8,965 results match your criteria Diabetic Ketoacidosis


Adverse events associated with immune checkpoint inhibitors: a new era in autoimmune diabetes.

Curr Opin Endocrinol Diabetes Obes 2020 Aug;27(4):187-193

Barbara Davis Center for Diabetes, University of Colorado, School of Medicine, Aurora, Colorado, USA.

Purpose Of Review: To summarize a new form of autoimmune diabetes as an adverse event of specific cancer immunotherapies. Immune checkpoint inhibitors are revolutionary treatments in advanced cancers; however, they can cause type 1 diabetes following treatment with these state-of-the-art therapies.

Recent Findings: A review of the literature showed that this new form of autoimmune diabetes has significant similarities with childhood-onset type 1 diabetes but also some distinctions. Read More

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http://dx.doi.org/10.1097/MED.0000000000000546DOI Listing

Fatal Acute Pancreatitis in an Adolescent: A Case Report.

Am J Forensic Med Pathol 2020 Jun 30. Epub 2020 Jun 30.

From the Department of Pathology, University of New Mexico.

Acute pancreatitis is uncommon in children and adolescents, and when it does occur, it is rarely fatal. The cause of death may be misdiagnosed as a death due to diabetic ketoacidosis or an infectious disease if an autopsy is not performed. Because these deaths are often unexpected and may occur before medical care, the forensic pathologist may be contacted to determine the cause of death. Read More

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http://dx.doi.org/10.1097/PAF.0000000000000582DOI Listing

Health Care Utilization of Homeless Minors With Diabetes in New York State From 2009 to 2014.

Diabetes Care 2020 Jul 2. Epub 2020 Jul 2.

The Lundquist Institute for Biomedical Innovation, Torrance, CA.

Objective: This study aims to describe differences in health care utilization between homeless and nonhomeless minors with diabetes.

Research Design And Methods: Data from the Healthcare Cost and Utilization Project's Statewide Inpatient Database from New York for years 2009-2014 were examined to identify pediatric patients <18 years old with diabetes. Outcomes of interest included hospitalization rate, in-hospital mortality, admission through the emergency department (ED), diabetic ketoacidosis (DKA), hospitalization cost, and length of stay (LOS). Read More

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http://dx.doi.org/10.2337/dc19-2219DOI Listing

Anti-PD-1 Therapy Associated Type 1 Diabetes in a Pediatric Patient With Relapsed Classical Hodgkin Lymphoma.

Diabetes Care 2020 Jul 2. Epub 2020 Jul 2.

Department of Diabetes Immunology, Diabetes & Metabolism Research Institute, City of Hope, Duarte, CA

Objective: Immune checkpoint inhibitors (ICIs) perturb T-cell regulatory pathways to enhance antitumor immunity. However, an increase reporting of ICI-associated diabetes is observed in adults. To our knowledge, no cases have been reported in the pediatric population. Read More

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http://dx.doi.org/10.2337/dc20-0740DOI Listing

High prevalence of COVID-19-associated diabetic ketoacidosis in UK secondary care.

Diabetes Res Clin Pract 2020 Jun 29:108291. Epub 2020 Jun 29.

Department of Diabetes and Endocrinology, Whipps Cross University Hospital, London, UK.

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http://dx.doi.org/10.1016/j.diabres.2020.108291DOI Listing

Intractable hiccups as a rare gastrointestinal manifestation in severe endocrine and metabolic crisis: case report and review of the literature.

Ther Adv Endocrinol Metab 2020 20;11:2042018820934307. Epub 2020 Jun 20.

Department of Endocrinology and Nephrology, Chongqing Emergency Medical Hospital, Chongqing University Central Hospital, No.1 Jiankang Road, Yuzhong District, Chongqing 400014, China.

