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diabetic ketoacidosis diagnosis

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https://www.readbyqxmd.com/read/27770618/diabetic-ketoacidosis-in-a-pediatric-intensive-care-unit
#1
Clarice L S Lopes, Paula Pitta Pinheiro, Luzia S Barberena, Guilherme U Eckert
OBJECTIVE: To describe the characteristics of children aged 0-14 years diagnosed with diabetic ketoacidosis and compare the following outcomes between children with prior diagnosis of type 1 diabetes mellitus (DM1) and children without prior diagnosis of DM1: length of hospital stay, severity on admission, insulin dosage, time of continuous insulin use, volume of fluids infused during treatment, and complications. METHODS: A retrospective descriptive study with review of medical records of patients admitted to the pediatric intensive care unit of a referral hospital from June 2013 to July 2015...
October 19, 2016: Jornal de Pediatria
https://www.readbyqxmd.com/read/27758023/clinical-outcomes-in-youth-beyond-the-first-year-of-type-1-diabetes-results-of-the-pediatric-diabetes-consortium-pdc-type-1-diabetes-new-onset-neon-study
#2
Eda Cengiz, Peiyao Cheng, Katrina J Ruedy, Craig Kollman, William V Tamborlane, Georgeanna J Klingensmith, Robin L Gal, Janet Silverstein, Joyce Lee, Maria J Redondo, Roy W Beck
OBJECTIVE: Current data are limited on the course of type 1 diabetes (T1D) in children and adolescents through the first few years of diabetes. The Pediatric Diabetes Consortium T1D new onset (NeOn) Study was undertaken to prospectively assess natural history and clinical outcomes in children treated at 7 US diabetes centers from the time of diagnosis. This paper describes clinical outcomes in the T1D NeOn cohort during the first 3 years postdiagnosis. RESULTS: A total of 1048 participants (mean age 9...
October 19, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27752032/starvation-ketoacidosis-as-a-cause-of-unexplained-metabolic-acidosis-in-the-perioperative-period
#3
Monique Mostert, Anthony Bonavia
BACKGROUND Besides providing anesthesia for surgery, the anesthesiologist's role is to optimize the patient for surgery and for post-surgical recovery. This involves timely identification and treatment of medical comorbidities and abnormal laboratory values that could complicate the patient's perioperative course. There are several potential causes of anion and non-anion gap metabolic acidosis in surgical patients, most of which could profoundly affect a patient's surgical outcome. Thus, the presence of an acute acid-base disturbance requires a thorough workup, the results of which will influence the patient's anesthetic management...
October 18, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27726271/pathways-to-reduce-diabetic-ketoacidosis-with-new-onset-type-1-diabetes-evidence-from-a-regional-pediatric-diabetes-center-auckland-new-zealand-2010-to-2014
#4
Eleanor R Gunn, Benjamin B Albert, Paul L Hofman, Wayne S Cutfield, Alistair J Gunn, Craig A Jefferies
BACKGROUND: There has been little change in the incidence of diabetic ketoacidosis (DKA) in newly diagnosed type 1 diabetes mellitus (T1DM) in children and adolescents in most developed countries. OBJECTIVES: To assess potentially modifiable antecedents of DKA in children <15 years of age with new onset T1DM. METHODS: Retrospective review of prospectively collected data from a complete regional cohort of children with T1DM in Auckland (New Zealand) from 2010 to 2014...
October 11, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27726268/a-survey-of-youth-with-new-onset-type-1-diabetes-opportunities-to-reduce-diabetic-ketoacidosis
#5
Luke Baldelli, Ben Flitter, Laura Pyle, David M Maahs, Georgeanna Klingensmith, Robert Slover, G Todd Alonso
OBJECTIVE: Pediatric patients in Colorado with new onset type 1 diabetes (T1D) presenting with diabetic ketoacidosis (DKA) increased from 29.9% to 46.2% from 1998 to 2012. The purpose of this study was to compare differences between patients with newly diagnosed T1D who presented in DKA with those who did not across three domains: sociodemographic factors, access to medical care, and medical provider factors, aiming to identify potential targets for intervention. METHODS: Sixty-one patients <17 years of age with T1D duration <6 months completed the questionnaire...
