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https://www.readbyqxmd.com/read/28731823/maternal-fetal-outcomes-in-34-pregnant-women-with-type-1-diabetes-in-sensor-augmented-insulin-pump-therapy
#1
Ana María Gómez, Lisseth Fernanda Marín Carrillo, Carol M Arévalo Correa, Oscar Mauricio Muñoz Velandia, Martín Alonso Rondón Sepúlveda, Jaime Luis Silva Herrera, Diana Cristina Henao Carrillo
BACKGROUND: Pregnancy in women with type 1 diabetes (T1D) is associated with increased risk of maternal complications and neonatal morbidity and mortality. Optimizing glycemic control improves these outcomes. OBJECTIVE: To describe the experience of using sensor-augmented insulin pump therapy (SAPT) and SAPT + low-glucose suspension (LGS) on pregnant women with T1D, including neonatal and maternal outcomes. METHODS: A prospective observational study was conducted in women with T1D who started SAPT and SAPT + LGS before or during pregnancy at the San Ignacio University Hospital Diabetes Center in Bogotá, Colombia...
July 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28674636/diabetes-during-pregnancy-influence-of-body-mass-index-on-composite-morbidity
#2
Amy E O'Neil Dudley, Zachary B Jenner, Hector Mendez-Figueroa, Viviana S Ellis, Suneet P Chauhan
Objective  This study aims to compare composite maternal and neonatal morbidities (MM, NM) among pregnant women with diabetes mellitus whose body mass index (BMI) at delivery was < 30 (group 1), 30.0 to 39.9 (group 2), and ≥ 40 kg/m (2) (group 3). We hypothesized that increased BMI class at delivery would be associated with worsening maternal and neonatal outcomes. Methods  This is a retrospective cohort study. MM was defined as: chorioamnionitis, wound infection, eclampsia, diabetic ketoacidosis, hypoglycemia admission, third/fourth degree laceration, and/or death...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28540053/euglycaemic-ketoacidosis-in-a-non-diabetic-primigravida-following-an-appendicectomy
#3
Dinushi Dilanka Dikowita, Thirunavukarasu Kumanan, Kopalasuntharam Muhunthan, Janaki Arulmoli
Pregnancy creates significant alterations in energy metabolism which itself is a physiological adaptation to provide continuous flow of energy metabolites to the foetus. The state of insulin resistance created by hormonal changes in pregnancy enables free flow of glucose to the foetus and allows its absorption through facilitated diffusion. As glucose is preferentially available for the foetus, maternal fasting glucose level would be less than that of a non-pregnant state and in contrast plasma ketones and free fatty acids levels are elevated, resulting in a state of accelerated starvation...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28491217/-guillain-barr%C3%A3-syndrome-and-diabetic-acido-ketotic-decompensation-during-pregnancy-a-case-report-and-review-of-the-literature
#4
REVIEW
Lilia Affes, Mouna Elleuch, Fatma Mnif, Faten Hadj Kacem, Dhouha Ben Salah, Mouna Mnif, Nadia Charfi, Nabila Rekik, Mohamed Abid
A 27-year-old pregnant woman was admitted to the resuscitation department with severe spontaneous acute ketoacidosis as early symptom of type 1 diabetes. The patient underwent resuscitation and insulin treatment with good clinical and biological evolution. On day 4, the patient had polyradiculoneuritis characterised by acute onset. Additional emergency examinations were negative. Lumbar cytopunction showed albuminocytologic dissociation. Electromyogram confirmed the diagnosis of Guillain Barré syndrome (GBS)...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28488182/successful-management-of-pregnancies-in-patients-with-inherited-disorders-of-ketone-body-metabolism
#5
Raashda Ainuddin Sulaiman, Maha Al-Nemer, Rubina Khan, Munirah Almasned, Bedour S Handoum, Zuhair N Al-Hassnan
Patients with succinyl-CoA:3-oxoacid CoA transferase (SCOT) deficiency and 3-hydroxy-3-methylglutaryl (HMG)-CoA lyase deficiency are at increased risk of developing metabolic acidosis and hypoglycemia during pregnancy, delivery, and postpartum period. This can be fatal if not treated appropriately. Pregnancy in such patients should be managed in a specialist center by a multidisciplinary team including metabolic physician, high-risk obstetrician, and metabolic dietician. We report two pregnancies in women with SCOT deficiency and HMG-CoA lyase deficiency, which were successfully managed at this tertiary care center...
