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diabetic ketoacidosis diagnosis

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https://www.readbyqxmd.com/read/29431304/ketoacidosis-in-newly-diagnosed-type-1-diabetes-in-children-and-adolescents-in-israel-prevalence-and-risk-factors
#1
Ori Eyal, Asaf Oren, Dganit Almasi-Wolker, Yardena Tenenbaum-Rakover, Marianna Rachmiel, Naomi Weintrob
BACKGROUND: Diabetic ketoacidosis (DKA) as the first presentation of type 1 diabetes mellitus (T1DM) is a serious complication that is preventable. OBJECTIVES: To identify risk factors for DKA at presentation of T1DM to delineate high-risk Israeli populations that could benefit from preventative measures. METHODS: Data for this multicenter retrospective study were collected from the medical files of three pediatric diabetes centers representing three districts in Israel...
February 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29396187/diabetes-care-and-dementia-among-older-adults-a-nationwide-3-year-longitudinal-study
#2
Matthieu Wargny, Adeline Gallini, Hélène Hanaire, Fati Nourhashemi, Sandrine Andrieu, Virginie Gardette
OBJECTIVES: To compare diabetes monitoring and the incidence of acute diabetic complications between patients with and without incident Alzheimer's Disease and Related Syndromes (ADRS). DESIGN: Longitudinal observational study from 2010 to 2014. SETTING: Data from the French national health system database. PARTICIPANTS: The France-Démence cohort: individuals aged 65 years or older suffering from incident ADRS, based on long-term disease registry, hospitalization for dementia, or antidementia drug delivery...
January 25, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29386248/trends-in-hospital-admission-for-diabetic-ketoacidosis-in-adults-with-type-1-and-type-2-diabetes-in-england-1998-2013-a-retrospective-cohort-study
#3
Victor W Zhong, Juhaeri Juhaeri, Elizabeth J Mayer-Davis
OBJECTIVE: This study determined trends in hospital admission for diabetic ketoacidosis (DKA) in adults with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) from 1998 to 2013 in England. RESEARCH DESIGN AND METHODS: The study population included 23,246 adults with T1DM and 241,441 adults with T2DM from the Clinical Practice Research Datalink and Hospital Episode Statistics. All hospital admissions for DKA as the primary diagnosis from 1998 to 2013 were identified...
January 31, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29384776/evaluating-an-order-set-for-improvement-of-quality-outcomes-in-diabetic-ketoacidosis
#4
Anna Marie Joyner Blair, Bernita K Hamilton, Amy Spurlock
The timely management of diabetic ketoacidosis (DKA) is essential to avoid lengthy hospitalizations and poor clinical outcomes. There is often an absence of ownership for glycemic management in hospitalized patients, most notably in those with a diagnosis other than diabetes. Evidence supports the use of evidence-based DKA protocols. The purpose of this project was to determine whether utilization of an evidence-based order set versus an individualized provider approach for the treatment and management of DKA decreases resolution time and occurrences of hypoglycemia and improves clinical outcomes...
January 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29378735/new-onset-diabetes-after-nivolumab-treatment
#5
Ricardo Capitao, Carlos Bello, Ricardo Fonseca, Catarina Saraiva
The authors describe a case of a life-threatening diabetic emergency 25 days after initiation of nivolumab (3 mg/kg) for stage 4 lung adenocarcinoma. She was admitted to the emergency department, with hyperglycaemia-related signs and symptoms, such as polyuria, polydipsia, weight loss, confusion, asthenia, dehydration, hypotension and Kussmaul respiratory pattern. Her body mass index was 21.9 kg/m 2 and she did not show acanthosis nigricans. Arterial blood gas determination revealed high anion gap metabolic acidaemia and blood tests showed hyperglycaemia (1060 mg/dL), hyperketonaemia (beta-hydroxybutyrate: 6...
