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diabetic ketoacidosis diagnosis

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https://www.readbyqxmd.com/read/28090050/euglycemic-diabetic-ketoacidosis-with-persistent-diuresis-treated-with-canagliflozin
#1
Junichiro Adachi, Yuusuke Inaba, Chisato Maki
Diabetic ketoacidosis is characterized by hyperglycemia, anion-gap acidosis, and increased plasma ketones. After the resolution of hyperglycemia, persistent diuresis is rare. We herein report the case of a 27-year-old Asian woman with type 2 diabetes who was treated with a sodium-glucose cotransporter 2 (SGLT2) inhibitor (canagliflozin) who developed euglycemic diabetic ketoacidosis and persistent diuresis in the absence of hyperglycemia. Physicians should consider euglycemic diabetic ketoacidosis in the differential diagnosis of patients treated with SGLT2 inhibitors...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28074994/-normoglycemic-diabetic-ketoacidosis-in-pregnancy-report-of-one-case
#2
Margarita Rivas M, Pamela Belmar Z, Pilar Durruty A, Lilian Sanhueza M, Gloria López S
Normoglycemic diabetic ketoacidosis should be suspected in pregnant women presenting nausea, vomiting, abdominal pain and anorexia. We report a 39 years old woman with a 32 weeks pregnancy who sought emergency care due to hyperemesis. She was hospitalized with the following diagnoses: pregnancy hypertension syndrome, gestational diabetes, morbid obesity and poor prenatal control. The evaluation of the feto-placental unit showed perception of fetal movements, non-reactive non-stress baseline record and a biophysical profile of 6/8...
October 2016: Revista Médica de Chile
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
#3
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/28031780/double-diabetes-in-saudi-arabia-a-new-entity-or-an-underestimated-condition
#4
Rim Braham, Aus Alzaid, Asirvatham Alwin Robert, Muhammad Mujammami, Rania Ahmad Ahmad, Monther Zitouni, Samia Hasan Sobki, Mohamed Abdulaziz Al Dawish
AIM: To determine the clinical and biological characteristics of double diabetes (DD) among young people in Saudi Arabia. METHODS: This was a retrospective descriptive chart review study including 312 young newly diagnosed diabetic patients (aged 12-20 years), whom were admitted over a five year period (January 2009 to December 2013). Family history of diabetes mellitus (DM) (first degree), physical body mass index (BMI), acanthosis nigricans, history of auto-immune disease and laboratory information for glycosylated hemoglobin, basal C peptide level and diabetes autoantibody response (anti-GAD, anti-IA2 and anti-ICA) were collected from medical report...
December 15, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/28004468/first-2-cases-with-thiamine-responsive-megaloblastic-anemia-in-the-czech-republic-a-rare-form-of-monogenic-diabetes-mellitus-a-novel-mutation-in-the-thiamine-transporter-slc19a2-gene-intron-1-mutation-c-204-2t-g
#5
Renata Pomahačová, Jana Zamboryová, Josef Sýkora, Petra Paterová, Karel Fiklík, Tomáš Votava, Zdeňka Černá, Petr Jehlička, Václav Lád, Ivan Šubrt, Jiří Dort, Eva Dortová
Thiamine-responsive megaloblastic anemia (TRMA) is a rare autosomal recessive disorder caused by mutations in the SLC19A2 gene. To date at least 43 mutations have been reported for the gene encoding a plasma membrane thiamine transporter protein (THTR-1). TRMA has been reported in less than 80 cases worldwide. Here, we illustrate 2 female patients with TRMA first diagnosed in the Czech Republic and in central Europe being confirmed by sequencing of the THTR-1 gene SLC19A2. Both subjects are compound heterozygotes with 3 different mutations in the SLC19A2 gene...
December 22, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/28003053/sglt2-inhibitor-associated-diabetic-ketoacidosis-clinical-review-and-recommendations-for-prevention-and-diagnosis
#6
REVIEW
Ronald M Goldenberg, Lori D Berard, Alice Y Y Cheng, Jeremy D Gilbert, Subodh Verma, Vincent C Woo, Jean-François Yale
PURPOSE: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the newest class of antihyperglycemic agents available on the market. Regulator warnings and concerns regarding the risk of developing diabetic ketoacidosis (DKA), however, have dampened enthusiasm for the class despite the combined glycemic, blood pressure, and occasional weight benefits of SGLT2 inhibitors. With the goal of improving patient safety, a cross-Canada expert panel and writing group were convened to review the evidence to-date on reported SGLT2 inhibitor-related DKA incidents and to offer recommendations for preventing and recognizing patients with SGLT2 inhibitor-associated DKA...
