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https://www.readbyqxmd.com/read/28646357/management-of-hyperglycemia-and-diabetes-in-the-emergency-department
#1
REVIEW
Justin B Echouffo-Tcheugui, Rajesh Garg
PURPOSE OF REVIEW: Hyperglycemia in the emergency department (ED) is being recognized as a public health problem and presents a clinical challenge. This review critically summarizes available evidence on the burden, etiology, diagnosis, and practical management strategies for hyperglycemia in the ED. RECENT FINDINGS: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are hyperglycemic emergencies that commonly present to the ED. However, the most common form of hyperglycemia in ED is associated with non-hyperglycemic medical emergencies...
August 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28645198/diabetes-specific-and-general-life-stress-and-glycemic-outcomes-in-emerging-adults-with-type-1-diabetes-is-race-ethnicity-a-moderator
#2
Ashley M Butler, Bridget E Weller, Joyce P Yi-Frazier, Kelly Fegan-Bohm, Barbara Anderson, Catherine Pihoker, Marisa E Hilliard
This study examines whether race/ethnicity moderates relationships of (a) diabetes stress and general life stressors with (b) diabetes outcomes of glycemic control and diabetic ketoacidosis (DKA) among emerging adults (aged 18-25 years) with type 1 diabetes (T1D). Using a T1D Exchange Registry sample of non-Hispanic White, African American, and Hispanic emerging adults ( N  = 3,440), multiple group analyses were used to determine whether race/ethnicity moderates the relationships between stress and diabetes outcomes...
June 22, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28637729/incidence-of-diabetes-related-complications-in-chinese-patients-with-type-1-diabetes-a-population-based-longitudinal-cohort-study-in-taiwan
#3
Huang-Tz Ou, Tsung-Ying Lee, Chung-Yi Li, Jin-Shang Wu, Zih-Jie Sun
OBJECTIVE: To estimate the incidence densities and cumulative incidence of diabetes-related complications in patients with type 1 diabetes for a maximum of 15-year follow-up. The estimations were further stratified by gender and age at diagnosis (ie, early onset: 0-12 years, late onset:≥13 years). DESIGN: A population-based retrospective longitudinal cohort study. SETTING: Taiwan's National Health Insurance medical claims. PARTICIPANTS: 4007 patients newly diagnosed with type 1 diabetes were identified during 1999-2012...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28636569/diabetic-ketoacidosis-associated-with-antipsychotic-drugs-case-reports-and-a-review-of-literature
#4
Antonia Vuk, Martina Rojnic Kuzman, Maja Baretic, Martina Matovinovic Osvatic
BACKGROUND: Second generation antipsychotics (SGAs) are associated with metabolic disturbances. Diabetic ketoacidosis (DKA) is a rare, but potentially fatal sign of acute glucose metabolism dysregulation linked to the use of SGAs. The aims of this article are to present patients with a history of psychotic disorders and of severe metabolic diabetic ketoacidosis, possibly associated with the use of antipsychotics, and to review the current literature on the topic of antipsychotic-induced DKA...
June 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28634592/euglycemic-diabetic-ketoacidosis-with-prolonged-glucosuria-associated-with-the-sodium-glucose-cotransporter-2-canagliflozin
#5
Daniel A Kelmenson, Kelsey Burr, Yusra Azhar, Paul Reynolds, Chelsea A Baker, Neda Rasouli
Sodium-glucose cotransporter-2 (SGLT2) inhibitors improve glycemic control by a reversible inhibition of the sodium-glucose cotransporters in the renal proximal tubules resulting in increased urinary glucose. This unique mechanism, independent of insulin secretion and beta cell function, has made this class of medication desirable in patients with type 2 diabetes. However in May 2015, the US Food and Drug Administration issued a safety warning pertaining to the development of diabetic ketoacidosis (DKA) with the use of SGLT2 inhibitors...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28604407/diabetic-ketoacidosis-heralding-type-1-diabetes-in-children
#6
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
#7
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/28592007/-effect-of-the-use-of-antibiotics-controlled-by-clinical-pharmacist-in-patients-with-diabetic-ketoacidosis
#8
Y Liu, C X Gong, D Wu, X L Wang
Objective: To analyze the effect of the use of antibiotics intervened by clinical pharmacist in diabetic ketoacidosis (DKA) patients. Method: This was a prospective clinical study with a historical control group.The group 1 was the control group which was not intervened for antibiotics use from January 2010 to November 2012. The group 2 was the intervention group treated from December 2012 to June 2016. Group 1 was divided into group 1a which included newly-onset diabetes patients and group 1b which included long standing diabetes patients...
