Search Our Scientific Publications & Authors

Int J Surg Case Rep 2022 Jun 13;96:107299. Epub 2022 Jun 13.

Department of Head and Neck Surgery, Facial Plastic and Reconstructive Surgery, University of Texas Rio Grande Valley, United States of America.

Introduction: Mucormycosis is an opportunistic mycosis common in poorly-controlled insulin dependent diabetic patients particularly with ketoacidosis. Fungal osteomyelitis is a life-threatening condition affectation of the nose and paranasal sinuses within the orofacial region.

Presentation Of Case: We present a 63-year-old diabetic male patient with maxillary mucormycotic osteomyelitis threatening his better seeing eye and review the clinical symptoms, relevant imaging, and management. Read More

Ann Endocrinol (Paris) 2022 Apr 27. Epub 2022 Apr 27.

Diabetes department, Sud-Francilien hospital, Corbeil-Essonne, France; Paris-Saclay university, Paris, France. Electronic address:

Air Med J 2022 Jul-Aug;41(4):370-375. Epub 2022 May 23.

Department of General Surgery, Novant Health New Hanover Regional Medical Center, Wilmington, NC.

Objective: Point-of-care laboratory testing (POCT) is associated with a reduced time to testing results and critical decision making within emergency departments. POCT is an essential clinical assessment tool because laboratory data are used to support timely critical decisions regarding acute medical conditions onditions ; however, there is currently limited research to support the use of POCT in the critical care transport environment. Few studies have evaluated the changes in patient care that occur after POCT during critical care transport. Read More

Expert Rev Endocrinol Metab 2022 Jun 24:1-13. Epub 2022 Jun 24.

Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK.

Introduction: Eating disorders (EDs) are common complications in people with type 1 diabetes (PwT1D), given the rigid focus on food and insulin dose adjustment. Dietary recommendations for T1D match those for the general population, yet many fail to achieve target HbA1c. Evidence suggests that lower carbohydrate meals and thus reduced insulin requirements may decrease inconsistencies in insulin absorption, maintain euglycemia and weight. Read More

Nutr Clin Pract 2022 Jun 24. Epub 2022 Jun 24.

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatric and Adolescent Medicine, Mayo Clinic Children's Center, Rochester, Minnesota, USA.

The proper use of intravenous fluids has likely been responsible for saving more lives than any other group of substances. Proper use includes prescribing an appropriate electrolyte and carbohydrate solution, at a calculated rate or volume, for the right child, at the right time. Forming intravenous fluid plans for hospitalized children requires an understanding of water and electrolyte physiology in healthy children and how different pathology deviates from the norm. Read More

Acta Endocrinol (Buchar) 2021 Oct-Dec;17(4):532-536

İnönü University Faculty of Medicine Research Hospital - Endocrinology and Metabolism, Malatya, Turkey.

COVID-19 is a viral disease that is recognized now as a pandemic by the World Health Organization. It is known that some viral infections may trigger autoimmune diseases. It has been revealed that COVID-19 may also lead to the pathogenesis of some autoimmune diseases, including Type 1 DM (T1DM) and autoimmune thyroid diseases. Read More

Acta Endocrinol (Buchar) 2021 Oct-Dec;17(4):528-531

Post Graduate Institute of Medical Education and Research - Endocrinology and Diabetes Unit, Department of Pediatrics, Chandigarh, India.

Context: Mealtime insulin bolus is traditionally administered before meals in children with type 1 diabetes (T1D). Controlled studies on the use of pre-and postprandial insulin bolus have shown variable results. There are no real-world studies on postprandial bolusing of insulin in young children with T1D. Read More

Can J Diabetes 2022 Feb 11. Epub 2022 Feb 11.

Division of Endocrinology and Metabolism, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada. Electronic address:

Objectives: Transition to adult care is challenging for youth with type 1 diabetes (T1D) and their caregivers. We have developed the diabetes-specific "On TRAck" transition readiness scale, and in this study we assess its reliability and validity compared with TRANSITION-Q, a generic transition readiness questionnaire.

