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Pediatr Endocrinol Rev 2018 Dec;16(2):233-239

Hospital Universitario de Cruces, CIBERDEM, CIBERER, BIOCRUCES, Plaza Cruces s/n, 48903 Bizkaia, Spain, E-mail:

Although the treatment of pediatric patients with T1DM has improved ketoacidosis (DKA) remains a frequent problem.

Objective: To estimate temporal changes in the prevalence of DKA at diagnosis of T1DM and to explore the factors associated with its occurrence.

Methods: Paediatric patients diagnosed at Cruces University Hospital (Spain) since 1997 were included. Read More

Pediatr Diabetes 2018 Dec 17. Epub 2018 Dec 17.

Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

Background: The diagnosis of type 1 diabetes (T1D) in youth is often associated with diabetic ketoacidosis (DKA). We aimed to evaluate if the presence of DKA at diagnosis of T1D is associated with less favorable hemoglobin A (HbA1c) trajectories over time.

Methods: The SEARCH for Diabetes in Youth study of 1396 youth aged <20 years with newly diagnosed T1D were followed for up to 13 [median 8 (IQR 6-9)] years post-diagnosis. Read More

J Med Case Rep 2018 Dec 14;12(1):368. Epub 2018 Dec 14.

Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.

Introduction: Acquired partial lipoatrophy has been reported after bone marrow transplantation during childhood; however, no adult cases have previously been reported. We herein report two adult cases of acquired partial lipoatrophy after transplantation.

Case Presentation: A 28-year-old Japanese woman developed diabetic ketoacidosis and received insulin therapy after bone marrow transplantation. Read More

Pharmacy (Basel) 2018 Dec 7;6(4). Epub 2018 Dec 7.

Department of Pharmacy and Drug Information, Grady Health System, 80 Jesse Hill Jr Drive SE, Atlanta, GA 30303, USA.

Despite the high incidence of diabetic ketoacidosis (DKA) there is no consensus on the most appropriate way to manage insulin therapy. This study was conducted to evaluate the effect of an insulin bolus on the resolution of DKA. A retrospective chart review of patients admitted between 1 September 2014 and 30 June 2016 with a diagnosis of DKA was conducted. Read More

Am J Med Case Rep 2018 7;6(9):173-179. Epub 2018 Oct 7.

Division of Cardiovascular Disease and Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, U.S.A- 11203.

Brugada syndrome is a rare cardiac arrhythmia which is associated with right bundle branch block pattern (RBBB) and ST-segment elevation in right precordial leads. SCNA5 mutation is the most common genetic abnormality associated with Brugada syndrome. Brugada pattern not related to genetic mutations has been previously reported in the setting of fever, metabolic conditions, lithium use, marijuana and cocaine abuse, ischemia and pulmonary embolism, myocardial and pericardial diseases. Read More

Curr Opin Anaesthesiol 2018 Dec 6. Epub 2018 Dec 6.

Department of Anesthesiology, Yale School of Medicine.

Purpose Of Review: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are a relatively new class of drugs used in the management of diabetes mellitus. This review will highlight key pharmacologic characteristics of this class of drugs; discuss their potential role in management of patients with cardiac disease; and raise several perioperative concerns for anesthesiologists caring for patients on SGLT-2 inhibitors.

Recent Findings: Recent trials have shown a strong mortality benefit in diabetic patients on SGLT 2 inhibitors especially in patients with a high cardiovascular burden. Read More

J Pediatr Endocrinol Metab 2018 Dec 7. Epub 2018 Dec 7.

Division of Critical Care Medicine, Children's National Health System, Washington, DC, USA.

Background Standard therapy of diabetic ketoacidosis (DKA) in pediatrics involves intravenous (IV) infusion of regular insulin until correction of acidosis, followed by transition to subcutaneous (SC) insulin. It is unclear what laboratory marker best indicates correction of acidosis. We hypothesized that an institutional protocol change to determine correction of acidosis based on serum bicarbonate level instead of venous pH would shorten the duration of insulin infusion and decrease the number of pediatric intensive care unit (PICU) therapies without an increase in adverse events. Read More

Biochem Pharmacol 2018 Dec 7. Epub 2018 Dec 7.

