DM...
May 3, 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29698339/disparities-in-adherence-to-pediatric-diabetic-ketoacidosis-management-guidelines-across-a-spectrum-of-emergency-departments-in-the-state-of-indiana-an-observational-in-situ-simulation-based-study
#9
Kamal Abulebda, Samer Abu-Sultaneh, Erin E White, Michele L Kirby, Brian C Phillips, Courtney T Frye, Lee D Murphy, Riad Lutfi
BACKGROUND: Diabetic ketoacidosis (DKA) is a common presentation to an emergency department (ED), with the majority presenting to community EDs. Adherence to clinical guidelines in these EDs can reduce morbidity and mortality. Few methods to describe practice gaps for DKA management have been reported. OBJECTIVES: We hypothesized that high-fidelity in situ simulation can be used to measure and compare the quality of the care provided to pediatric patients with DKA presenting to community EDs in the state of Indiana...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29692258/early-occurrence-cases-of-diabetes-mellitus-clinical-picture-in-two-major-tertiary-care-hospitals-in-india
#10
Nitin Joseph, Shreya Sharma, Vinisha Modi, Sanath Majunatha, Saad Arshad Siddiqui, Mihika Sinha
INTRODUCTION: Type 1 diabetes mellitus (T1D) is one of the most common endocrine disease in childhood. However, very limited information is available on this disease. OBJECTIVES: This study was done to assess risk factors, clinical features and management practices in T1D patients. METHODS: A review of records of 39 T1D cases admitted over the past five years in two hospitals was done. RESULTS: The mean age at diagnosis among males was 19...
April 24, 2018: Current Diabetes Reviews
https://www.readbyqxmd.com/read/29691964/transition-to-adult-diabetes-care-in-germany-high-risk-for-acute-complications-and-declining-metabolic-control-during-the-transition-phase
#11
T M Kapellen, S Müther, A Schwandt, J Grulich-Henn, B Schenk, K O Schwab, W Marg, R W Holl
OBJECTIVE: There is evidence that transition from pediatric to adult health care is frequently associated with deterioration of health in youths with type 1 diabetes (T1D). The aim of this study was to compare metabolic control, acute complications and microvascular complications in adolescents and young adults before and after transfer to an adult treatment center with respect to the time between first visit in the adult center and last visit in pediatric treatment. METHODS: All data were collected during routine care and retrieved from the German/Austrian DPV database...
April 25, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29686175/diabetic-ketoacidosis-in-adolescents-and-children-a-prospective-study-of-blood-versus-urine-ketones-in-monitoring-therapeutic-response
#12
Aman Bhakti Pulungan, Erlin Juwita, Antonius H Pudjiadi, Siti Rahmayanti, Ireska Tsaniya
BACKGROUND: diabetic ketoacidosis (DKA) is a potentially lethal complication of diabetes mellitus (DM). There is no study in Indonesia that compares the much-preferred capillary beta hydroxybutirate (β-OHB) measurement to urine acetoacetate in monitoring therapeutic response of DKA in adolescents. METHODS: a prospective study of 37 adolescents and children with DKA in Cipto Mangunkusumo Hospital was done between June 2006 and March 2011. The patients were followed until the time of DKA resolution...
January 2018: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29671962/glycemic-control-is-related-to-cognitive-dysfunction-in-chinese-children-with-type-1-diabetes-mellitus
#13
Jing He, Shichen Li, Fang Liu, Hong Zheng, Xiang Yan, Yuting Xie, Xia Li, Zhiguang Zhou, Xiongzhao Zhu
BACKGROUND: Type 1 diabetes mellitus (T1DM) type 1 diabetes is considered to be a risk factor for developing cognitive difficulties. The present study examined if Chinese children with T1DM differ in cognitive performance from healthy control (HC) children, and whether cognitive dysfunction is related to glycemic control. METHODS: Using a cross-sectional design, we administered cognitive tests, including general intelligence tests, to pediatric T1DM patients (N = 105) and HC participants (N = 90)...
April 19, 2018: Journal of Diabetes
https://www.readbyqxmd.com/read/29643888/spectrum-of-complications-of-severe-dka-in-children-in-pediatric-intensive-care-unit
#14
Qalab Abbas, Saba Arbab, Anwar Ul Haque, Khadija Nuzhat Humayun
Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis (DKA) observed in children admitted with severe DKA. Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit (PICU) of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied. Results: Total 37 children were admitted with complicated DKA (1...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29628184/the-two-bag-method-for-treatment-of-diabetic-ketoacidosis-in-adults
#15
Nathan L Haas, Roma Y Gianchandani, Kyle J Gunnerson, Benjamin S Bassin, Arun Ganti, Christopher Hapner, Caryn Boyd, James A Cranford, Sage P Whitmore
BACKGROUND: The "two-bag method" of management of diabetic ketoacidosis (DKA) allows for titration of dextrose delivery by adjusting the infusions of two i.v. fluid bags of varying dextrose concentrations while keeping fluid, electrolyte, and insulin infusion rates constant. OBJECTIVE: We aimed to evaluate the feasibility and potential benefits of this strategy in adult emergency department (ED) patients with DKA. METHODS: This is a before-and-after comparison of a protocol using the two-bag method operationalized in our adult ED in 2015...