Methods: We systematically created 3 versions of On TRAck: adolescent, parent and health-care provider (HCP) versions (for case managers and physicians). Read More

Arch Dis Child 2022 Jun 23. Epub 2022 Jun 23.

Paediatric Emergency Department, Sidra Medicine, Doha, Qatar.

Importance: Diabetic ketoacidosis (DKA) is a serious complication of type 1 diabetes mellitus, which may lead to significant morbidity and mortality.

Objectives: To compare the safety and efficacy of liberalised versus conservative intravenous fluid regimens in the management of DKA in children.

Data Source And Study Selection: Databases from inception to January 2022: MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials were included. Read More

Cureus 2022 May 20;14(5):e25157. Epub 2022 May 20.

Internal Medicine, The Brooklyn Hospital Center, Brooklyn, USA.

Purpose: The effect of comorbid obesity hypoventilation syndrome (OHS) on hospitalized patients with diabetic ketoacidosis (DKA) has not been studied so far. This study elucidates the outcomes of DKA patients with OHS compared to those without OHS.

Methods: Patients above 18 years of age were included in the study. Read More

BMJ Case Rep 2022 Jun 22;15(6). Epub 2022 Jun 22.

Internal Medicine, University of Florida, Gainesville, Florida, USA.

Sodium glucose cotransporter-2 (SGLT2) inhibitors are glucose-lowering drugs with proven efficacy in treating type 2 diabetes mellitus, and more recently, have been shown to improve heart failure outcomes in patients without diabetes. A rare complication of SGLT2 inhibitor use is the development of euglycaemic diabetic ketoacidosis (EDKA), characterised by euglycaemia (blood glucose level <250 mg/dL), metabolic acidosis (arterial pH <7.3 and serum bicarbonate <18 mEq/L), and ketonaemia. Read More

J Diabetes Investig 2022 Jun 22. Epub 2022 Jun 22.

Department of Diabetes and Endocrinology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.

Plant sterol intake is widely recommended in patients with cardiovascular risk factors based on the inhibitory effect on intestinal cholesterol absorption. Although plant sterols, once absorbed, can promote atherosclerosis, their intake is believed to be safe because of poor absorption, except in rare hyperabsorbers with homozygous ABCG5/8 mutations. We report a case of new-onset type 1 diabetes accompanied by hypercholesterolemia. Read More

N Z Med J 2022 May 20;135(1555):114-117. Epub 2022 May 20.

Waikato Medical Research Centre, University of Waikato, Hamilton; Waikato Regional Diabetes Service, Waikato District Health Board, Hamilton.

Curr Diab Rep 2022 Jun 21. Epub 2022 Jun 21.

Department of Pediatrics, Division of Endocrinology and Diabetes, Children's Mercy Kansas City, 2401 Gilham Road, Kansas City, MO, 64108, USA.

Purpose Of Review: To synthesize findings from studies published within the last 5 to 10 years and recruiting families of children with new-onset type 1 diabetes (T1D).

Recent Findings: Children can establish glycated hemoglobin (HbA1c) trajectories in the new-onset period that may persist for up to a decade. Demographic factors, family conflict, and diabetic ketoacidosis at the time of diagnosis may be risk factors for sub-optimal child HbA1c, while new immune modulating therapies and a treatment approach that combines advanced technologies and remote patient monitoring may improve child HbA1c. Read More

Diabetes Care 2022 Jun 21. Epub 2022 Jun 21.

Zentralinstitut für Biomedizinische Technik (ZIBMT), Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.

Objective: To investigate whether socioeconomic deprivation and urbanization are associated with the frequency of diabetic ketoacidosis (DKA) at diagnosis of pediatric type 1 diabetes.

Research Design And Methods: Children and adolescents aged ≤18 years, living in Germany, with newly diagnosed type 1 diabetes documented between 2016 and 2019 in the Diabetes Prospective Follow-up Registry (DPV; Diabetes-Patienten-Verlaufsdokumentation), were assigned to a quintile of regional socioeconomic deprivation (German Index of Socioeconomic Deprivation) and to a degree of urbanization (Eurostat) by using their residence postal code. With multiple logistic regression models, we investigated whether the frequency of DKA at diagnosis was associated with socioeconomic deprivation or urbanization and whether associations differed by age-group, sex, or migration status. Read More

Front Endocrinol (Lausanne) 2022 2;13:871965. Epub 2022 Jun 2.

Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, GA, United States.

Objective: Approximately 50% of obese Black patients with unprovoked diabetic ketoacidosis (DKA) or severe hyperglycemia (SH) at new-onset diabetes achieve near-normoglycemia remission with intensive insulin treatment. Despite the initial near-normoglycemia remission, most DKA/SH individuals develop hyperglycemia relapse after insulin discontinuation. Traditional biomarkers such as normal glucose tolerance at the time of remission were not predictive of hyperglycemia relapse. Read More

Front Immunol 2022 26;13:863234. Epub 2022 May 26.

Department of Immunology, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.

Mucormycosis is a potentially fatal illness that arises in immunocompromised people due to diabetic ketoacidosis, neutropenia, organ transplantation, and elevated serum levels of accessible iron. The sudden spread of mucormycosis in COVID-19 patients engendered massive concern worldwide. Comorbidities including diabetes, cancer, steroid-based medications, long-term ventilation, and increased ferritin serum concentration in COVID-19 patients trigger favorable fungi growth that in turn effectuate mucormycosis. Read More

Acta Diabetol 2022 Jun 19. Epub 2022 Jun 19.

Division of Internal Medicine, Department of Internal Medicine, SS Annunziata Hospital-Chieti, Chieti, Italy.

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096221105249

Department of Hematology and Oncology, University of Louisiana Health Science Center, New Orleans, USA.

Postmenopausal patients with metastatic breast cancer (mBC) may live years with their disease on therapies with minimal toxicities but they will eventually progress on first-line therapy. For those eligible for second-line therapy, PIK3CA mutation testing is recommended in estrogen receptor-positive, her2-negative disease. If present, alpelisib, a PI3K inhibitor, has been shown to improve progression-free survival. Read More

Oman Med J 2022 May 31;37(3):e373. Epub 2022 May 31.

Department of Critical Care, Tawam Hospital, Al Ain, UAE.

Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) are oral hypoglycemic agents that have insulin-independent glucose-lowering effects mediated by increasing the renal excretion of glucose by inhibiting the SGLT2-mediated renal glucose reabsorption. An increasingly recognized complication induced by SGLT2i is euglycemic diabetic ketoacidosis (eDKA). Here, we describe the case of a 26-year-old male patient with type 2 diabetes mellitus and morbid obesity. Read More

Front Endocrinol (Lausanne) 2022 30;13:867647. Epub 2022 May 30.

Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia.

The current widespread use of sodium-glucose co-transporter 2 (SGLT2) inhibitors has triggered an increase in reported cases of euglycemic diabetic ketoacidosis (EDKA), often characterized by a protracted metabolic acidosis that is resistant to conventional DKA treatment. We report a case of empagliflozin-induced EDKA with severe metabolic acidosis intractable to aggressive fluid resuscitation and boluses of bicarbonate infusion. Following the introduction of high-calorie glucose infusion coupled with tight glycemic control, the recalcitrant acidosis was successfully corrected. Read More

J Community Hosp Intern Med Perspect 2022 31;12(1):75-78. Epub 2022 Jan 31.

St. Joseph's University Medical Center, Paterson, NJ, USA.

Patients with diabetes mellitus have diabetic dyslipidemia that occurs due to disturbances in glucose metabolism and can lead to hypertriglyceridemia (HPTG). Severe HPTG is associated with significantly increased risk of developing acute pancreatitis (AP). Acute pancreatitis (AP) is characterized as an inflammatory condition where inactive digestive enzymes become activated causing pancreatic tissue destruction. Read More

Arch Dis Child 2022 Jun 16. Epub 2022 Jun 16.

Children's Acute Transport Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

Objectives: To compare clinical management and key outcomes of critically ill children with diabetic ketoacidosis (DKA) in two cohorts (2015 cohort: managed according to the 2015 British Society of Paediatric Endocrinology and Diabetes (BSPED) guidelines; 2020 cohort: managed according to the 2020 BSPED guidelines).