October 11, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27726262/high-incidence-of-diabetic-ketoacidosis-at-diagnosis-of-type-1-diabetes-among-polish-children-aged-10-12-and-under-5-years-of-age-a-multicenter-study
#6
Agnieszka Szypowska, Katarzyna Dżygało, Marta Wysocka-Mincewicz, Artur Mazur, Lucyna Lisowicz, Iwona Ben-Skowronek, Joanna Sieniawska, Bożenna Klonowska, Dorota Charemska, Jolanta Nawrotek, Irena Jałowiec, Artur Bossowski, Milena Jamiołkowska, Beata Pyrżak, Izabela Rogozińska, Mieczysław Szalecki
AIM: Despite its characteristic symptoms, type 1 diabetes (T1D) is still diagnosed late causing the development of diabetic ketoacidosis (DKA). The aim of this study was to estimate the incidence of DKA and factors associated with the development of acidosis at T1D recognition in Polish children aged 0-17. METHODS: The study population consisted of 2100 children with newly diagnosed T1D in the years 2010-2014 in 7 hospitals in eastern and central Poland. The population living in these areas accounts for 35% of the Polish population...
October 11, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27717592/euglycemic-diabetic-ketoacidosis-with-elevated-acetone-in-a-patient-taking-a-sodium-glucose-cotransporter-2-sglt2-inhibitor
#7
Tory J Andrews, Robert D Cox, Christina Parker, James Kolb
BACKGROUND: Sodium-glucose cotransporter-2 (SGLT2) inhibitor medications are a class of antihyperglycemic agents that increase urinary glucose excretion by interfering with the reabsorption of glucose in the proximal renal tubules. In May of 2015, the U.S. Food and Drug Administration released a warning concerning a potential increased risk of ketoacidosis and ketosis in patients taking these medications. CASE REPORT: We present a case of a 57-year-old woman with type 2 diabetes mellitus taking a combination of canagliflozin and metformin who presented with progressive altered mental status over the previous 2 days...
October 4, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27696192/fulminant-type-i-diabetes-mellitus-associated-with-nivolumab-in-a-patient-with-relapsed-classical-hodgkin-lymphoma
#8
Wataru Munakata, Ken Ohashi, Nobuhiko Yamauchi, Kensei Tobinai
We report the case of a patient with relapsed classical Hodgkin lymphoma who developed fulminant type I diabetes mellitus as a severe adverse event of treatment with the anti-programmed cell death-1 (PD-1) antibody, nivolumab. On the first day of the sixth cycle, the blood glucose level was markedly elevated (375 mg/dL). Although neither ketoacidosis nor ketonuria was detected, the markedly acute onset of the hyperglycemia was consistent with the typical clinical course of fulminant type I diabetes mellitus, and this diagnosis was supported by clinical data...
October 1, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27660061/small-fiber-neuropathy-in-children-two-case-reports-illustrating-the-importance-of-recognition
#9
Janneke G J Hoeijmakers, Catharina G Faber, Carien J Miedema, Ingemar S J Merkies, Johan S H Vles
Small fiber neuropathy (SFN) is a debilitating condition that often leads to pain and autonomic dysfunction. In the last few decades, SFN has been gaining more attention, particularly in adults. However, literature about SFN in children remains limited. The present article reports the cases of 2 adolescent girls diagnosed with SFN. The first patient (14 years of age) complained about painful itch and tingling in her legs, as well as dysautonomia symptoms for years. She also reported a red/purple-type discoloration of her legs aggravated by warmth and standing, compatible with erythromelalgia...
September 22, 2016: Pediatrics
https://www.readbyqxmd.com/read/27636019/diabetic-ketoacidosis-without-diabetes
#10
Devina Willard, Jagriti Upadhyay, Chan Kim, Devin Steenkamp
CONTEXT: Type B insulin resistance syndrome is a rare disease which occurs due to the development of autoantibodies to the insulin receptor and can result in either severe insulin resistance and hyperglycemia or conversely hypoglycemia. Diabetes mellitus is often severe, usually transient and poorly responsive to exogenous insulin. Diabetic ketoacidosis is an unusual consequence of this most severe form of transient diabetes mellitus. CASE DESCRIPTION: A 39 year old Nigerian woman presented with significant weight loss, severe diabetic ketoacidosis and severe insulin resistance requiring massive doses of exogenous insulin...