Diabetic ketoacidosis (DKA) and thyroid storm (TS) are severe metabolic and endocrine disorders. Both usually manifest with multiple systemic clinical signs and symptoms, and digestive symptoms, such as nausea and vomiting, are most common in these patients. Moreover, the presence of a concurrent severe or rare complication may worsen the condition or even cause death due to misdiagnosis, delayed diagnosis, or inappropriate treatment. Read More

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http://dx.doi.org/10.1177/2042018820934307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307285PMC

A Triad of Ketoacidosis, Hypertriglyceridemia, and Acute Pancreatitis Associated With Sugar-Sweetened Soft Drinks Abuse in a Caucasian Patient With Undiagnosed Type 2 Diabetes Mellitus.

Cureus 2020 May 26;12(5):e8299. Epub 2020 May 26.

U. O. C. Di Medicina Generale E Lungodegenza, San Giovanni Bosco Hospital, Asl Napoli 1 Centro, Naples, ITA.

A 24-year-old obese Caucasian male, without relevant anamnesis, who was admitted to the ER presented with abdominal pain, nausea and vomiting, hyperglycemia, and diabetic ketoacidosis (DKA). The diagnosis of acute pancreatitis (AP) was supported by increased serum levels of triglycerides and lipase associated with abdominal CT scans. The patient was treated for five days with IV regular insulin, hydration, electrolytes replacement, and statin/fibrate therapy with clinical improvement. Read More

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http://dx.doi.org/10.7759/cureus.8299DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320639PMC

Ketoacidosis associated with ketogenic diet in a non-diabetic lactating woman.

BMJ Case Rep 2020 Jun 30;13(6). Epub 2020 Jun 30.

Division of Pulmonary and Critical Care Medicine, South Shore Hospital, Weymouth, Massachusetts, USA.

A 37-year-old woman who had 8 weeks post partum, breast feeding and on a low carbohydrate and high protein (ketogenic) diet, was admitted to the hospital with acute onset of nausea, vomiting and abdominal pain of 1-day duration. On admission, she was found to have high anion gap metabolic acidosis, elevated beta-hydroxybutyric acid level, normal glucose level and evidence of ketoacidosis. She was treated with lactated Ringer solution, along with dextrose 5% solution with the resolution of symptoms and metabolic derangement. Read More

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http://dx.doi.org/10.1136/bcr-2019-234046DOI Listing

Safety and effectiveness of tofogliflozin in Japanese patients with type 2 diabetes mellitus treated in real-world clinical practice: Results of J-STEP/LT, a 36-month post-marketing surveillance study.

J Diabetes Investig 2020 Jun 29. Epub 2020 Jun 29.

Kawasaki Medical School, Kurashiki, Japan.

Aims/introduction: Tofogliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that lowers plasma glucose levels by enhancing urinary glucose excretion. Following its approval in Japan in 2014 for the treatment of type 2 diabetes mellitus (T2DM), we conducted a 3-year prospective observational post-marketing surveillance study in Japanese patients (J-STEP/LT).

Methods: This surveillance was conducted between September 2014 and February 2019, and recorded safety in terms of adverse drug reactions (ADRs) and ADRs of special interest, and effectiveness in terms of changes in HbA1c and body weight from baseline to last observation carried forward (LOCF). Read More

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http://dx.doi.org/10.1111/jdi.13333DOI Listing

Microbiota, epidemiological and nutritional factors related to ketoacidosis at the onset of type 1 diabetes.

Acta Diabetol 2020 Jun 27. Epub 2020 Jun 27.

Department of Public Health and Pediatrics, University of Study of Torino, Piazza Polonia 94, 10126, Turin, Italy.

Aims: The incidence of type 1 diabetes has increased over the last decades. The pathological pathway is not yet clear, even if genetic and environmental risk factors are known. An early diagnosis can avoid ketoacidosis and its complications. Read More

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http://dx.doi.org/10.1007/s00592-020-01555-zDOI Listing

Clinical Characteristics and Outcome in Patients with Combined Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State Associated with COVID-19: A Retrospective, Hospital-Based Observational Case Series.