Center for Pharmacy and Experimental Therapeutics, University of Georgia College of Pharmacy, Augusta, Georgia, USA; Charlie Norwood VA Medical Center, Augusta, Georgia, USA; Vascular Biology Center, Department of Pharmacology and Toxicology, Georgia Regents University, Augusta, Georgia, USA; Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA. Electronic address:

Alcoholic ketoacidosis and diabetic ketoacidosis are life-threatening complications that share the characteristic features of high anion gap metabolic acidosis. Ketoacidosis is attributed in part to the massive release of ketone bodies (e.g. Read More

J Med Case Rep 2018 Dec 10;12(1):364. Epub 2018 Dec 10.

Unidad de Investigación Médica en Endocrinología Experimental, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Cuauhtémoc 330, Colonia Doctores, 06720, Mexico City, Mexico.

Background: Cyclophosphamide may induce autoimmune diabetes through a decrease in suppressor T cells and increase of proinflammatory T helper type 1 response in animal models. In humans, this association is not as clear due to the presence of other risk factors for hyperglycemia, but it could be a precipitant for acute complications.

Case Presentation: A 31-year-old Mestizo-Mexican woman with a history of systemic lupus erythematosus presented with severe diabetic ketoacidosis, shortly after initiating a multi-drug immunosuppressive therapy. Read More

Anatol J Cardiol 2018 Dec 6. Epub 2018 Dec 6.

Department of Cardiology, Koşuyolu Kartal Training and Research Hospital; İstanbul-Turkey.

Diabetologia 2018 Dec 1. Epub 2018 Dec 1.

Medical Research Laboratory, Aarhus University, Nørrebrogade 44, building 3, DK-8000, Aarhus C, Denmark.

Aims/hypothesis: Lack of insulin and infection/inflammation are the two most common causes of diabetic ketoacidosis (DKA). We used insulin withdrawal followed by insulin administration as a clinical model to define effects on substrate metabolism and to test whether increased levels of counter-regulatory hormones and cytokines and altered adipose tissue signalling participate in the early phases of DKA.

Methods: Nine individuals with type 1 diabetes, without complications, were randomly studied twice, in a crossover design, for 5 h followed by 2. Read More

Case Rep Med 2018 31;2018:4132738. Epub 2018 Oct 31.

Department of Medicine, Internal Medicine Residency Program, Hackensack Meridian Health, Jersey Shore University Medical Center, Neptune, New Jersey 07753, USA.

Rhabdomyolysis is a potentially life-threatening clinical syndrome associated with muscle injury which can cause a leakage of intracellular contents, manifested from the range of being asymptomatic to a life-threatening condition causing acute kidney injury and severe electrolyte abnormalities. Rhabdomyolysis has been associated with both diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic nonketotic syndrome, though there is an increased association with rhabdomyolysis and acute kidney injury with hyperosmolar nonketonic state compared with patients with diabetic ketoacidosis. Common clinical manifestations are muscle pain, dark urine, and generalized weakness. Read More

J Prev Med Public Health 2018 Nov 29;51(6):265-274. Epub 2018 Oct 29.

Institute of Human Complexity and Systems Science, Yonsei University, Incheon, Korea.

Objectives: A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than 10 μm in aerodynamic diameter, nitrogen dioxide [NO2], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009. Read More

Turk J Pediatr 2018 ;60(3):348-351

Department of Pediatric Endocrinology, Erciyes University Medical Faculty, Kayseri, Turkey.

Argun M, Baykan A, Hatipoğlu N, Akın L, Şahin Y, Narin N, Kurtoğlu S. Arrhythmia in thiamine responsive megaloblastic anemia syndrome. Turk J Pediatr 2018; 60: 348-351. Read More

Diabetes Obes Metab 2018 Nov 30. Epub 2018 Nov 30.

Kumamoto University, Kumamoto, Japan.

Aims: To assess the pharmacokinetics/pharmacodynamics (PK/PD) of dapagliflozin, a sodium-glucose co-transporter 2 inhibitor that increases urinary glucose excretion (UGE), and its major metabolite, dapagliflozin-3-O-glucuronide (D3OG), in Japanese patients with type 1 diabetes (T1D) and inadequate glycemic control (HbA1c 7-10%).