April 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29624095/external-validation-of-the-diabetes-early-readmission-risk-indicator-derri-%C3%A2
#16
Daniel J Rubin, Dominic Recco, Alexander Turchin, Huaqing Zhao, Sherita Hill Golden
OBJECTIVE: The Diabetes Early Readmission Risk Indicator (DERRI™ ) was previously developed and internally validated as a tool to predict the risk of all-cause readmission within 30 days of discharge (30-d readmission) of hospitalized patients with diabetes. In this study, the predictive performance of the DERRI™ with and without additional predictors was assessed in an external sample. METHODS: We conducted a retrospective cohort study of adult patients with diabetes discharged from 2 academic medical centers between 1/1/2000 and 12/31/2014...
April 6, 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29611621/perception-attitude-and-satisfaction-of-paediatric-physicians-and-nurses-towards-clinical-practice-guidelines-at-a-university-teaching-hospital
#17
Yasser Sami Amer, Abdulrahman Al Nemri, Mohamed Elfaki Osman, Elshazaly Saeed, Asaad Mohamed Assiri, Sarar Mohamed
RATIONALE, AIMS, AND OBJECTIVES: To explore perception, attitude, and satisfaction of paediatric clinicians, trainees, and nurses at King Khalid University Hospital towards clinical practice guidelines (CPGs) including the locally adapted diabetic ketoacidosis CPG (DKA-CPG). METHODS: A cross-sectional survey was distributed to 260 doctors and nurses working in the paediatrics department. RESULTS: The response rate was 95.4%. The respondents had a positive perception and attitude towards general CPGs and specifically for the DKA-CPG; 98...
April 3, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29602453/sglt2-inhibitor-induced-euglycaemic-diabetic-ketoacidosis-may-be-due-to-abrupt-severe-and-transient-impaired-glucose-sensing-in-susceptible-individuals-with-a-hitherto-unrecognised-beta-cell-sglt-variant
#18
F M Finucane
Euglycaemic diabetic ketoacidosis (EDKA) is a rare complication of treatment with SGLT2 inhibitors in patients with type 2 diabetes. Uncertainty remains about its precise mechanistic basis, but the physiological derangement is acute and profound, yet reversible with cessation of the drug. It is reminiscent of other "non type 1" presentations with DKA such as ketosis prone diabetes, except that glucose levels are usually normal. Impaired beta cell glucose sensing that mimicked a state of hypoglycaemia could theoretically lead to abrupt and transient cessation of insulin secretion...
May 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29600506/prediabetes-directly-deteriorates-into-diabetic-ketoacidosis-and-hyperosmolar-hyperglycemic-syndrome-triggered-by-acute-pancreatitis-a-case-report-illustrating-a-chicken-and-egg-paradigm-in-ketosis-prone-diabetes
#19
Runbo Song, Shanjin Cao
INTRODUCTION: Diabetic crises occur most often in patients with type 1 diabetes and occasionally in type 2 diabetes, especially under stressful conditions. However, a diabetic crisis occurring directly from prediabetes is an unusual phenomenon. CASE REPORT: A 45-year-old woman presented with postprandial left upper quadrant abdominal pain, nausea, and vomiting. She had a past medical history of prediabetes with impaired fasting glucose and HbA1c 6.4%. On admission, routine laboratory tests showed high anion gap metabolic acidosis (pH 6...
March 29, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29596400/trends-in-diabetic-ketoacidosis-hospitalizations-and-in-hospital-mortality-united-states-2000-2014
#20
Stephen R Benoit, Yan Zhang, Linda S Geiss, Edward W Gregg, Ann Albright
Diabetes is a common chronic condition and as of 2015, approximately 30 million persons in the United States had diabetes (23 million with diagnosed and 7 million with undiagnosed) (1). Diabetic ketoacidosis (DKA) is a life-threatening but preventable complication of diabetes characterized by uncontrolled hyperglycemia (>250 mg/dL), metabolic acidosis, and increased ketone concentration that occurs most frequently in persons with type 1 diabetes (2). CDC's United States Diabetes Surveillance System* (USDSS) indicated an increase in hospitalization rates for DKA during 2009-2014, most notably in persons aged <45 years...
March 30, 2018: MMWR. Morbidity and Mortality Weekly Report
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