Diabetes Res Clin Pract 2020 Jun 24:108279. Epub 2020 Jun 24.

Department of Medical Education, Saint Michael's Medical Centre, New York Medical College, New Jersey, United States; Department of Infectious Disease, Saint Michael's Medical Centre, New York Medical College, New Jersey, United States.

Aim: One of the risk factors for poor outcome with SARS-CoV-2 infection is diabetes mellitus; diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the most serious complications of diabetes mellitus. We aimed to explore the clinical characteristics and outcomes of COVID-19 patients presenting with combined DKA/HHS to our institution.

Methods: A retrospective, hospital based observation case series was performed on patients with SARS-CoV-2 admitted to Intensive Care Unit between 3/20/2020 and 4/20/2020. Read More

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http://dx.doi.org/10.1016/j.diabres.2020.108279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314685PMC

Unexpected high mortality in COVID-19 and diabetic ketoacidosis.

Metabolism 2020 Jun 23:154301. Epub 2020 Jun 23.

Division of Endocrinology, Department of Internal Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America. Electronic address:

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http://dx.doi.org/10.1016/j.metabol.2020.154301DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311346PMC

Development of a rubric for assessing delayed diagnosis of appendicitis, diabetic ketoacidosis and sepsis.

Diagnosis (Berl) 2020 Jun 25. Epub 2020 Jun 25.

Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA.

Objectives Using case review to determine whether a patient experienced a delayed diagnosis is challenging. Measurement would be more accurate if case reviewers had access to multi-expert consensus on grading the likelihood of delayed diagnosis. Our objective was to use expert consensus to create a guide for objectively grading the likelihood of delayed diagnosis of appendicitis, new-onset diabetic ketoacidosis (DKA), and sepsis. Read More

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http://dx.doi.org/10.1515/dx-2020-0035DOI Listing

Clinical spectrum, etiology and outcome of infectious disease emergencies in adult diabetic patients in northern India.

Diabetes Metab Syndr 2020 Jun 12;14(5):921-925. Epub 2020 Jun 12.

Department of Medical Microbiology, PGIMER, Chandigarh, India. Electronic address:

Background And Aims: The patients with diabetes mellitus (DM) have an increased incidence of both common and unusual infections. Despite an increasing prevalence of DM in India, local data on the epidemiology and clinical spectrum of associated infections are lacking. We aimed to investigate the spectrum, etiology, and outcome of infectious disorders in adult patients with DM admitted in a medical emergency. Read More

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http://dx.doi.org/10.1016/j.dsx.2020.06.004DOI Listing

Significant reduction of ketoacidosis at diabetes onset in children and adolescents with type 1 diabetes - the Stuttgart Diabetes Awareness Campaign, Germany.

Pediatr Diabetes 2020 Jun 24. Epub 2020 Jun 24.

Public Health Department of Stuttgart, Stuttgart, Germany.

Background: To prevent the potentially life-threatening complication (diabetic ketoacidosis, DKA) at type 1 diabetes onset in children and adolescents, awareness campaigns can lead to a significant reduction of DKA. As in Germany the incidence of DKA at diabetes onset had remained at a constant rate over the last 15 years and increasing numbers of very young children present with higher risk for DKA we decided to set up the Stuttgart Ketoacidosis Awareness Campaign.

Methods: Over 3 years (2015-2017) the campaign was conducted using information flyers and posters illustrating the typical symptoms of diabetes at school entry health examinations at the Public Health Department, in day-care facilities, in all pediatric practices and by regular public activities. Read More

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http://dx.doi.org/10.1111/pedi.13064DOI Listing

Management of adult patients with type 1 diabetes mellitus in Africa: A post-hoc cohort analysis of 12 African countries participating in the International Diabetes Management Practices Study (Wave 7).

Medicine (Baltimore) 2020 Jun;99(25):e20553

Clinical Pharmacology & Toxicology, University Hospital / Inselspital Bern, Bern, Switzerland.