May 10, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28304323/diabetic-ketoacidosis-complicating-pregnancy
#6
S N Bryant, C L Herrera, D B Nelson, F G Cunningham
BACKGROUND: Although diabetic ketoacidosis (DKA) in pregnancy can result in significant adverse consequences for both mother and fetus, the response to treatment, time course of recovery, and perinatal outcomes have not been well studied in pregnancy. OBJECTIVE: We examined the precipitating factors, laboratory abnormalities, treatment strategies, and clinical recovery in pregnancies complicated by DKA. STUDY DESIGN: This is a retrospective cohort study of pregnancies complicated by DKA between October 1999 and June 2015...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28264604/maternal-and-perinatal-outcomes-in-pregnant-women-with-type-1-diabetes-treated-with-continuous-subcutaneous-insulin-infusion-and-real-time-continuous-glucose-monitoring-in-two-specialized-centers-in-medellin-colombia
#7
Mónica Restrepo-Moreno, Alex Ramírez-Rincón, Jaime Hincapié-García, Andrés Palacio, Claudia Monsalve-Arango, Natalia Aristizabal-Henao, Camila Restrepo-Zapata, José Fernando Botero-Arango
OBJECTIVE: We assessed maternal and perinatal outcomes in pregnant women with type 1 diabetes, treated with continuous subcutaneous insulin infusion and real time continuous glucose monitoring. METHODS: This is a retrospective study, analyzing the basal characteristics, glycemic control, maternal and perinatal outcomes of pregnant women with type 1 diabetes, who were on an insulin pump with continuous glucose monitoring between 2011 and 2015. RESULTS: Fourteen patients were included...
March 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28074994/-normoglycemic-diabetic-ketoacidosis-in-pregnancy-report-of-one-case
#8
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/27729426/operationalizing-and-examining-family-planning-vigilance-in-adult-women-with-type-1-diabetes
#9
Susan M Sereika, Dorothy Becker, Patricia Schmitt, A Blair Powell, Ana Maria Diaz, Andrea F R Fischl, Jennifer Thurheimer-Cacciotti, William H Herman, Denise Charron-Prochownik
OBJECTIVE: Because unplanned pregnancies could cause maternal-fetal complications for women with diabetes, family planning vigilance (FPV) is imperative. The aims of this article are to operationalize and describe FPV and examine the associations among FPV behaviors and diabetes self-care management (DSM) and health outcomes of women with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: Retrospective data were used from a follow-up study of adult women with T1D who participated as adolescents in a preconception counseling (PC) intervention trial and matched comparison women with T1D who did not receive the adolescent PC intervention...
December 2016: Diabetes Care
https://www.readbyqxmd.com/read/27590952/maternal-complications-in-pregnancy-with-diabetes
#10
Vidushi Kulshrestha, Nutan Agarwal
Maternal complications of diabetes in pregnancy include obstetric complications such as pre-eclampsia, preterm labour, polyhydramnios, increased operative delivery and increased infective morbidity. These can be minimized with optimal glycaemic control. Additionally, pregnancies with overt/pregestational diabetes may have diabetes related complications such as hypoglycaemia, worsening of retinopathy, nephropathy and diabetic ketoacidosis. Women with pre-existing diabetic vasculopathy should be managed with multi-disciplinary approach with maternal and foetal surveillance to detect any deterioration...
September 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27582159/maternal-complications-in-pregnancy-with-diabetes
#11
Vidushi Kulshrestha, Nutan Agarwal
Maternal complications of diabetes in pregnancy include obstetric complications such as pre-eclampsia, preterm labour, polyhydramnios, increased operative delivery and increased infective morbidity. These can be minimized with optimal glycaemic control. Additionally, pregnancies with overt/pregestational diabetes may have diabetes related complications such as hypoglycaemia, worsening of retinopathy, nephropathy and diabetic ketoacidosis. Women with pre-existing diabetic vasculopathy should be managed with multi-disciplinary approach with maternal and foetal surveillance to detect any deterioration...
September 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27512495/pregnancy-and-ketoacidosis-is-pancreatitis-a-missing-link
#12
REVIEW
Charlotte J Frise, Anna Ashcroft, Bryony A Jones, Lucy Mackillop
Non-diabetic ketoacidosis is increasingly recognised in pregnancy, particularly during the third trimester, and is usually associated with vomiting. In many cases, the cause of the vomiting is not identified and resolves rapidly, alongside the metabolic abnormalities, following delivery. Here, we report three cases in which pancreatitis was identified as an underlying cause of the gastrointestinal symptoms. To our knowledge, these are the first reports of pancreatitis precipitating non-diabetic ketoacidosis in pregnancy...
June 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27512491/life-threatening-ketoacidosis-in-a-pregnant-woman-with-psychotic-disorder
#13
Charlotte Frise, Ben Attwood, Peter Watkinson, Lucy Mackillop
Pregnancy is an insulin resistant state. Hyperglycaemia and gestational diabetes mellitus are well-recognised complications even in women without existing metabolic syndrome or obesity. Pregnant women also appear to be more vulnerable to ketoacidosis, particularly after short periods of reduced oral intake in the third trimester, and may present with very severe starvation ketoacidosis, prompting emergent delivery. We present a case of a woman with a background of depression and psychotic episodes. Olanzapine had been commenced after a psychotic episode at 20 weeks' gestation...
