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https://www.readbyqxmd.com/read/28211788/hemolytic-uremic-syndrome-complicated-by-clostridium-septicum-bacteremia-and-new-onset-type-1-diabetes-mellitus-report-of-a-case%C3%A2
#1
Anna C Iddings, Asha N Shenoi, Alba Morales Pozzo, Stefan G Kiessling
We report the unusual case of a 5-year-old male hospitalized for management of diabetic ketoacidosis (DKA) and new-onset type 1 diabetes mellitus (T1DM) who developed acute renal injury secondary to hemolytic uremic syndrome (HUS). He was diagnosed with Shiga toxin-producing entero-hemorrhagic Escherichia coli (EHEC) 0157:H7-positive HUS 48 hours after being diagnosed with new-onset T1DM/DKA. His hospital course was complicated by Clostridium septicum sepsis with colonic perforation. This patient's diagnosis of new-onset T1DM just prior to HUS is novel...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28207721/clinical-anatomy-e-cases-a-five-year-follow-up-of-learning-analytics
#2
Geoffrey Braatvedt, Amelia Tekiteki, Holly Britton, John Wallace, Manish Khanolkar
AIMS: To examine the length of stay and need for intensive care of people admitted with diabetic ketoacidosis (DKA) to a single centre between 1988 and 2011. METHODS: Patients aged ≥15 years admitted for the first time with DKA (plasma glucose ≥ 10mmol/L and a bicarbonate concentration ≤15mmol/L and a pH <7.35, and raised plasma or urine ketones or anion gap) to Auckland City Hospital from 1988-2011 were identified retrospectively. The patients were divided into four cohorts (1988-1996; 1997-2001; 2002-2006; 2007-2011)...
February 17, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28203360/blood-versus-urine-ketone-monitoring-in-a-pediatric-cohort-of-patients-with-type-1-diabetes-a-crossover-study
#3
Line Goffinet, Thierry Barrea, Véronique Beauloye, Philippe A Lysy
BACKGROUND: The aim of our study was to determine the influence of routine ketone monitoring on hyperglycemic events (HE) and ketosis in youngsters with type 1 diabetes (T1D). METHODS: Our single-site, controlled and randomized study was conducted on children and adolescents with T1D outside of remission phase. During two crossover periods of 6 months, patients (n = 22) experiencing HE tested ketones alternatively with a blood ketone meter or urine ketone test strips and gave their opinion on screening methods after completion of clinical trial...
January 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28154987/striving-for-control-lessons-learned-from-a-successful-international-type-1-diabetes-youth-challenge
#4
Olga Kordonouri, Andriani Vazeou, Mauro Scharf, Martina Würsig, Tadej Battelino
AIMS: To demonstrate whether young people with T1D using modern insulin treatment and CGM could successfully participate in extreme sport activity while maintaining good glycemic control. METHODS: The challenge took place in Crete/Greece over 4 days combining a long-distance trek of different levels of severity with final destination the summit of the White Mountains at 2080 m. Eleven participants (5/6 female/male, age 18.2 ± 1.3 years, T1D duration 7.9 ± 3...
February 2, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28146595/pediatric-diabetes-outpatient-center-at-rhode-island-hospital-the-impact-of-changing-initial-diabetes-education-from-inpatient-to-outpatient
#5
Mia M Pingul, Erin M Mulvihill, Steven E Reinert, Geetha Gopalakrishnan, Wendy A Plante, Charlotte M Boney, Shara R Bialo, Jose Bernardo Quintos
BACKGROUND: This study compared outcomes and costs for new-onset Type 1 diabetes mellitus (T1DM) patients educated at the outpatient versus inpatient settings. METHODS/DESIGN: Retrospective study examining the following variables: 1) hemoglobin A1c (HbA1c), 2) severe hypoglycemia, 3) admissions for diabetic ketoacidosis (DKA) or ER visits, and 4) healthcare cost. RESULTS: 152 patients with new-onset T1DM from September 2007-August 2009. There were no differences between outpatient group (OG) and inpatient group (IG) in mean HbA1c levels at 1, 2 and 3 years post-diagnosis (OG 8%, 8...
