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diabetic ketoacidosis with normal ph

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https://www.readbyqxmd.com/read/27871165/acute-pancreatitis-complicated-with-diabetic-ketoacidosis-in-a-young-adult-without-hypertriglyceridemia-a-case-report
#1
Jung Hyun Kim, Myung Jin Oh
Systemic complications related to acute pancreatitis include acute respiratory distress syndrome, multiple organ dysfunction syndrome, disseminated intravascular coagulation, hypocalcemia, hyperglycemia, and insulin dependent diabetes or diabetic ketoacidosis. In practice, the development of diabetic ketoacidosis induced by acute pancreatitis is rare and generally associated with hypertriglyceridemia. However, herein we report a case of a 34-year-old female without hypertriglyceridemia, who was diagnosed with acute pancreatitis complicated with diabetic ketoacidosis...
November 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27251911/an-in-vitro-analysis-of-the-effect-of-acidosis-on-coagulation-in-chronic-disease-states-a-thromboelastograph-study
#2
Hayden White, Robert Bird, Kellie Sosnowski, Mark Jones
Thrombosis is a complication of many chronic illnesses. Chronic obstructive pulmonary disease (COPD) and diabetes mellitus are common medical conditions frequently associated with a hypercoagulable state. Acidaemia has been shown to reduce coagulation. COPD and diabetes mellitus during acute deterioration can present with a severe acidaemia. The impact of this acidaemia on coagulation is poorly studied. Patients presenting with a diagnosis of diabetic ketoacidosis or type II respiratory failure from COPD and a pH of less than 7...
June 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27097605/euglycemic-diabetic-ketoacidosis
#3
Anar Modi, Abhinav Agrawal, Farah Morgan
INTRODUCTION: Diabetic ketoacidosis (DKA) is one of the most serious complications of diabetes. It is characterised by the triad of hyperglycemia (blood sugar >250 mg/dl), metabolic acidosis (arterial pH <7.3 and serum bicarbonate <18 mEq/L) and ketosis. Rarely these patients can present with blood glucose (BG) levels of less than 200 mg/dl, which is defined as euglycemic DKA. The possible etiology of euglycemic DKA includes the recent use of insulin, decreased caloric intake, heavy alcohol consumption, chronic liver disease and glycogen storage disorders...
April 21, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27082665/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-position-statement-on-the-association-of-sglt-2-inhibitors-and-diabetic-ketoacidosis
#4
Yehuda Handelsman, Robert R Henry, Zachary T Bloomgarden, Sam Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Ele Ferrannini, Vivian A Fonseca, Alan J Garber, George Grunberger, Derek LeRoith, Guillermo E Umpierrez, Matthew R Weir
AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology DKA = diabetic ketoacidosis EMA = European Medicines Agency FDA = U.S. Food and Drug Administration SGLT-2 = sodium glucosecotransporter 2 T1D = type 1 diabetes T2D = type 2 diabetes.
June 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27074163/hypochloremia-in-cats-prevalence-and-associated-diseases
#5
Florian K Zeugswetter, Maximilian Pagitz, Mona Sarah Friedrich
OBJECTIVE: To describe the prevalence and possible causes of hypochloremia in the local hospital cat population. MATERIAL AND METHODS: Retrospective study consisting of two parts. Data were collected from the local electronic medical records database using the search terms "chloride" and "cats" (part A), and "blood gas analysis" and "cats" (part B). The medical records of the hypochloremic cats were then reviewed to determine prior treatment or infusions and to identify major underlying disease processes...
August 17, 2016: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/26901141/lpl-gene-mutation-as-the-cause-of-severe-hypertriglyceridemia-in-the-course-of-ketoacidosis-in-a-patient-with-newly-diagnosed-type-1-diabetes-mellitus
#6
Julita Nocoń-Bohusz, Beata Wikiera, Aleksander Basiak, Robert Śmigiel, Anna Noczyńska
INTRODUCTION: Severe hypertriglyceridemia is a condition associated with extremely high triglycerides (TG) plasma concentrations exceeding 1000mg/dl. This condition may result in mutations in genes encoding lipoprotein lipase (LPL), apolipoprotein C2 (APOC2) and apolipoprotein A5 (APOA5) characterized by an autosomal recessive inheritance pattern. AIM: A case report of a patient in which clinical picture of type 1 diabetes mellitus (T1DM) was accompanied by diabetic ketoacidosis (DKA) and severe hypertriglyceridemia...