Materials And Methods: Japanese patients (18-65 years) with inadequately controlled T1D were randomized 1:1:1 to dapagliflozin 5 mg, 10 mg, or placebo (n=14 each) once daily for seven days with adjustable insulin. The PK/PD characteristics of dapagliflozin and D3OG were assessed on Day 7. Read More

J R Coll Physicians Edinb 2018 Dec;48(4):321-322

Department of General Medicine, Monklands Hospital, Airdrie, UK.

We present a case of sudden-onset reversible blindness secondary to severe diabetic ketoacidosis. The exact mechanism is not fully understood but is postulated to be due to uncoupling of retinal electrical transmission in a severe acidic environment. This report adds to the small number of reported cases of reversible blindness secondary to severe diabetic ketoacidosis and serves to raise awareness of this unusual diagnosis. Read More

Medicina (Kaunas) 2018 Nov 26;54(6). Epub 2018 Nov 26.

Department of Internal Medicine, Hospital Regional Lambayeque, Chiclayo, Lambayeque 14012, Peru.

Thyrotoxicosis and diabetic ketoacidosis (DKA) both may present as endocrine emergencies and may have devastating consequences if not diagnosed and managed promptly and effectively. The combination of diabetes mellitus (DM) with thyrotoxicosis is well known, and one condition usually precedes the other. Furthermore, thyrotoxicosis is complicated by some degree of cardiomyopathy in at least 5% de patients; but the coexistence of DKA, thyroxin (T₄) toxicosis, and acute cardiomyopathy is extremely rare. Read More

Diabetes Res Clin Pract 2018 Nov 24;147:55-61. Epub 2018 Nov 24.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. Electronic address:

Aim: Diabetes mellitus (DM) is a known risk factor for dementia. It is unclear whether diabetic ketoacidosis (DKA) further increases the risk of dementia in patients with type 2 DM.

Methods: This retrospective nationwide population-based cohort study was conducted using Taiwan's National Health Insurance database. Read More

World J Diabetes 2018 Nov;9(11):199-205

Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA 23501, United States.

Diabetic ketoacidosis (DKA) is a severe and too-common complication of uncontrolled diabetes mellitus. Acidosis is one of the fundamental disruptions stemming from the disease process, the complications of which are potentially lethal. Hydration and insulin administration have been the cornerstones of DKA therapy; however, adjunctive treatments such as the use of sodium bicarbonate and protocols that include serial monitoring with blood gas analysis have been much more controversial. Read More

Am J Forensic Med Pathol 2018 Nov 20. Epub 2018 Nov 20.

Forensic Pathology and.

Biochemical analysis of cerebrospinal fluid (CSF) and vitreous humor (VH) forms an important diagnostic ancillary test at autopsy. Cerebrospinal fluid can be sampled from the ventricular system (VA) and from lumbar puncture (LP), whereas VH can be sampled from the orbits. Biochemical electrolytes seem to vary between VH and CSF collected from different sites, but whether there is any difference in glucose and β-hydroxybutyrate is unclear. Read More

Cureus 2018 Sep 19;10(9):e3336. Epub 2018 Sep 19.

Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, THA.

Viral hemorrhagic fever is one of the most important emerging infectious diseases. Some viral hemorrhagic fevers include dengue, hantavirus, Ebola infection, and yellow fever. Dengue virus infection results in a wide spectrum of clinical diseases, including dengue hemorrhagic fever, characterized by the transient period of plasma leakage and hemorrhagic tendency. Read More

Acta Clin Belg 2018 Nov 23:1-6. Epub 2018 Nov 23.

a Departments of Nephrology , Universitair Ziekenhuis Brussel , Brussels , Belgium.

Biochim Biophys Acta Mol Basis Dis 2018 Nov 20;1865(2):428-433. Epub 2018 Nov 20.

Institute of Biomedical Sciences, Mackay Medical College, New Taipei City 25245, Taiwan; Department of Pediatric Endocrinology, Mackay Children's Hospital, Taipei City 10449, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Tamsui Branch, New Taipei City 25160, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei City 11031, Taiwan. Electronic address:

Monogenic diabetes is caused by mutations that reduce β-cell function. While Sanger sequencing is the standard method used to detect mutated genes. Next-generation sequencing techniques, such as whole exome sequencing (WES), can be used to find multiple gene mutations in one assay. Read More

Diabetes Ther 2018 Nov 20. Epub 2018 Nov 20.

First Endocrinology Department, Shengjing Hospital Affiliated to China Medical University, Shenyang, People's Republic of China.