There is a paucity of information on real world management of African adult patients with type 1 diabetes mellitus (T1DM). We aimed to describe a cohort of African adults with T1DM.The International Diabetes Management Practices Study is an observational survey conducted from 2005 to 2017. Read More

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http://dx.doi.org/10.1097/MD.0000000000020553DOI Listing

Adjunct Therapies in Treatment of Type 1 Diabetes.

J Diabetes 2020 Jun 21. Epub 2020 Jun 21.

Division of Endocrinology, Diabetes and Metabolism, State University of New York at Buffalo, Williamsville, NY.

In spite of developments with novel insulin preparations, novel modes of insulin delivery with insulin infusion pumps, and the facility of continuous glucose monitoring, only 20% of patients with type 1 diabetes are under adequate control. The need for innovation is clear and, therefore, the use of adjunct therapies with other pharmacological agents, currently in use for type 2 diabetes, has been tried. Currently, pramlintide is the only agent licensed for use in this condition in addition to insulin. Read More

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http://dx.doi.org/10.1111/1753-0407.13078DOI Listing

Acute Psychosis in Withdrawal from Nicotine Vaping in a Young Man with Comorbid Diabetic Ketoacidosis and Cannabis Use.

Case Rep Psychiatry 2020 3;2020:5710810. Epub 2020 Jun 3.

Central Michigan University College of Medicine, Department of Psychiatry, 1000 Houghton Ave, Saginaw MI 48602, USA.

Electronic delivery of nicotine, also termed "vaping," has a growing evidence base suggesting potential harm through both exposure and withdrawal effects. The current report presents the case of a young man with multiple medical comorbidities, including insulin-dependent diabetes mellitus on an insulin pump and presumed Gilbert's disease, and chronic cannabis use who experienced acute agitation with hallucinations in the context of quitting his vape pen "cold turkey" or abruptly discontinuing use without a nicotine replacement. While undergoing hospitalization for his complaint of nausea and vomiting in the context of euglycemic diabetic ketoacidosis and cannabis use, his psychotic symptoms became evident and continued until beginning a nicotine replacement patch. Read More

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http://dx.doi.org/10.1155/2020/5710810DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292970PMC

Acute hypoxic hepatitis as a complication of diabetic ketoacidosis in a boy with newly diagnosed diabetes.

Pediatr Endocrinol Diabetes Metab 2020 ;26(2):108-112

Department of Endocrinology and Diabetology for Children and Adolescents, Wroclaw Medical University, Poland.

Introduction: Hypoxic hepatitis is characterised by centrilobular liver cell necrosis associated with a rapid and transient increase in serum aminotransferase levels (ALT, AST) in critically ill patients. The aim of this paper is to present a case report of a paediatric patient with severe ketoacidosis in the course of newly diagnosed diabetes types 1 complicated by hypoxic hepatitis.

Case Report: A boy, nearly three years old, was admitted to the hospital with ketoacidosis (pH - 7. Read More

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http://dx.doi.org/10.5114/pedm.2020.95628DOI Listing
January 2020

Cases from the Immune-Related Adverse Event Tumor Board: Diagnosis and Management of Immune Checkpoint Blockade Induced Diabetes.

Oncologist 2020 Jun 21. Epub 2020 Jun 21.

Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland, Ohio, USA.

The addition of immune checkpoint inhibitors to the armamentarium of cancer therapies has resulted in unprecedented improvement in clinical outcomes for a vast range of malignancies. Because they interfere with the physiologic function of immune checkpoints, such as programmed cell death protein 1 or cytotoxic T-lymphocyte-associated protein 4, to promote self-tolerance, these agents are associated with a unique spectrum of immune-related adverse events (irAEs). Immune-mediated endocrinopathies are among the most commonly noted irAEs. Read More

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http://dx.doi.org/10.1634/theoncologist.2019-0806DOI Listing

Combination therapy with SGLT2 inhibitors for diabetic kidney disease.