June 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28588816/diabetic-ketoacidosis-inducing-myocardial-infarction-secondary-to-treatment-with-dapagliflozin-a-case-report
#9
José M Gil-Perdomo, Tomás F Fariña González, Benjamín Jordán-Arias, Sara Domingo-Marín, Juan J González Armengol, Fernando Martínez-Sagasti
Sodium-glucose cotransporter 2 (SGLT2) inhibitors are able to provoke diabetic ketoacidosis (DKA) with absence or low levels of ketone bodies in urine and slightly elevated blood glucose levels, which could delay the diagnosis; however, the presence of high urine output, due to the excretion of glucose, can help to identify the true cause.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28587531/dapagliflozin-for-the-treatment-of-type-1-diabetes-mellitus
#10
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/28571190/the-study-of-different-clinical-pattern-of-diabetic-ketoacidosis-and-common-precipitating-events-and-independent-mortality-factors
#11
M G Mahesh, Rajendra Prasad Shivaswamy, Bj Subhash Chandra, Sajid Syed
INTRODUCTION: Diabetic Ketoacidosis (DKA) is an important cause of morbidity and mortality among diabetic patients in spite of major advances in the pathogenesis and more standardized diagnosis and treatment. AIM: To find out the different patterns of clinical presentations, common precipitating factors and independent mortality factors in DKA. MATERIALS AND METHODS: This study was conducted in a tertiary care hospital, Mysuru on 110 patients from November 2007 to October 2009...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28570924/effects-of-sglt-2-inhibitors-on-diabetic-ketoacidosis-a-meta-analysis-of-randomised-controlled-trials
#12
Matteo Monami, Besmir Nreu, Stefania Zannoni, Carlotta Lualdi, Edoardo Mannucci
AIMS: Diabetic ketoacidosis (DKA) associated with SGLT-2 inhibitors (SGLT-2i) is a possible adverse event. In fact, SGLT-2i are capable of stimulating the release of glucagon and ketone re-absorption in the renal tubuli, thus increasing the concentration of ketone bodies. METHODS: A Medline search for SGLT2i (dapagliflozin, empagliflozin, canagliflozin, ipragliflozin, ertugliflozin, luseogliflozin) was performed, collecting all randomized trials with a duration of treatment≥12weeks, enrolling patients with type 2 diabetes, and comparing a SGLT2i with placebo or other comparators...
May 18, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28568379/ketoacidosis-at-onset-of-type-1-diabetes-is-a-predictor-of-long-term-glycemic-control
#13
Shlomit Shalitin, Sharon Fisher, Michal Yackbovitch-Gavan, Liat de Vries, Liora Lazar, Yael Lebenthal, Moshe Phillip
BACKGROUND: Few studies have evaluated the impact of diabetic ketoacidosis (DKA) at diabetes onset on long-term glycemic control in patients with type 1 diabetes (T1D). OBJECTIVE: We aimed to determine any differences in long-term glycemic control between children/adolescents with T1D presenting with DKA at diabetes onset and those without. METHODS: This retrospective study comprised 335 patients diagnosed with T1D from September 2007 to December 2012, among which 132 (39...
June 1, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28544185/ketoacidosis-at-diagnosis-of-type-1-diabetes-effect-of-prospective-studies-with-newborn-genetic-screening-and-follow-up-of-risk-children
#14
Anne M Hekkala, Jorma Ilonen, Jorma Toppari, Mikael Knip, Riitta Veijola
We studied the frequency of diabetic ketoacidosis (DKA) in children at diagnosis of type 1 diabetes (T1D) in a region where newborn infants have since 1995 been recruited for genetic screening for human leukocyte antigen (HLA)-conferred disease susceptibility and prospective follow up. The aim was to study whether participation in newborn screening and follow up affected the frequency of DKA, and to follow the time trends in DKA frequency. We first included children born in Oulu University Hospital since 1995 when the prospective studies have been ongoing and diagnosed with T1D <15 years by 2015 (study cohort 1, n = 517)...