February 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28145127/cortisol-levels-in-children-with-diabetic-ketoacidosis-associated-with-new-onset-type-1-diabetes-mellitus
#6
Kristen M Williams, Pamela Fazzio, Sharon E Oberfield, Mary P Gallagher, Gaya S Aranoff
There is little data documenting cortisol levels in children with diabetic ketoacidosis (DKA), despite the fact that untreated adrenal insufficiency (AI) could worsen the outcome of DKA. In this cross-sectional study, we assessed serum cortisol levels in 28 children with DKA and new onset type 1 diabetes mellitus evaluated at our center over a 5-year period. Average duration of diabetes-related symptoms was positively associated with age ( P = .002), and significantly lower hemoglobin A1c levels were observed in the youngest children...
February 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28145026/self-reported-regular-alcohol-consumption-in-adolescents-and-emerging-adults-with-type-1-diabetes-a-neglected-risk-factor-for-diabetic-ketoacidosis-multicenter-analysis-of-29-630-patients-from-the-dpv-registry
#7
Julia M Hermann, Michael Meusers, Rainer Bachran, Ursula Kuhnle-Krahl, Norbert Jorch, Sabine E Hofer, Reinhard W Holl
BACKGROUND: The risk of hypoglycemia increases after alcohol consumption in patients with type 1 diabetes. This study aimed to investigate the association between metabolic control and self-reported alcohol consumption in young patients with type 1 diabetes. MATERIALS AND METHODS: N = 29 630 patients with type 1 diabetes aged 12 to <30 years (median age 17.0 [14.9, 18.3] years, duration of diabetes 6.8 [3.3, 10.9] years, 53% male) from the German/Austrian DPV registry were analyzed...
February 1, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28135278/clinical-characteristics-of-diabetic-ketoacidosis-in-children-with-newly-diagnosed-type-1-diabetes-in-addis-ababa-ethiopia-a-cross-sectional-study
#8
Helen Siyoum Atkilt, Muluken Gizaw Turago, Balewgizie Sileshi Tegegne
BACKGROUND: Diabetic ketoacidosis (DKA) is one of the most serious acute complications of type 1 diabetes (T1D) and the leading cause of morbidity and mortality in children with T1D. This study was aimed at assessing the prevalence and associated factors of DKA in children with newly diagnosed T1D in Addis Ababa. METHODS: A hospital based cross-sectional study was conducted in selected hospitals in Addis Ababa. Children below the age of 12 years with DKA who were admitted to the pediatric ward in the selected hospitals between January 2009 and December 2014 and the residence of Addis Ababa were included...
2017: PloS One
https://www.readbyqxmd.com/read/28129999/long-term-risk-of-stroke-in-type-2-diabetes-patients-with-diabetic-ketoacidosis-a-population-based-propensity-score-matched-longitudinal-follow-up-study
#9
Y-L Chen, S-F Weng, C-Y Yang, J-J Wang, K-J Tien
AIM: To investigate the long-term risk of stroke in type 2 diabetes (T2D) patients with previous episodes of diabetic ketoacidosis (DKA). METHODS: This retrospective nationwide population-based cohort study was conducted using Taiwan's National Health Insurance database. Claims data from 2000 to 2002 were extracted for 3572 T2D patients with DKA and 7144 controls matched for age, gender, diabetes complications severity index, frequency of clinical visits and baseline comorbidities...
January 24, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28127835/residual-beta-cell-function-in-diabetes-children-followed-and-diagnosed-in-the-teddy-study-compared-to-community-controls
#10
Andrea K Steck, Helena Elding Larsson, Xiang Liu, Riitta Veijola, Jorma Toppari, William A Hagopian, Michael J Haller, Simi Ahmed, Beena Akolkar, Åke Lernmark, Marian J Rewers, Jeffrey P Krischer
OBJECTIVE: To explore whether children diagnosed with type 1 diabetes during islet autoantibody surveillance through The Environmental Determinants of Diabetes in the Young (TEDDY) study retain greater islet function than children diagnosed through the community. METHODS: TEDDY children identified at birth with high-risk human leukocyte antigen and followed every 3 months until diabetes diagnosis were compared to age-matched children diagnosed with diabetes in the community...