Biomed Pharmacother 2020 Jul 20;127:110192. Epub 2020 May 20.

Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Jiangxi, China. Electronic address:

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of oral antihyperglycemic agents developed in recent years. They could block most glucose reabsorption in renal proximal tubules, thereby exerting glucose lowering effects through glycosuric ways. The renal and cardiovascular protection effects of SGLT2 inhibitors have also been demonstrated both in preclinical studies and clinical trials. Read More

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http://dx.doi.org/10.1016/j.biopha.2020.110192DOI Listing

Dissecting the Interaction between Coronavirus Disease 2019 and Diabetes Mellitus.

J Diabetes Investig 2020 Jun 18. Epub 2020 Jun 18.

Division of Endocrinology, Department of Medicine, Khoo Teck Puat Hospital, Singapore.

Coronavirus disease 2019 (COVID-19) is a global pandemic that is caused by a novel coronavirus, severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Data from several countries have demonstrated higher morbidity and mortality among individuals with chronic metabolic diseases such as diabetes mellitus (DM). In this review, we explore the contributing factors for poorer prognosis in these individuals. Read More

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http://dx.doi.org/10.1111/jdi.13326DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323255PMC

Usefulness of a blood glucose and ketone monitoring device as a screening tool for lethal diabetic ketoacidosis.

Int J Legal Med 2020 Jun 18. Epub 2020 Jun 18.

Department of Biochemistry, University Hospital of Montpellier, Montpellier, France.

Diabetic ketoacidosis (DKA) is a frequent and life-threatening complication, whose diagnosis remains challenging in forensic practice. We aimed at assessing the performance of a commercially available blood glucose and ketone monitoring device (BGMD) in measuring glucose and ketone levels in post-mortem vitreous (VH) and blood samples, in order to determine if such a device can be used for screening lethal cases of DKA at autopsy. VH and blood samples were collected in cases of unexplained causes of death at autopsy. Read More

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http://dx.doi.org/10.1007/s00414-020-02343-8DOI Listing

Diabetic Ketoacidosis in COVID-19: unique concerns and considerations.

J Clin Endocrinol Metab 2020 Jun 18. Epub 2020 Jun 18.

Brigham and Women's Hospital and Harvard Medical School, Boston, MA.

While individuals with diabetes appear to be at similar risk for SARS-CoV-2 infection than those without diabetes, they are more likely to suffer severe consequences, including death. Diabetic ketoacidosis (DKA) is a common and potentially lethal acute complication of diabetes arising from a relative insulin deficiency, which occurs more often in those with type 1 diabetes and in the setting of moderate to severe illness. Early reports indicate that among patients with preexisting diabetes, DKA may be a common complication of severe COVID-19 and a poor prognostic sign. Read More

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http://dx.doi.org/10.1210/clinem/dgaa360DOI Listing

Cerebral Venous Thrombosis Associated with COVID-19.

AJNR Am J Neuroradiol 2020 Jun 18. Epub 2020 Jun 18.

From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).

Despite the severity of coronavirus disease 2019 (COVID-19) being more frequently related to acute respiratory distress syndrome and acute cardiac and renal injuries, thromboembolic events have been increasingly reported. We report a unique series of young patients with COVID-19 presenting with cerebral venous system thrombosis. Three patients younger than 41 years of age with confirmed Severe Acute Respiratory Syndrome coronavirus 2 (SARS-Cov-2) infection had neurologic findings related to cerebral venous thrombosis. Read More

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http://dx.doi.org/10.3174/ajnr.A6644DOI Listing

Safety and tolerability of empagliflozin and linagliptin combination therapy in patients with type 2 diabetes mellitus: a pooled analysis of data from five randomized, controlled clinical trials.

Expert Opin Drug Saf 2020 Jul 2:1-10. Epub 2020 Jul 2.

Medicine Division, Nippon Boehringer Ingelheim Co. Ltd , Tokyo, Japan.