January 29, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29349041/unusual-cause-of-severe-diabetic-ketoacidosis-precipitated-by-streptococcus-bovis-equinus-sbsec-bacteremia-case-report-and-review-of-literature
#6
Sana Idrees, Sonali Gupta, Miguel Mantilla, Pradeep Goyal, Ilja Hulinsky
Diabetic ketoacidosis is a feared complication in patients with diabetes mellitus and poses high risk of mortality and morbidity unless treated in timely manner. Infection is one of the most common precipitating factors for the development of diabetic ketoacidosis. Bacteremia with Group A and Group B beta hemolytic streptococcal strains are well known, however nonenterococcal Group D strains such as the Streptococcus bovis/Streptococcus equinus complex (SBSEC) still remains an understudied entity. Here we present a case of a 35-year-old Type I diabetic female presenting with severe diabetic ketoacidosis with overlapping features of hyperosmolar hyperglycemia, precipitated by Streptococcus alactolyticus bacteremia, successfully treated with four-week course of parenteral ceftriaxone...
2018: IDCases
https://www.readbyqxmd.com/read/29330587/posterior-reversible-encephalopathy-syndrome-with-spinal-cord-involvement-pres-sci-as-a-rare-complication-of-severe-diabetic-ketoacidosis-a-case-report-and-review-of-the-literature
#7
Jianfei Nao, Han Zhang, Si Wu, Xiaotian Zhang, Dongming Zheng
INTRODUCTION: In addition to diffuse brain oedema, diabetic ketoacidosis (DKA) can lead to ischaemic or haemorrhagic stroke, extrapontine myelinolysis, and sinovenous thrombosis. However, posterior reversible encephalopathy syndrome (PRES) and spinal cord oedema are rarely reported in patients with DKA. METHODS: We present a case of a 17-year-old-girl who developed headache, blurred vision, and paraplegia after her DKA was controlled. Sequential magnetic resonance (MR) scans of the brain and spinal cord were performed...
January 12, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29327148/autoantibodies-against-zinc-transporter-8-are-related-to-age-and-metabolic-state-in-patients-with-newly-diagnosed-autoimmune-diabetes
#8
Elżbieta Niechciał, Anita Rogowicz-Frontczak, Stanisław Piłaciński, Marta Fichna, Bogda Skowrońska, Piotr Fichna, Dorota Zozulińska-Ziółkiewicz
AIMS: To assess the prevalence of ZnT8-ab and its correlation to other autoimmune markers and diabetic ketoacidosis occurrence in children and adults with T1DM onset. METHODS: The study included 367 patients (218 children; 149 adults) at the T1DM onset. Selected diabetes-related autoantibodies such as GAD-ab, IA2-ab, ZnT8-ab were tested before the initiation of insulin therapy. Diabetic ketoacidosis was defined as glucose concentration > 13.9 mmol/l, pH < 7...
January 11, 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29316133/diabetic-ketoacidosis-in-adult-patients-an-audit-of-factors-influencing-time-to-normalisation-of-metabolic-parameters
#9
Melissa H Lee, Genevieve L Calder, John D Santamaria, Richard J MacIsaac
BACKGROUND: Diabetic ketoacidosis (DKA) is an acute life-threatening metabolic complication of diabetes that imposes substantial burden on our healthcare system. There is a paucity of published data in Australia assessing factors influencing time to resolution of DKA and length of stay (LOS). AIMS: To identify factors that predict a slower time to resolution of DKA in adults with diabetes. METHODS: Retrospective audit of patients admitted to St Vincent's Hospital Melbourne between 2010 to 2014 coded with a diagnosis of 'Diabetic Ketoacidosis'...
January 8, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29295580/diabetic-ketoacidosis-severity-at-diagnosis-and-glycaemic-control-in-the-first-year-of-childhood-onset-type-1-diabetes-a-longitudinal-cohort-study
#10
Amal R Khanolkar, Rakesh Amin, David Taylor-Robinson, Russell M Viner, Justin Warner, Evelien F Gevers, Terence Stephenson
It is unclear whether diabetic ketoacidosis (DKA) severity at diagnosis affects the natural history of type 1 diabetes (T1D). We analysed associations between DKA severity at diagnosis and glycaemic control during the first year post-diagnosis. We followed 341 children with T1D, <19 years (64% non-white) attending paediatric diabetes clinics in East London. Data were extracted from routine medical registers. Subjects were categorized with normal, mild, moderate, or severe DKA. Linear mixed-effects modelling was used to assess differences in longitudinal HbA1c trajectories (glycaemic control) during 12 months post-diagnosis (1288 HbA1c data-points) based on DKA, adjusting for sex, age, ethnicity, SES (Socioeconomic Status) and treatment type...