February 18, 2016: Pediatric Endocrinology, Diabetes, and Metabolism
https://www.readbyqxmd.com/read/26823137/effect-of-volume-of-fluid-resuscitation-on-metabolic-normalization-in-children-presenting-in-diabetic-ketoacidosis-a-randomized-controlled-trial
#7
Katherine Bakes, Jason S Haukoos, Sara J Deakyne, Emily Hopkins, Josh Easter, Kim McFann, Alison Brent, Arleta Rewers
BACKGROUND: The optimal rate of fluid administration in pediatric diabetic ketoacidosis (DKA) is unknown. OBJECTIVE: Our aim was to determine whether the volume of fluid administration in children with DKA influences the rate of metabolic normalization. METHODS: We performed a randomized controlled trial conducted in a tertiary pediatric emergency department from December 2007 until June 2010. The primary outcome was time to metabolic normalization; secondary outcomes were time to bicarbonate normalization, pH normalization, overall length of hospital treatment, and adverse outcomes...
April 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26158275/analysis-of-the-safety-and-efficacy-of-diabetic-ketoacidosis-management-in-a-community-general-hospital-2001-2010-a-descriptive-study
#8
E Peeters, W J van IJperen, L Robertson, P Royle, W J van IJperen
BACKGROUND: The recommended place for treatment of diabetic ketoacidosis in children is a paediatric High Dependency Unit. This facility is not available in all areas where children with type 1 diabetes mellitus are cared for. AIMS: This study investigates the safety and efficacy of diabetic ketoacidosis management in a community general hospital without a paediatric high dependency unit. METHODS: Data from children with diabetic ketoacidosis were collected from all diabetes related admissions in Dr Gray's Hospital, Elgin from 2001 to 2010...
August 2015: Scottish Medical Journal
https://www.readbyqxmd.com/read/25546713/a-pilot-study-comparing-a-protocol-using-intermittent-administration-of-glargine-and-regular-insulin-to-a-continuous-rate-infusion-of-regular-insulin-in-cats-with-naturally-occurring-diabetic-ketoacidosis
#9
RANDOMIZED CONTROLLED TRIAL
Brandi R Gallagher, Orla M Mahony, Elizabeth A Rozanski, Sibylle Buob, Lisa M Freeman
OBJECTIVE: The goal of this pilot study was to compare regular insulin administered by continuous rate infusion (CRI) to an approach using insulin glargine and regular insulin administered intermittently. DESIGN: Prospective randomized clinical trial. SETTING: University teaching hospital. ANIMALS: Sixteen cats with diabetic ketoacidosis (DKA). INTERVENTIONS: Cats with DKA were randomized to either low-dose regular insulin CRI (CRI group; n = 8) or intermittent short- and long-acting insulin injections (subcutaneous [SC] glargine plus intramuscular [IM] regular insulin; SC/IM group; n = 8)...
March 2015: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/24711923/a-case-of-a-woman-with-late-pregnancy-onset-dka-who-had-normal-glucose-tolerance-in-the-first-trimester
#10
Hiromi Himuro, Takashi Sugiyama, Hidekazu Nishigori, Masatoshi Saito, Satoru Nagase, Junichi Sugawara, Nobuo Yaegashi
UNLABELLED: Diabetic ketoacidosis (DKA) during pregnancy is a serious complication in both mother and fetus. Most incidences occur during late pregnancy in women with type 1 diabetes mellitus. We report the rare case of a woman with type 1 diabetes mellitus who had normal glucose tolerance during the first trimester but developed DKA during late pregnancy. Although she had initially tested positive for screening of gestational diabetes mellitus during the first trimester, subsequent diagnostic 75-g oral glucose tolerance tests showed normal glucose tolerance...