Fulminant type 1 diabetes (fT1D) is a severe subtype of type 1 diabetes which progresses rapidly with islet cells destroyed almost completely within a short period of time. It is often characterized by flu-like or gastrointestinal symptoms at the onset with negative islet-associated autoantibodies, resulting in an absolute deficiency of endogenous insulin secretion. Poor prognosis can be caused by the significantly higher incidence of metabolic disorders (such as severe ion disorders and elevated serum pancreatic enzymes), acute and chronic complications if not diagnosed and treated in a timely manner. Read More

Am J Med Sci 2018 Oct 4. Epub 2018 Oct 4.

Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

The presenting symptoms of diabetic ketoacidosis (DKA) include abdominal pain, polyuria and nausea. Diabetes has well known chronic ocular complications like glaucoma, cataracts and retinopathy. We report a case of reversible blindness as a presenting manifestation of DKA that has been reported in literature only 3 times previously. Read More

BMJ 2018 Nov 14;363:k4365. Epub 2018 Nov 14.

Clinical Epidemiology Division, Department of Medicine, Solna, Eugeniahemmet, T2, Karolinska University Hospital, 17176 Stockholm, Sweden.

Objective: To assess the association between the use of sodium glucose cotransporter 2 (SGLT2) inhibitors and seven serious adverse events of current concern.

Design: Register based cohort study.

Setting: Sweden and Denmark from July 2013 to December 2016. Read More

Endocrinol Diabetes Metab Case Rep 2018 Oct 31;2018:18-0064. Epub 2018 Oct 31.

Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Rochester, Rochester, New York, USA.

We report a case of a 21-year-old African American female with history of pre-diabetes, and a diagnosis of a rare leukemia, blastic-plasmacytoid dendritic neoplasm (BPDCN), who developed diabetic ketoacidosis (DKA) after the third dose of PEG-asparaginase infusion. She was successfully treated with insulin. Asparaginase is a vital part of treatment protocols for acute lymphoblastic leukemia (ALL) in combination with other chemotherapeutic drugs. Read More

Diabetologia 2019 Jan 13;62(1):24-27. Epub 2018 Nov 13.

Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.

Pediatr Diabetes 2018 Nov 11. Epub 2018 Nov 11.

Department of Pediatrics, University of California Davis Health, University of California Davis, School of Medicine, Sacramento, California.

The optimal fluid treatment protocol for children with diabetic ketoacidosis (DKA) has long been a subject of controversy. Until recently, there was no high-quality evidence from randomized clinical trials to support an optimal guideline, and recommendations were mainly based on theoretical considerations. As a consequence, fluid treatment protocols for children with DKA vary between institutions (and countries). Read More

N Engl J Med 2018 Nov 10. Epub 2018 Nov 10.

From the Thrombolysis in Myocardial Infarction (TIMI) Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital (S.D.W., M.P.B., T.A.Z., J.F.K., S.A.M., D.L.B., C.T.R., M.S.S.), and the Cardiology Division, Massachusetts General Hospital (M.G.S.) - both in Boston; the Diabetes Unit, Hadassah Hebrew University Hospital, Jerusalem (I.R., O.M., A.C.); the Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan (E.T.K.); Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.); the Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom (J.P.H.W.); and AstraZeneca Gothenburg, Mölndal, Sweden (I.A.M.G.-N., M.F., P.A.J., A.-M.L.).

Background: The cardiovascular safety profile of dapagliflozin, a selective inhibitor of sodium-glucose cotransporter 2 that promotes glucosuria in patients with type 2 diabetes, is undefined.

Methods: We randomly assigned patients with type 2 diabetes who had or were at risk for atherosclerotic cardiovascular disease to receive either dapagliflozin or placebo. The primary safety outcome was a composite of major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction, or ischemic stroke. Read More

Can J Diabetes 2018 Aug 16. Epub 2018 Aug 16.

The Ottawa Hospital, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada. Electronic address:

Objectives: Diabetic ketoacidosis (DKA) is associated with significant morbidity and mortality. Using standardized protocols for DKA management improves outcomes and is recommended in Diabetes Canada's clinical practice guidelines. Audits of DKA care at our institution revealed inconsistent management. Read More

Am J Case Rep 2018 Nov 10;19:1342-1344. Epub 2018 Nov 10.