September 16, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27631252/an-unusual-presentation-of-eruptive-xanthoma-a-case-report-and-literature-review
#11
Muhammad Kashif, Hanesh Kumar, Misbahuddin Khaja
BACKGROUND: Eruptive xanthomas are benign skin lesions caused by localized deposition of lipids in the dermis. The lesions are generally caused by elevated levels of serum triglycerides that leak through the capillaries and are phagocytosed by macrophages in the dermis. Clinical manifestation varies from asymptomatic skin lesions to intense pruritus and tenderness. METHODS: We present a case of a middle-aged man admitted with diabetic ketoacidosis secondary to noncompliance with insulin...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27609719/thyroid-storm-presenting-as-psychosis-masked-by-diabetic-ketoacidosis
#12
Raafia Memon, WuQiang Fan, Richard Snyder, Mahesh Krishnamurthy
INTRODUCTION: While extremely uncommon, diabetic ketoacidosis (DKA) and thyroid storm (TS) are endocrine emergencies that can coexist. We describe a case with a confounding clinical presentation that identifies these two emergencies within the setting of sepsis and influenza. CASE: A 69-year-old diabetic female was found by the paramedic staff to be disoriented. She demonstrated tachycardia and had a foul-smelling abdominal wound. Laboratory evaluation revealed DKA, leukocytosis, influenza B, and urinary tract infection...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27595573/hospitalization-of-elderly-diabetic-patients-characteristics-reasons-for-admission-and-gender-differences
#13
Wei Lin, Chan Chen, Huaqin Guan, Xiaohong Du, Junjian Li
BACKGROUND: Understanding the differences in characteristics, gender, and common causes for admission in hospitalized elderly diabetic patients provides a theoretical basis for their successful management. This study explored the reasons and gender differences in hospitalizations of elderly patients with diabetes mellitus. METHODS: Patients aged ≥60 years who had received a diagnosis of diabetes by the time of discharge, from 1 January 2011 to 1 January 2014, were retrospectively enrolled...
2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27592232/diabetic-ketoacidosis-in-patients-exposed-to-antipsychotics-a-systematic-literature-review-and-analysis-of-danish-adverse-drug-event-reports
#14
Christoffer Polcwiartek, Torkel Vang, Christina Hedegård Bruhn, Nasseh Hashemi, Mary Rosenzweig, Jimmi Nielsen
RATIONALE: Patients exposed to second-generation antipsychotics (SGAs) have approximately 10 times increased risk of diabetic ketoacidosis (DKA) compared with the general population. However, as DKA is a rare complication of type 2 diabetes mellitus, and susceptible patients exposed to antipsychotics may rapidly develop DKA independently of treatment duration and weight gain, this is rather suggestive of type 1 diabetes mellitus (T1DM) or latent autoimmune diabetes in adults. OBJECTIVES: We performed a systematic review of current studies regarding antipsychotic-associated DKA with type 1 etiology and analyzed Danish adverse drug event (ADE) reports (previously unpublished cases)...
October 2016: Psychopharmacology
https://www.readbyqxmd.com/read/27591535/usefulness-of-postmortem-biochemistry-in-identification-of-ketosis-diagnosis-of-ketoacidosis-at-the-onset-of-autoimmune-type-1-diabetes-in-an-autopsy-case-with-cold-exposure-and-malnutrition
#15
Naoto Tani, Tomomi Michiue, Jian-Hua Chen, Shigeki Oritani, Takaki Ishikawa
A severely malnourished, Japanese female in her twenties was found dead in her apartment. On autopsy, most of the findings from the internal examination were suggestive of hypothermia. Postmortem biochemistry, however, showed severely increased levels of glycated hemoglobin (HbA1c) and blood and urine glucose levels. Levels of acetone, 3-hydroxybutyric acid, and acetoacetate in various body fluids were also highly increased, indicating ketosis. The serum insulin and c-peptide levels were severely low, and subsequent testing was positive for anti-GAD antibodies...