May 23, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28533125/markers-of-immune-mediated-inflammation-in-the-brains-of-young-adults-and-adolescents-with-type-1-diabetes-and-fatal-diabetic-ketoacidosis-is-there-a-difference
#15
William H Hoffman, Carol M Artlett, Dallas Boodhoo, Mary G F Gilliland, Luis Ortiz, Dries Mulder, David H T Tjan, Alvaro Martin, Alexandru Tatomir, Horea Rus
Due to the limited data on diabetic ketoacidosis and brain edema (DKA/BE) in children/adolescents and the lack of recent data on adults with type 1 diabetes (T1D), we addressed the question of whether neuroinflammation was present in the fatal DKA of adults. We performed immunohistochemistry (IHC) studies on the brains of two young adults with T1D and fatal DKA and compared them with two teenagers with poorly controlled diabetes and fatal DKA. C5b-9, the membrane attack complex (MAC) had significantly greater deposits in the grey and white matter of the teenagers than the young adults (p=0...
May 19, 2017: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/28517913/sodium-glucose-co-transporter-2-inhibitors-and-diabetic-ketoacidosis-an-updated-review-of-the-literature
#16
REVIEW
Benedetta Maria Bonora, Angelo Avogaro, Gian Paolo Fadini
AIMS: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are increasingly used for the treatment of type 2 diabetes (T2D) and can improve glucose control also in type 1 diabetes (T1D). In May 2015, regulatory agencies issued a warning that SGLT2i may cause diabetic ketoacidosis (DKA). We report details on two new cases of SGLT2i-associated DKA and review the literature for similar cases within randomised controlled trials (RCTs), cohort studies, and single reports. METHODS: We searched the medical literature for reports of SGLT2i-associated DKA cases...
May 18, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#17
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/28500396/sglt2-inhibitors-and-diabetic-ketoacidosis-data-from-the-fda-adverse-event-reporting-system
#18
Gian Paolo Fadini, Benedetta Maria Bonora, Angelo Avogaro
AIMS/HYPOTHESIS: Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are indicated for the treatment of type 2 diabetes and may also improve glucose control in type 1 diabetes. In 2015, regulatory agencies warned that SGLT2i may favour diabetic ketoacidosis (DKA). We provide a detailed analysis of DKA reports in which an SGLT2i was listed among suspect or concomitant drugs in the US Food and Drug Administration Adverse Event Reporting System (FAERS). METHODS: We first analysed the entire public FAERS up to September (third quarter [Q3]) 2016 to extract the number of reports, background indications and concomitant medications, and to calculate proportional reporting ratios (PRRs) and safety signals...
May 12, 2017: Diabetologia
https://www.readbyqxmd.com/read/28496033/joint-toxicity-of-fluoroquinolone-and-tetracycline-antibiotics-to-zebrafish-danio-rerio-based-on-biochemical-biomarkers-and-histopathological-observation
#19
Lihe Ding, Luxiu Zang, Yuna Zhang, Yuhuan Zhang, Xuedong Wang, Weiming Ai, Nani Ding, Huili Wang
Herein, we report on the joint toxicity of four fluoroquinolones and two tetracyclines (β-diketone antibiotics-DKAs) to zebrafish based on a series of toxicological endpoints and histopathological observations. A positive dose-dependence was observed in DKA-exposure groups with a 72-hpf EC50 of 130.3 mg/L for hatching rate, 120-hpf LC50 of 149.8 mg/L, and 120-hpf EC50 of 135.1 mg/L for malformation rate. When zebrafish at 60 dpf were exposed to a series of DKA concentrations (45, 60 and 90 mg/L) for 7, 14 and 21 days, creatine kinase and AChE activities were significantly induced, and intracellular malondialdehyde increased in all treatments except for the 45 mg/L treatment...
2017: Journal of Toxicological Sciences
https://www.readbyqxmd.com/read/28473928/dka-induced-takotsubo-cardiomyopathy-in-patient-with-known-hocm
#20
Ayla Gordon, Gina LaCapra, Roberto Roberti
The first published case of Diabetic Ketoacidosis-induced Takotsubo cardiomyopathy was in 2009. Our patient is the 1st reported case of Diabetic Ketoacidosis- (DKA-) induced Takotsubo cardiomyopathy (TC) in a patient with known hypertrophic cardiomyopathy (HOCM) in the United States. In the literature, there are only two examples linking DKA to TC; however, this report focuses on the biochemical and physiological causes of TC in a patient with known HOCM and new-onset DKA. TC in previously diagnosed HOCM poses particular complications...
2017: Case Reports in Critical Care
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