December 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27991500/high-frequency-of-diabetic-ketoacidosis-at-diagnosis-of-type-1-diabetes-in-italian-children-a-nationwide-longitudinal-study-2004-2013
#7
Valentino Cherubini, Edlira Skrami, Lucia Ferrito, Stefano Zucchini, Andrea Scaramuzza, Riccardo Bonfanti, Pietro Buono, Francesca Cardella, Vittoria Cauvin, Giovanni Chiari, Giuseppe D Annunzio, Anna Paola Frongia, Dario Iafusco, Ippolita Patrizia Patera, Sonia Toni, Stefano Tumini, Ivana Rabbone, Fortunato Lombardo, Flavia Carle, Rosaria Gesuita
This longitudinal population-based study analyses the frequency of diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis in Italian children under 15 years of age, during 2004-2013. DKA was defined as absent (pH ≥ 7.30), mild/moderate (7.1 ≤ pH < 7.30) and severe (pH < 7.1). Two multiple logistic regression models were used to evaluate the time trend of DKA frequency considered as present versus absent and severe versus absent, adjusted for gender, age group and geographical area of residence at diagnosis...
December 19, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27931088/sglt2-inhibitors-a-systematic-review-of-diabetic-ketoacidosis-and-related-risk-factors-in-the-primary-literature
#8
Kelly R Burke, Christine A Schumacher, Spencer E Harpe
STUDY OBJECTIVE: There is currently minimal information regarding risk factors for the development of sodium-glucose cotransporter-2 inhibitor (SGLT2i)-related diabetic ketoacidosis (DKA). We aim to identify individual patient characteristics associated with cases of SGLT2i-related DKA to better describe potential risk factors. DESIGN: Systematic review of primary literature. PATIENTS: 34 case reports of patients with Type 1 and Type 2 Diabetes Mellitus who developed DKA while receiving an SGLT2i...
December 8, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27928503/metabolic-ketoacidosis-with-normal-blood-glucose-a-rare-complication-of-sodium-glucose-cotransporter-2-inhibitors
#9
Saad Ullah, Noman Khan, Hassan Zeb, Hassan Tahir
Ketoacidosis is a significant and often a life-threatening complication of diabetes mellitus seen mostly in type 1 diabetes mellitus as well as occasionally in type 2 diabetes mellitus. Diabetic ketoacidosis usually manifests with high blood glucose more than 250 mg/dL, but euglycemic diabetic ketoacidosis is defined as ketoacidosis associated with blood glucose level less than 250 mg/dL. Normal blood glucose in such patients results in significant delay in diagnosis and management of diabetic ketoacidosis, thus increasing mortality and morbidity...
2016: SAGE open medical case reports
https://www.readbyqxmd.com/read/27920854/recurrent-urinary-tract-infections-in-an-adult-with-a-duplicated-renal-collecting-system
#10
Junaid Raja, Amir M Mohareb, Bilori Bilori
Because of advancements in fetal imaging, anatomic variants of the genitourinary tract are most often discovered in the antenatal period. As such, general internists are less likely to encounter adult patients with previously undiagnosed anatomic abnormalities of the renal collecting system, such as duplicated kidneys. These abnormalities put patients at risk for urinary obstruction and recurrent infections of the urinary tract. We report the case of a 40-year-old diabetic patient with a previously undiagnosed duplex kidney who had recurrent episodes of diabetic ketoacidosis triggered by urinary tract infections...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27912129/incidence-of-complications-in-young-onset-diabetes-comparing-type-2-with-type-1-the-young-diab-study
#11
Anandakumar Amutha, Ranjit Mohan Anjana, Ulagamathesan Venkatesan, Harish Ranjani, Ranjit Unnikrishnan, K M Venkat Narayan, Viswanathan Mohan, Mohammed K Ali
BACKGROUND: There is little data on the incidence of diabetes complications in young onset type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in non European populations. METHODS: From a tertiary diabetes centre, Chennai, India, we recruited 108 T1DM (defined by abrupt onset of symptoms or diabetic ketoacidosis, absent insulin reserve requiring insulin treatment) and 90 T2DM participants (defined by absence of ketosis, good beta-cell reserve, and good response to oral agents) who were diagnosed between the ages of 10 and 25years, and without any evidence of diabetes complications at diagnosis...
November 17, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27770618/diabetic-ketoacidosis-in-a-pediatric-intensive-care-unit
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
October 2016: Pediatrics
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