December 25, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29280234/clinical-and-biochemical-features-at-diagnosis-of-type-1-diabetes-in-patients-between-0-and-18-years-of-age-from-jordan
#11
Rasha Odeh, Abeer Alassaf, Kamel Ajlouni
OBJECTIVE: Data regarding type 1 diabetes mellitus (T1D) in Jordan are extremely scarce. We aim to evaluate the clinical and laboratory characteristics at diagnosis of T1D in a group of children from Jordan. METHODS: The records of 437 (boys/girls: 224/213) children with type 1 diabetes followed in the years 2012 to 2016 were evaluated retrospectively. The data were assessed by sex and age subgroups (<5, 6-10, and 11-18 years). RESULTS: Mean age of children at diagnosis was 7...
December 27, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/29258472/pediatric-non-diabetic-ketoacidosis-a-case-series-report
#12
Ke Bai, Yueqiang Fu, Chengjun Liu, Feng Xu, Min Zhu
BACKGROUND: This study is to explore the clinical characteristics, laboratory diagnosis, and treatment outcomes in pediatric patients with non-diabetic ketoacidosis. METHODS: Retrospective patient chart review was performed between March 2009 to March 2015. Cases were included if they met the selection criteria for non-diabetic ketoacidosis, which were: 1) Age ≤ 18 years; 2) urine ketone positive ++ or >8.0 mmol/L; 3) blood ketone >3.1 mmol/L; 4) acidosis (pH < 7...
December 19, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29241389/euglycemic-diabetic-ketoacidosis-associated-with-sodium-glucose-cotransporter-type-2-inhibitors-in-patients-with-type-2-diabetes-mellitus-receiving-oral-therapy
#13
Ryan B Dull, Mikayla L Spangler, Emily L Knezevich, Britney M Lau
INTRODUCTION AND OBJECTIVE: Postmarketing reports and warnings of serious adverse events such as diabetic ketoacidosis (DKA) have raised concern regarding the safety of sodium-glucose cotransporter 2 inhibitors (SGLT2i). This report describes 2 cases of symptomatic SGLT2i-associated euglycemic DKA (euDKA) leading to hospitalization in patients with type 2 diabetes mellitus (DM) previously well controlled on oral medications. CASE REPORTS: Subject 1 is a 55-year-old female admitted with euDKA precipitated by infection and managed with intravenous insulin...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29218226/hamman-s-syndrome-in-diabetic-ketoacidosis
#14
Alexandra Rose Pain, Josh Pomroy, Andrea Benjamin
Hamman's syndrome (spontaneous subcutaneous emphysema and pneumomediastinum) is a rare complication of diabetic ketoacidosis (DKA), with a multifactorial etiology. Awareness of this syndrome is important: it is likely underdiagnosed as the main symptom of shortness of breath is often attributed to Kussmaul's breathing and the findings on chest radiograph can be subtle and easily missed. It is also important to be aware of and consider Boerhaave's syndrome as a differential diagnosis, a more serious condition with a 40% mortality rate when diagnosis is delayed...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29214049/latent-autoimmune-diabetes-of-adulthood-case-report
#15
Cristen P Page, Brian Fitzgerald, Emily M Hawes
Background: Primary care clinicians will see a higher incidence of type 2 diabetes in adult patients, and the diagnosis and management of an initial presentation of type 1 diabetes can pose challenges to clinicians who see it less frequently. Symptoms of hyperglycemia and risk of ketoacidosis may be missed. Further, endocrine autoimmune disease can run together in patients and families. Case presentation: A 49-year-old Caucasian female with history of pituitary adenoma and Graves' disease with history of thyroid ablation presented in the outpatient setting due to hand tingling of her right middle finger that was worse in the mornings and improved throughout the day...