March 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27432097/fulminant-type-1-diabetes-mellitus-presenting-11-days-after-delivery-in-a-patient-of-mixed-genetic-background
#14
Shoko Furukawa, Kazuya Fujihara, Ryo Kumagai, Momoko Isono, Hiroaki Yagyu
The patient was a 25-year-old woman whose paternal family was Japanese, maternal grandfather was Filipino, and maternal grandmother was Chinese. Eleven days after delivery, she presented with excessive thirst and disturbed consciousness due to diabetic ketoacidosis. She was diagnosed as having fulminant type 1 diabetes associated with pregnancy (PF). The antibody concentration against glutamic acid decarboxylase was 1.2 (<1.5) U/mL, and human leukocyte antigen (HLA) class II haplotypes were DRB1*04:10-DQB1*03:02 and DRB1*15:02-DQB1*05:01...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27368034/short-term-starvation-with-a-near-fatal-asthma-attack-induced-ketoacidosis-in-a-nondiabetic-pregnant-woman-a-case-report
#15
Kuang-Yu Wei, Shan-Yueh Chang, Sheng-Huei Wang, Her-Young Su, Chen-Liang Tsai
Life-threatening refractory metabolic acidosis due to starvation ketoacidosis is rarely reported, even among nondiabetic pregnant women, and may be overlooked. Furthermore, stressful situations may increase the acidosis severity.In the present case, a nondiabetic multiparous woman was admitted for a near-fatal asthma attack and vomiting during the third trimester of pregnancy. She was intubated and rapidly developed high anion gap metabolic acidosis. We diagnosed the patient with starvation ketoacidosis based on vomiting with concomitant periods of stress during pregnancy and the absence of other causes of high anion gap metabolic acidosis...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27239954/postmortem-biochemistry-in-suspected-starvation-induced-ketoacidosis
#16
Cristian Palmiere, Camilla Tettamanti, Marc Augsburger, Sandra Burkhardt, Sara Sabatasso, Christelle Lardi, Dominique Werner
Significantly increased blood ketone body levels can be occasionally observed in the forensic setting in situations other than exposure to cold, diabetic or alcoholic ketoacidosis. Though infrequent, these cases do occur and deserve thorough evaluation in order to establish appropriate differential diagnoses and quantify the role that hyperketonemia may play in the death process. Starvation ketoacidosis is a rare cause of metabolic acidosis and is a phenomenon that occurs normally during fasting, as the body switches from carbohydrate to lipid energy sources...
August 2016: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/27097605/euglycemic-diabetic-ketoacidosis
#17
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/27052245/-insulin-pump-therapy-in-children-adolescents-and-adults
#18
REVIEW
Marietta Stadler, Sandra Zlamal-Fortunat, Ingrid Schütz-Fuhrmann, Birgit Rami-Merhar, Elke Fröhlich-Reiterer, Sabine Hofer, Julia Mader, Michael Resl, Alexandra Kautzky-Willer, Raimund Weitgasser, Rudolf Prager, Martin Bischof
This position statement is based on the current evidence available on the safety and benefits of continuous subcutaneous insulin pump therapy (CSII) in diabetes with an emphasis on the effects of CSII on glycemic control, hypoglycaemia rates, occurrence of ketoacidosis, quality of life and the use of insulin pump therapy in pregnancy. The current article represents the recommendations of the Austrian Diabetes Association for the clinical praxis of insulin pump treatment in children, adolescents and adults.
April 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27051381/managing-diabetic-ketoacidosis-in-pregnancy
#19
Gómez-Ríos Má, Gómez-Ríos D, Paech Mj, Diéguez-Fernández M
No abstract text is available yet for this article.
April 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/26924774/using-technology-to-advance-type-1-diabetes-care-among-women-during-the-reproductive-years-and-in-pregnancy
#20
REVIEW
Sarit Polsky, Dominique Giordano, Mary K Voelmle, Rachel Garcetti, Satish K Garg
The prevalence of diabetes is increasing globally. Technology to improve care among individuals with diabetes is constantly being developed. Women living with Type 1 Diabetes Mellitus (T1DM) have unique challenges affecting their glucose control relating to menstrual cycles, pregnancy, and menopause. The purpose of this review is to examine the literature related to the use of technology to help women with T1DM manage their diabetes during the reproductive years, pregnancy, and beyond. Continuous subcutaneous insulin infusion (CSII) therapy can provider equivalent or better glucose control when compared with multiple daily injections (MDI), with less hypoglycemia, diabetic ketoacidosis, and weight gain...
May 2016: Postgraduate Medicine
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