January 27, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28112679/mechanism-for-leptin-s-acute-insulin-independent-effect-to-reverse-diabetic-ketoacidosis
#11
Rachel J Perry, Liang Peng, Abudukadier Abulizi, Lynn Kennedy, Gary W Cline, Gerald I Shulman
The mechanism by which leptin reverses diabetic ketoacidosis (DKA) is unknown. We examined the acute insulin-independent effects of leptin replacement therapy in a streptozotocin-induced rat model of DKA. Leptin infusion reduced rates of lipolysis, hepatic glucose production (HGP), and hepatic ketogenesis by 50% within 6 hours and were independent of any changes in plasma glucagon concentrations; these effects were abrogated by coinfusion of corticosterone. Treating leptin- and corticosterone-infused rats with an adipose triglyceride lipase inhibitor blocked corticosterone-induced increases in plasma glucose concentrations and rates of HGP and ketogenesis...
February 1, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28099783/ketosis-and-diabetic-ketoacidosis-in-response-to-sglt2-inhibitors-basic-mechanisms-and-therapeutic-perspectives
#12
REVIEW
Hongyu Qiu, Aleksandra Novikov, Volker Vallon
Inhibitors of the sodium-glucose cotransporter SGLT2 are a new class of anti-hyperglycemic drugs that have been approved for the treatment of type 2 diabetes mellitus (T2DM). These drugs inhibit glucose reabsorption in the proximal tubules of the kidney thereby enhancing glucosuria and lowering blood glucose levels. Additional consequences and benefits include a reduction in body weight, uric acid levels, and blood pressure. Moreover, SGLT2 inhibition can have protective effects on the kidney and cardiovascular system in patients with T2DM and high cardiovascular risk...
January 18, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28098426/dapagliflozin-in-patients-with-type-1-diabetes-a-post-hoc-analysis-of-the-effect-of-insulin-dose-adjustments-on-24-hour-continuously-monitored-mean-glucose-and-fasting-beta-hydroxybutyrate-levels-from-a-phase-iia-pilot-study
#13
Robert R Henry, Paresh Dandona, Jeremy Pettus, Sunder Mudaliar, John Xu, Lars Hansen
AIMS: To investigate the effects of total daily insulin dose (TDD) reductions on 24-hour continuously monitored mean glucose and fasting beta-hydroxybutyrate (a marker for diabetic ketosis/ketoacidosis [DKA]) using patient-level data from a 14-day, pilot study of dapagliflozin in type 1 diabetes. MATERIALS AND METHODS: Exploratory correlation analysis was performed post-hoc to determine the relationship between change in TDD and a) 24-hour mean glucose (by continuous glucose monitoring) and b) fasting beta-hydroxybutyrate, in 70 patients with type 1 diabetes receiving insulin and dapagliflozin (1-, 2...
January 18, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28090049/thyroid-storm-precipitated-by-diabetic-ketoacidosis-and-influenza-a-a-case-report-and-literature-review
#14
Toshiyuki Ikeoka, Hiroaki Otsuka, Naruhiro Fujita, Yukiko Masuda, Shigeto Maeda, Ichiro Horie, Takao Ando, Norio Abiru, Atsushi Kawakami
A 46-year-old woman with a history of Graves' disease presented with the chief complaints of appetite loss, weight loss, fatigue, nausea, and sweating. She was diagnosed with diabetic ketoacidosis (DKA), thyroid storm, and influenza A. She was treated with an intravenous insulin drip, intravenous fluid therapy, intravenous hydrocortisone, oral potassium iodine, and oral methimazole. As methimazole-induced neutropenia was suspected, the patient underwent thyroidectomy. It is important to maintain awareness that thyroid storm and DKA can coexist...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28077344/detection-of-h-fabp-heart-type-fatty-acid-binding-protein-levels-in-diabetic-ketoacidosis-and-identification-of-early-cardiac-effects-of-ketoacidosis
#15
Fatma Hilal Yılmaz, Sevil Arı Yuca, Hüsamettin Vatansev, Emine Ayça Cimbek, Yaşar Şen, İsa Yılmaz, Fikret Akyürek, Derya Arslan, Derya Çimen, Alaadin Yorulmaz
OBJECTIVE: This is study aims to measure the level of serum heart-type fatty acid binding protein (h-FABP) in patients presenting with diabetic ketoacidosis (DKA) and diabetic ketosis (DK) and to determine its role in identifying early period cardiac ischemia. METHODS: This prospective study included 35 patients diagnosed with DKA, 20 patients diagnosed with DK, and 20 control subjects.The h-FABP, creatine kinase-MB (CK-MB), and troponin-I levels were studied in patients with DKA and DK as well as in the control group at the time of presentation...