Design: Retrospective cohort study using prospectively collected data.

Setting: A critical care advice and transport service based in London, and referring hospitals within the critical care network. Read More

Arch Dis Child Educ Pract Ed 2022 Jun 15. Epub 2022 Jun 15.

Paediatrics, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Cureus 2022 May 12;14(5):e24932. Epub 2022 May 12.

Internal Medicine, Hospital Professor Doutor Fernando Fonseca, Amadora, PRT.

Mucormycosis is a severe fungal infection that occurs mainly in immunocompromised patients. It is characterized by several syndromes with rhino-orbito-cerebral and pulmonary involvement. We report the case of a 49-year-old patient admitted for diabetic ketoacidosis and Influenza B pneumonia nonresponsive to treatment, which was later diagnosed with pulmonary mucormycosis. Read More

Cureus 2022 Jun 8;14(6):e25746. Epub 2022 Jun 8.

Diabetes and Endocrinology, Peterborough City Hospital, Peterborough, GBR.

Type 1 diabetes is a chronic disease characterized by abnormal metabolism and hyperglycemia due to insulin deficiency. There is a rapid decline in insulin production due to autoimmune destruction of the pancreatic beta cells. Partial remission (honeymoon phase) of type 1 diabetes is common in children and young adults with newly diagnosed type 1 diabetes. Read More

Pediatr Diabetes 2022 Jun 14. Epub 2022 Jun 14.

Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland.

Background: There are several observations from various countries that the onset of Coronavirus 19 (COVID-19) pandemic was associated with an increase in the prevalence of DKA. However, due to heterogeneity in study designs and country-specific healthcare policies, more national-level evidence is needed to provide generalizable conclusions.

Objective: To compare the rate of diabetic ketoacidosis (DKA) in Polish children diagnosed with type 1 diabetes (T1D) between the first year of coronavirus 19 (COVID-19) pandemic (15. Read More

Cureus 2022 Jun 10;14(6):e25818. Epub 2022 Jun 10.

Medicine, St. Barnabas Hospital (SBH) Health System, Bronx, USA.

Empagliflozin-induced euglycemic diabetic ketoacidosis is a life-threatening metabolic complication of diabetes mellitus characterized by metabolic acidosis, ketonemia, and relatively normal serum glucose levels. We present a rare case of empagliflozin-induced diabetic ketoacidosis obscured by alkalosis. This case report aims to create awareness among clinicians about this entity and consider this diagnosis in their differential, especially in patients taking sodium-glucose co-transporter (SGLT-2) inhibitors who present to the hospital with unspecific symptoms that may not suggest DKA. Read More

Endocr Pract 2022 Jun 7. Epub 2022 Jun 7.

Staff Specialist Intensive Care Unit, Royal Darwin Hospital, 105 Rocklands Dr, Tiwi NT 0810, Australia; Associate Professor Flinders University, Sturt Rd, Bedford Park SA 5042 Australia; Honorary Clinical Fellow, Menzies School of Health Research, Royal Darwin Hospital Campus, 105 Rocklands Dr, Tiwi NT 0810, Australia.

Objective: International guidelines for the treatment of diabetic ketoacidosis (DKA) advise against rapid changes in osmolarity and glucose, but the optimal rates of correction are unknown. We aimed to evaluate rates of change in tonicity and glucose in intensive care patients with DKA and their relationship with mortality and altered mental status.

Methods: Observational cohort study using two publicly available databases of USA intensive care patients (Medical Information Mart for Intensive Care-IV and eICU), evaluating adults with DKA and associated hyperosmolarity (baseline Osm≥300mosm/L). Read More

Medicine (Baltimore) 2022 Jun 10;101(23):e28253. Epub 2022 Jun 10.

Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.

Introduction: There are variable complications of hyperthyroidism, including atrial fibrillation, heart failure, osteoporosis, and thyroid storm. One infrequent complication of hyperthyroidism is non-diabetic ketoacidosis (NDKA). To the best of our knowledge, our case is the third report of NDKA related to thyrotoxicosis. Read More