2014: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/24642459/severe-pretreatment-cerebral-edema-in-newly-diagnosed-type-1-diabetes
#11
Katharina Warncke, Petra Dressel, Anette-G Ziegler, Marc Steinborn, Walter Bonfig, Stefan Burdach, Ilse Engelsberger
INTRODUCTION: Cerebral edema (CE) is a rare and dangerous complication of diabetic ketoacidosis. In typical cases, it may develop during several hours after the beginning of ketoacidosis therapy. Nevertheless, CE sometimes occurs before the start of any therapy - as for the patient in this report here. CASE REPORT: We describe a 12-year-old girl with newly diagnosed type 1 diabetes, presenting with severe headache and disorientation. Diabetes-related symptoms were not reported by the family...
2014: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/24389778/diabetic-ketoalkalosis-in-children-and-adults
#12
Emily A Huggins, Shawn A Chillag, Ali A Rizvi, Robert R Moran, Martin W Durkin
OBJECTIVES: Diabetic ketoacidosis (DKA) with metabolic alkalosis (diabetic ketoalkalosis [DKALK]) in adults has been described in the literature, but not in the pediatric population. The discordance in the change in the anion gap (AG) and the bicarbonate is depicted by an elevated delta ratio (DR; rise in AG/drop in bicarbonate), which is normally approximately 1. The primary aim of this study was to determine whether DKALK occurs in the pediatric population, as has been seen previously in the adult population...
January 2014: Southern Medical Journal
https://www.readbyqxmd.com/read/24179938/history-of-medical-understanding-and-misunderstanding-of-acid-base-balance
#13
Christopher Geoffrey Alexander Aiken
To establish how controversies in understanding acid base balance arose, the literature on acid base balance was reviewed from 1909, when Henderson described how the neutral reaction of blood is determined by carbonic and organic acids being in equilibrium with an excess of mineral bases over mineral acids. From 1914 to 1930, Van Slyke and others established our acid base principles. They recognised that carbonic acid converts into bicarbonate all non-volatile mineral bases not bound by mineral acids and determined therefore that bicarbonate represents the alkaline reserve of the body and should be a physiological constant...
September 2013: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/24005972/acute-pancreatitis-and-severe-hypertriglyceridaemia-masking-unsuspected-underlying-diabetic-ketoacidosis
#14
Kewan Aboulhosn, Terra Arnason
A healthy 18-year-old girl presented to a local emergency room with 48 h of abdominal pain and vomiting. A radiological and biochemical diagnosis of moderate acute pancreatitis was made. Bloodwork demonstrated prominent hypertriglyceridaemia (HTG) of 19.5 mmol/L (severe HTG: 11.2-22.4), detectable urine ketones and a random blood glucose of 13 mmol/L dropping to 10.5 mmol/L on repeat (normal random <11). Ketone levels were deemed consistent with fasting ketosis after 48 h of vomiting. There was no known history of diabetes in the patient...
2013: BMJ Case Reports
https://www.readbyqxmd.com/read/23630441/correlation-between-peripheral-white-blood-cell-counts-and-hyperglycemic-emergencies
#15
Wei Xu, Hai-feng Wu, Shao-gang Ma, Feng Bai, Wen Hu, Yue Jin, Hong Liu
OBJECTIVE: To determine the correlation between differential leukocyte counts and hyperglycemic emergencies. METHODS: Fifty patients with diabetic ketoacidosis (DKA), 50 patients with diabetic ketosis (DK), 50 non-DK diabetic patients with stable glycemic control, and 50 normal controls were enrolled. Their total and differential leukocyte counts were measured and evaluated at admission and after treatment. RESULTS: The patients with DKA and DK had higher plasma glucose levels (20...
2013: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/23277751/hyperglycemic-hyperosmolar-syndrome-at-the-onset-of-type-2-diabetes-mellitus-in-an-adolescent-male
#16
Sarah L Tsai, Stasia Hadjiyannakis, Meranda Nakhla
Hyperglycemic hyperosmolar state (HHS) is rare in the paediatric population. The diagnosis and management of HHS presents a challenge in paediatric patients who may present with a mixed picture of HHS and diabetic ketoacidosis (DKA).A 15-year-old obese African American male was brought to the emergency department following a two-day history of feeling unwell. The patient was obtunded, hypotensive and tachypneic. Initial investigations revealed the following: pH 6.97 (normal 7.35 to 7.41), HCO(3) (-) 5 mEq/L (normal 20 mEq/L to 25 mEq/L), glucose 90...