Objectives: The fixed-dose combination of empagliflozin and linagliptin, two glucose-lowering drugs prescribed for type 2 diabetes mellitus, has demonstrated good tolerability in phase III clinical trials. To further evaluate the safety profile of this combination, the data from these trials were pooled and analyzed.

Methods: This was a post-hoc pooled analysis of five randomized, double-blind, clinical trials of the empagliflozin/linagliptin fixed-dose combination. Read More

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http://dx.doi.org/10.1080/14740338.2020.1782884DOI Listing

Multi-Organ Failure in a Patient With Diabetes due to COVID-19 With Clear Lungs.

Cureus 2020 May 15;12(5):e8147. Epub 2020 May 15.

Internal Medicine, Wayne State University - Detroit Medical Center, Detroit, USA.

The pandemic of coronavirus disease 2019 has emerged in late 2019 infecting millions of people worldwide. Diabetes mellitus (DM) has been associated with severe illness and mortality mainly due to acute respiratory distress syndrome. We report a case of a middle-aged man with DM and COVID-19 who developed seizure and altered mental status, found to have diabetic ketoacidosis (DKA), acute kidney injury, hypovolemic shock, and hyperammonemia all contributing to metabolic encephalopathy. Read More

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http://dx.doi.org/10.7759/cureus.8147DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294884PMC

Recurrent diabetic ketoacidosis and cognitive function among older adults with type 1 diabetes: findings from the Study of Longevity in Diabetes.

BMJ Open Diabetes Res Care 2020 Jun;8(1)

Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.

Introduction: Diabetic ketoacidosis (DKA) is a serious complication of diabetes. DKA is associated with poorer cognition in children with type 1 diabetes (T1D), but whether this is the case in older adults with T1D is unknown. Given the increasing life expectancy in T1D, understanding the role of DKA on brain health in older adults is crucial. Read More

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http://dx.doi.org/10.1136/bmjdrc-2020-001173DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299028PMC

Euglycemic diabetic ketoacidosis in a patient with type 1 diabetes and SARS-CoV-2 pneumonia: case report and review of the literature.

Acta Clin Belg 2020 Jun 16:1-5. Epub 2020 Jun 16.

Cliniques Universitaires Saint-Luc, Service d'Endocrinologie et Nutrition , Brussels, Belgium.

Objective: Recent publications on Coronavirus Disease-2019 (COVID-19) report that diabetic people with or without co-morbidities are at higher risk of developing severe and/or fatal illnesses.

Method And Result: We report the first case of a 60-year-old man with a 27-year history of type 1 diabetes mellitus, infected by SARS-CoV-2 presenting with an euglycaemic ketoacidosis and an acute respiratory distress syndrome.

Conclusion:  This case report reminds us of the importance of adjusting more recent glucose-lowering drugs, including sodium-glucose cotransporter 2 inhibitors, in the overall management of type 1 diabetic individuals during the ongoing COVID-19 outbreak. Read More

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http://dx.doi.org/10.1080/17843286.2020.1780390DOI Listing

Effect of Continuous Glucose Monitoring on Glycemic Control in Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial.

JAMA 2020 06;323(23):2388-2396

Jaeb Center for Health Research, Tampa, Florida.

Importance: Adolescents and young adults with type 1 diabetes exhibit the worst glycemic control among individuals with type 1 diabetes across the lifespan. Although continuous glucose monitoring (CGM) has been shown to improve glycemic control in adults, its benefit in adolescents and young adults has not been demonstrated.

Objective: To determine the effect of CGM on glycemic control in adolescents and young adults with type 1 diabetes. Read More

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http://dx.doi.org/10.1001/jama.2020.6940DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298603PMC

If case reports be the food of knowledge, write on: our Cases of the Quarter.