2017: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/29199115/frequency-and-phenotype-of-type-1-diabetes-in-the-first-six-decades-of-life-a-cross-sectional-genetically-stratified-survival-analysis-from-uk-biobank
#16
Nicholas J Thomas, Samuel E Jones, Michael N Weedon, Beverley M Shields, Richard A Oram, Andrew T Hattersley
BACKGROUND: Type 1 diabetes is typically considered a disease of children and young adults. Genetic susceptibility to young-onset type 1 diabetes is well defined and does not predispose to type 2 diabetes. It is not known how frequently genetic susceptibility to type 1 diabetes leads to a diagnosis of diabetes after age 30 years. We aimed to investigate the frequency and phenotype of type 1 diabetes resulting from high genetic susceptibility in the first six decades of life. METHODS: In this cross-sectional analysis, we used a type 1 diabetes genetic risk score based on 29 common variants to identify individuals of white European descent in UK Biobank in the half of the population with high or low genetic susceptibility to type 1 diabetes...
November 30, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29170817/postmortem-1h-mrs-detection-of-ketone-bodies-and-glucose-in-diabetic-ketoacidosis
#17
Jakob Heimer, Dominic Gascho, Vasiliki Chatzaraki, Damaris Fröhlich Knaute, Vera Sterzik, Rosa Maria Martinez, Michael J Thali, Niklaus Zoelch
Diabetic ketoacidosis (DKA) is a metabolic complication of diabetes mellitus that takes a lethal course if untreated. In this way relevant to forensic medicine, secure diagnosis of DKA usually involves the evidence of elevated levels of glucose and the ketone bodies acetone, acetoacetate, and β-hydroxybutyrate in corpse fluids. We conducted a postmortem hydrogen proton magnetic resonance spectroscopy (1H-MRS) in a case of lethal DKA. Distinctive resonances of all three ketone bodies as well as glucose were visible in spectra of cerebrospinal fluid, vitreous humor, and white matter...
November 23, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29168157/perioperative-implications-of-sodium-glucose-cotransporter-2-inhibitors-a-case-series-of-euglycemic-diabetic-ketoacidosis-in-three-patients-after-cardiac-surgery
#18
Aaron Lau, Simon Bruce, Erica Wang, Ron Ree, Kevin Rondi, Anthony Chau
PURPOSE: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) comprise the newest class of oral hypoglycemic agents approved for treating type II diabetes mellitus (DM-II). Their use, however, has been associated with the rare development of euglycemic diabetic ketoacidosis (euDKA). We present three cases of euDKA that occurred following elective coronary artery bypass grafting surgery. The role of the anesthesiologist in the prevention, diagnosis, and management of this complication is also discussed...
November 22, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29165898/thrombocytopenia-associated-multi-organ-failure-secondary-to-hyperglycemic-hyperosmolar-non-ketotic-syndrome-a-case-report
#19
Naile Tufan-Pekkucuksen, Maria Carolina Gazzaneo, Natasha Susana Afonso, Sarah J Swartz, Joseph R Angelo, Poyyapakkam Srivaths
Thrombocytopenia associated multi-organ failure (TAMOF) is a clinical syndrome with features of new onset thrombocytopenia, increased lactate dehydrogenase, and multi-organ failure in critically ill patients. TAMOF can be the initial presentation of an underlying disease process or can develop during the course of illness either during the hospital stay. TAMOF has a high mortality rate if not treated; therefore, early detection is critical. TAMOF has been rarely reported in diabetic ketoacidosis. We are describing the first case of a patient diagnosed with hyperglycemic, hyperosmolar non-ketotic syndrome who developed TAMOF on the third day of his hospital course...
November 22, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/29157798/euglycemic-diabetic-ketoacidosis-secondary-to-dapagliflozin-use-a-case-report
#20
Felicity Brown, Tamara McColl
BACKGROUND: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a novel class of oral antihyperglycemic agents. They are associated with rare cases of euglycemic diabetic ketoacidosis (DKA), which presents a diagnostic challenge in the emergency department (ED) and potentially severe consequences if missed. CASE REPORT: A 53-year-old man with type 2 diabetes mellitus and a recent Roux-en-Y gastric bypass surgery presented to the ED with nausea, vomiting, and generalized abdominal pain...
November 17, 2017: Journal of Emergency Medicine
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