Department of Internal Medicine, Presence Saint Francis Hospital, Evanston, IL, USA.

BACKGROUND Severe hypertriglyceridemia is a well-known cause of acute pancreatitis. Mild elevations of triglyceride levels are common in patients presenting with diabetic ketoacidosis (DKA). Rarely, DKA can be accompanied by an elevation of serum triglyceride level severe enough to lead to AP. Read More

Medicine (Baltimore) 2018 Nov;97(45):e12907

Department of Endocrinology, Second Affiliated Hospital of Soochow University, Suzhou.

Rationale: Programmed cell death-1 protein (PD-1) antibody is an immune-checkpoint inhibitor that triggers anti-tumor response by enhancing immune response. Although PD-1 antibody has been reported effective in some malignant tumor, it can also induce significant immune-related adverse events (irAEs) such as autoimmune diabetes.

Patient Concerns: A 67-year-old male patient with non-small cell lung cancer (NSCLS) presented with polydipsia, polyuria, weakness, and weight loss after use of anti-programmed cell death-1 antibody therapy. Read More

Indian J Crit Care Med 2018 Oct;22(10):733-736

Department of Biochemistry, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.

Context: Diabetes mellitus is one of the most prevalent diseases worldwide. One of the acute complications of diabetes mellitus is diabetic ketoacidosis. It becomes essential for the healthcare physicians to identify the individuals who are likely to be prone to the development of ketosis. Read More

J Emerg Med 2018 Nov 3. Epub 2018 Nov 3.

Department of Emergency Medicine, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania.

Background: The resuscitation and critical care unit is a novel emergency department-intensive care unit designed to provide early critical care to emergency department patients for ≤24 h.

Objectives: This study sought to identify clinical variables associated with short intensive care unit (ICU) stays in patients with diabetic ketoacidosis (DKA), who commonly require ICU-level care.

Methods: We conducted a retrospective, single-center, cross-sectional study of DKA patients ≥18 years of age who presented to an academic, urban hospital emergency department over 16 months. Read More

JAMA Intern Med 2018 Nov 5. Epub 2018 Nov 5.

Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora.

Nurs Stand 2018 Nov 6. Epub 2018 Nov 6.

Acute Medical Unit, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust, Taunton, England.

Nurses commonly encounter patients with type 1 or type 2 diabetes mellitus in their practice. Management of these conditions requires an in-depth knowledge of blood glucose monitoring. It is essential that nurses are aware of normal blood glucose levels, so that they can respond to complications caused by elevated and reduced blood glucose levels. Read More

Pediatr Neurol 2018 Dec 19;89:68-70. Epub 2018 Sep 19.

Nationwide Children's Hospital, Columbus, Ohio.

Med Hypotheses 2018 Dec 6;121:44-46. Epub 2018 Sep 6.

Paediatric Department, Luton & Dunstable University Hospital NHS Foundation Trust, Lewsey Road, Luton, Bedfordshire LU40DZ, United Kingdom. Electronic address:

Background: Brain injury in diabetic ketoacidosis (DKA) is common but under recognized and affects up to 54% of patients with this complication. It's manifestations include cerebral oedema (CE) and cerebral infarction (CI). The etiology of CE in DKA has up to the present time been uncertain. Read More

West Afr J Med 2018 Sep-Dec;35(3):137-143

Endocrine, Diabetes & Metabolism Unit, Department of Medicine, Federal Medical Centre, Umuahia, Abia State.

Background: Patterns of hyperglycaemic emergencies (HE) include diabetic ketoacidosis, (DKA), hyperglycaemic hypero-smolar state, (HHS), normo-osmolar non-ketotic hyper-glycaemic state, (NONKHS), or the mixed/indeterminate form. Certain factors are predictive of adverse HE outcome. There is a paucity of literature on the patterns and poor prognostic factors of HE in the South East (SE) region of Nigeria, hence, the need for this study. Read More

Intensive Care Med 2018 Dec 31;44(12):2183-2191. Epub 2018 Oct 31.

Sections of Cardiology, Department of Paediatrics, University of Colorado School of Medicine, Anschutz Medical Campus and Children's Hospital Colorado, Aurora, CO, USA.

Purpose: To determine if there is an association between mortality and admission chloride levels and/or increases in the chloride level in critically ill children.