September 2016: Legal Medicine
https://www.readbyqxmd.com/read/27563914/evaluation-of-the-accuracy-of-capillary-hydroxybutyrate-measurement-compared-with-other-measurements-in-the-diagnosis-of-diabetic-ketoacidosis-a-systematic-review
#16
REVIEW
Joanne Brooke, Marlon Stiell, Omorogieva Ojo
A complication of diabetes is diabetic ketoacidosis (DKA), which if left untreated is a life threatening condition. Prompt and accurate diagnosis of DKA is required for the commencement of life saving interventions. Measurements of ketone bodies in DKA have usually been through nitroprusside urine acetoacetate testing. The aim of this systematic review was to examine whether capillary β-hydroxybutyrate (β-OHB) testing is more accurate compared to other diagnostic methods of DKA. The following electronic databases were searched: EBSCO Host, MEDLINE, PSYCHInfo, CINAHL and Science Direct for publications from 1 January 2005 and up to and including 1 January 2016...
2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27547411/recovery-of-premorbid-bmi-trajectory-without-overshoot-during-the-first-year-of-treatment-of-children-with-type-1-diabetes
#17
Annika Grönberg, Ingemar Swenne
OBJECTIVE: To study body mass index (BMI) changes and metabolic control in children and adolescents during the first year following the diagnosis of type 1 diabetes. RESEARCH DESIGN AND METHODS: 200 children and adolescents (<18 years) diagnosed with type 1 diabetes, started on multiple injection treatment and followed up for 1 year were studied with respect to metabolic control and weight change. Growth curves preceding the onset of diabetes were procured from the school health services...
2016: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/27524542/type-1-diabetes-mellitus-presenting-with-diabetic-ketoacidosis-dka-in-a-neonate
#18
Fareed Ahmed, Ghazala Kazi, Waqas Khan
Neonatal diabetes mellitus (NDM) is a rare manifestation with an incidence of one affected individual among 400000 live births. NDM can be divided into Transient (TNDM) and Permanent (PNDM) types. A significant overlap occurs between both groups, to an extent that TNDM cannot be distinguished from PNDM based solely on clinical features. Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (TIDM). DKA at diagnosis is more common in young children near the age of five years...
August 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27521183/clinical-characteristics-of-type-1-diabetes-mellitus-in-taiwanese-children-aged-younger-than-6-years-a-single-center-experience
#19
Yi-Chen Chen, Yi-Ching Tung, Shih-Yao Liu, Cheng-Ting Lee, Wen-Yu Tsai
BACKGROUND/PURPOSE: Cases of type 1 diabetes mellitus in children aged younger than 6 years in Taiwan has increased in the past 10 years. This retrospective study aimed to review the management experience of such patients in a single center. METHODS: From January 2004 to June 2015, 52 newly diagnosed diabetic children younger than 6 years who had regular follow-up for > 1 year were enrolled, as well as 94 older diabetic children for comparison. Their medical records were thoroughly reviewed...
August 9, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27495830/-direct-service-costs-of-diabetes-mellitus-hospitalisations-in-the-mexican-institute-of-social-security
#20
Leonardo Salas-Zapata, Lina Sofía Palacio-Mejía, Belkis Aracena-Genao, Juan Eugenio Hernández-Ávila, Emmanuel Salvador Nieto-López
OBJECTIVE: To estimate the direct costs related to hospitalizations for diabetes mellitus and its complications in the Mexican Institute of Social Security METHODS: The hospital care costs of patients with diabetes mellitus using diagnosis-related groups in the IMSS (Mexican Institute of Social Security) and the hospital discharges from the corresponding E10-E14 codes for diabetes mellitus were estimated between 2008-2013. Costs were grouped according to demographic characteristics and main condition, and were estimated in US dollars in 2013...
August 2, 2016: Gaceta Sanitaria
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