January 2012: Paediatrics & Child Health
https://www.readbyqxmd.com/read/23234742/-what-you-should-know-of-the-arterial-blood-gases-during-the-watch
#17
Horacio Márquez-González, Jesús Pámanes-González, Horacio Márquez-Flores, Alonso Gómez-Negrete, Mireya C Muñoz-Ramírez, Antonio Rafael Villa-Romero
Gasometry is the measurement of dissolved gases in the blood, by measuring pH, carbon dioxide pressure (pCO(2)), serum bicarbonate (HCO(3-)), and lactate and serum electrolytes: sodium, potassium and chlorine you can make a diagnosis, etiology and treatment in the critically ill patient. The aim is to provide five steps for the interpretation of blood gases by: 1. The definition of acidemia or acidosis, or alkalemia or alkalosis. 2. Defining the metabolic component or respiratory. 3. To determine the anion gap; levels above 15 ± 2 determine other likely causes of excess anions (methanol, uremia, diabetic ketoacidosis, paraldehyde, ionized, lactic acidosis, ethylene glycol and salicylates...
July 2012: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/23187985/admission-and-treatment-factors-associated-with-the-duration-of-acidosis-in-children-with-diabetic-ketoacidosis
#18
Dai Kimura, Andre Raszynski, Balagangadhar R Totapally
BACKGROUND: Our goal was to determine the factors associated with prolonged acidosis in children with diabetic ketoacidosis. METHOD: The records of all children (109 admissions, 86 patients) admitted to the pediatric intensive care unit (PICU) during a 3-year period with the diagnosis of diabetic ketoacidosis were analyzed. RESULTS: The charts were reviewed after institutional review board approval was obtained. Demographic and serial laboratory data, time to correction of acidosis, as well as the first 24-hour chloride load, total fluid administered, fluid balance, and PICU and hospital lengths of stay were recorded...
December 2012: Pediatric Emergency Care
https://www.readbyqxmd.com/read/23075084/diabetic-ketoacidosis-associated-with-acute-pancreatitis-in-a-heart-transplant-recipient-treated-with-tacrolimus
#19
Moon-Sun Im, Hyo-Suk Ahn, Hyun-Jai Cho, Ki-Bong Kim, Hae-Young Lee
New-onset diabetes mellitus after transplant is a well-recognized complication of tacrolimus immunosuppression and commonly occurs as a form of type 2 diabetes mellitus. However, tacrolimus-associated acute pancreatitis causing diabetic ketoacidosis has not been reported in heart transplant patients. We report a 22-year-old women hospitalized owing to diabetic ketoacidosis associated with acute pancreatitis 7 months after a heart transplant. Her immunosuppression included tacrolimus. She was admitted with complaints of polydipsia, anorexia, and abdominal pain of 3 days' duration...
February 2013: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/22701829/type-1-renal-tubular-acidosis-in-a-patient-of-type-1-diabetes-mellitus-is-it-coincidence-or-coexistence
#20
Muzafar Naik, Tariq Bhat, Mubarik Naqash, Manzoor Wani, Nazir Dar, Younis Shah
A 26-year-old male patient suffering from Type 1 diabetes mellitus got admitted with abdominal pain and high blood sugars. On further evaluation, he was found to have normal anion gap metabolic acidosis without ketonuria and urinary pH was alkaline. The patient was diagnosed as Type 1 renal tubular acidosis (RTA) (distal RTA) and was managed by alkali replacement in addition to control of blood sugars. The association of Type 1 RTA with Type 1 diabetes mellitus has been rarely reported in the literature. The association needs a different attention as diagnosis and management of diabetic ketoacidosis in such cases will be tricky...
March 2012: Indian Journal of Endocrinology and Metabolism
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