Methods: We performed a retrospective cohort study of all patients admitted to the paediatric intensive care unit (PICU) from January 2014 to December 2015. Patients were excluded for the following reasons: (1) age < 90 days or > 18 years, (2) admission to the cardiac intensive care unit, (3) no laboratory values upon admission to the PICU, (4) history of end-stage renal disease, (5) a disorder of chloride transport, and (6) admission for diabetic ketoacidosis. Read More

Expert Rev Endocrinol Metab 2018 Nov 31;13(6):333-339. Epub 2018 Oct 31.

a The Association of Diabetes Investigators and The Rose Salter Medical Research Foundation , Newport Coast , CA , USA.

Introduction: Sotagliflozin is the first dual SGLT1/SGLT2 inhibitor developed for use in diabetes. The agent blocks SGLT2 in the kidneys and SGLT1 in the intestines resulting in reduced early phase glucose absorption and increased blood levels of GLP-1. Initial studies were directed at type 1 diabetes. Read More

Ir Med J 2018 03 14;111(3):714. Epub 2018 Mar 14.

Discipline of Paediatrics, Trinity Centre for Health Sciences Building, AMNCH, Tallaght, Dublin 24.

Type 1 diabetes (T1D) symptoms are subtle and easily overlooked. Delayed diagnosis can result in Diabetic ketoacidosis (DKA), a life threatening complication with lasting consequences. We sought to define the presenting features of T1D and DKA frequency, in children <15 years diagnosed in a single national tertiary centre, and identify predictive factors for DKA. Read More

J Paediatr Child Health 2018 Oct 30. Epub 2018 Oct 30.

Department of Paediatrics, Townsville Hospital and Health Service, Townsville, Queensland, Australia.

Aim: Peer review is one component of the improvement of diabetes care delivered by the National Health Service (NHS) in England and Wales. Queensland has a decentralised model of service provision with an established state diabetes network.

Methods: The NHS scheme was adapted for use in Australia, and seven trained reviewers were recruited to visit 14 'hub' centres, which in turn covered 29 'spoke' units delivering care to over 95% of all public patients <16 years old in the state. Read More

Pediatr Endocrinol Rev 2018 Sep;16(1):209-215

Children's Hospital Los Angeles, 4650 Sunset Blvd, MS #61, Los Angeles, CA 90027, USA.

Int J Endocrinol 2018 2;2018:7074868. Epub 2018 Oct 2.

Department of Endocrinology, Ningbo Medical Center Lihuili Hospital, Ningbo 315040, China.

Euglycemic diabetic ketoacidosis (EDKA) was considered a rare condition with its specific definition and precipitating factors. However, with the wide use of sodium glucose cotransporter 2 (SGLT-2) inhibitors, the newest class of antidiabetic agents, EDKA has come back into the spotlight. Relevant cases are increasingly being reported along with insights into the mechanism of EDKA. Read More

Case Rep Crit Care 2018 1;2018:1747850. Epub 2018 Oct 1.

Hospital Británico de Buenos Aires, Intensive Care Services, Argentina.

Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus, both type I and type II, as well as other types with diabetes such gestacional diabetes mellitus. It is characterized by blood glucose levels greater than 250 mg/dL and metabolic acidosis (pH < 7.3 and serum bicarbonate < 15 mEq/dL) with an increased anion gap and the presence of ketone bodies in the blood or urine. Read More

Diabet Med 2018 Oct 25. Epub 2018 Oct 25.

Sanofi, Guildford.

Aim: To conduct an open-label study to provide UK real-world evidence regarding the use of insulin glargine 300 units/ml (U300) in people with Type 1 diabetes mellitus.

Methods: People with Type 1 diabetes who had been prescribed U300 ≥6 months before data collection and had HbA levels recorded within 3 months prior to U300 (baseline) were included. The primary endpoint was change in HbA from baseline to month 6 after U300 initiation. Read More

Diabet Med 2018 Oct 25. Epub 2018 Oct 25.

Department of Paediatric Diabetes and Endocrinology, John Hunter Children's Hospital, Newcastle, NSW.

Dietary management has been a mainstay of care in Type 1 diabetes since before the discovery of insulin when severe carbohydrate restriction was advocated. The use of insulin facilitated re-introduction of carbohydrate into the diet. Current management guidelines focus on a healthy and varied diet with consideration of glycaemic load, protein and fat. Read More