January 12, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28070957/controlled-trial-of-hartmann-s-solution-versus-0-9-saline-for-diabetic-ketoacidosis
#16
Michael Yung, Georgia Letton, Steve Keeley
AIM: We aimed to determine whether using a balanced salt solution, Hartmann's solution (HS), in diabetic ketoacidosis (DKA) shortens the time to normalise acid-base status through the avoidance of hyperchloremic metabolic acidosis compared with 0.9% normal saline (NS). METHODS: We conducted a double-blind, randomised controlled trial comparing HS to NS as the initial intravenous fluid in children with DKA. Patients were stratified by severity (pH < 7.1) and known or new diabetes...
January 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28062431/disseminated-histoplasmosis-presenting-as-diabetic-keto-acidosis-in-an-immunocompetent-patient
#17
Negin Niknam, Prashant Malhotra, Angela Kim, Seth Koenig
Histoplasma capsulatum causes a spectrum of manifestations from asymptomatic to fatal disseminated disease. Disseminated histoplasmosis is mostly seen in endemic areas among immunocompromised patients such as those with AIDS. Here, we present a patient living in a non-endemic area with previously undiagnosed diabetes mellitus, who presented with septic shock and diabetic ketoacidosis (DKA), and was ultimately diagnosed with disseminated histoplasmosis. The patient rapidly recovered on administration of intravenous liposomal amphotericin followed by oral itraconazole...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28049242/factors-associated-with-the-presence-and-severity-of-diabetic-ketoacidosis-at-diagnosis-of-type-1-diabetes-in-korean-children-and-adolescents
#18
Hye Jin Lee, Hyeoh Won Yu, Hae Woon Jung, Young Ah Lee, Jae Hyun Kim, Hye Rim Chung, Jaeho Yoo, Eunyoung Kim, Jeesuk Yu, Choong Ho Shin, Sei Won Yang, Seong Yong Lee
The aim of this study was to identify the risk factors for presence and severity of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in Korean children and adolescents. A retrospective chart review of children and adolescents newly diagnosed with T1DM was conducted in seven secondary and tertiary centers in Korea. Eligible subjects were < 20 years of age and had records on the presence or absence of DKA at the time of T1DM diagnosis. DKA severity was categorized as mild, moderate, or severe...
February 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28044993/higher-than-conventional-subcutaneous-regular-insulin-doses-following-diabetic-ketoacidosis-are-associated-with-better-short-term-glycemic-control-in-children-and-adolescents
#19
Özlem Bağ, Selma Tunç, Özlem Nalbantoğlu, Çiğdem Ecevit, Aysel Öztürk, Behzat Özkan, Korcan Demir
OBJECTIVE: While some guidelines recommend 0.5-1.0 units/kg/d of subcutaneous insulin following resolution of diabetic ketoacidosis (DKA), up to 2 units/kg/d of insulin is used in various centers. The aim of this study is to evaluate the effect of initial insulin dosage on glycemic control in first 48 hours of subcutaneous regular insulin therapy after DKA. METHODS: Hospital records of patients with DKA in the last 3 years [n=76, median (25th - 75th percentile) age=10...
December 30, 2016: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28034690/impact-of-diabetic-ketoacidosis-on-thyroid-function-tests-in-type-1-diabetes-mellitus-patients
#20
Homeira Rashidi, Seyed Bahman Ghaderian, Seyed Mahmoud Latifi, Forogh Hoseini
The aim of current study was to evaluate the function of thyroid during diabetic acidosis, just after the treatment and two weeks after the treatment. This was the analytic study. The study subjects included 20 patients, aged 18-36 years old, with type1 diabetes and diabetic ketoacidosis. All subjects were evaluated for thyroid function tests such as triiodothyronine (T3), thyroxine (T4), T3 resin uptake (T3RU), free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH), before treatment. After completing DKA treatment and two weeks after discharge, the thyroid function tests were repeated on the subjects and the results were analyzed using paired T-test, ANOVA or repeated measure and Pearson correlation tests...
December 14, 2016: Diabetes & Metabolic Syndrome
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