Authors:
Stefan Slater

J R Coll Physicians Edinb 2020 Mar;50(1):75-79

Royal College of Physicians of Edinburgh, Edinburgh, UK, Email:

The value of publishing case reports has long been debated and the arguments are summarised. Last year, to encourage trainees, the Royal College of Physicians of Edinburgh's Senior Fellows Club inaugurated an annual prize for the best case report or case series published in the Journal of the Royal College of Physicians of Edinburgh by a doctor in training. Some of the highlights of last year's entries are reviewed, commented on and developed. Read More

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http://dx.doi.org/10.4997/JRCPE.2020.120DOI Listing

Newly diagnosed diabetes and diabetic ketoacidosis precipitated by COVID-19 infection.

Am J Emerg Med 2020 Jun 6. Epub 2020 Jun 6.

Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, OH, United States of America; Northeast Ohio Medical University, Rootstown, OH, United States of America. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2020.05.114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274947PMC

Uncovering Autoimmune Diabetes in a Patient With Euglycemic Diabetic Ketoacidosis.

Am J Med Sci 2020 May 21. Epub 2020 May 21.

Division of Diabetes and Endocrinology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.

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http://dx.doi.org/10.1016/j.amjms.2020.05.022DOI Listing

Diabetic ketoacidosis as first presentation of type 1 diabetes mellitus in a young child: Important differential diagnosis for respiratory distress.

Can Fam Physician 2020 Jun;66(6):425-426

Assistant Professor in the Department of Family Medicine at McMaster University in Hamilton, Ont.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292523PMC

Clinical characteristics and outcomes of COVID-19 hospitalized patients with diabetes in the United Kingdom: A retrospective single centre study.

Diabetes Res Clin Pract 2020 Jun 10;165:108263. Epub 2020 Jun 10.

Department of Diabetes and Endocrinology, William Harvey Hospital, Ashford, United Kingdom. Electronic address:

Aim: To describe the clinical characteristics and outcomes of hospitalized COVID-19 patients with diabetes.

Methods: A retrospective cross-sectional study was conducted among patients admitted to the William Harvey Hospital in England between March 10th and May10th, 2020 with a laboratory-confirmed severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), known as COVID-19. Variation in characteristics, length of stay in hospital, diabetes status, duration of diabetes, control of diabetes, comorbidities and outcomes were examined. Read More

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http://dx.doi.org/10.1016/j.diabres.2020.108263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283049PMC
June 2020
2.538 Impact Factor

Safety Audits in the Emergency Department: Applying the Threat and Error Model to the Management of Pediatric Diabetic Ketoacidosis.

Pediatr Emerg Care 2020 Jun 11. Epub 2020 Jun 11.

From the Department of Pediatrics, McMaster Children's Hospital.

Objectives: This study aims to better understand factors that impact management of patients with diabetic ketoacidosis (DKA) in the pediatric emergency department (ED) by novel application of the threat-and-error model, commonly used in the aviation industry.

Methods: This study was a retrospective chart review of all patients diagnosed with DKA and managed in our pediatric ED during a 1-year period. A "flight plan" was created for each patient's ED visit, from triage to final disposition. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002142DOI Listing

A NONSENSE GATA6 MUTATION EXPLAINS HISTORY OF CONGENITAL HEART DEFECTS AND 10 YEARS OF POORLY-CONTROLLED DIABETES LACKING DKA IN A NON-OBESE 30 YEAR-OLD INCIDENTALLY FOUND TO HAVE PANCREATIC HYPOPLASIA.

AACE Clin Case Rep 2020 May-Jun;6(3):e123-e126. Epub 2020 May 11.

Objective: To report a case of diabetes mellitus (DM) associated with partial pancreatic agenesis and congenital heart disease (CHD) in a patient found to have a nonsense mutation of the gene.

Methods: We present the imaging, laboratory, and genetic findings, and describe the clinical course of a patient with an atypical presentation of DM as well as CHD, who was found to have partial pancreatic agenesis on computed tomography (CT) imaging. Genetic testing was performed to identify monogenic DM. Read More

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http://dx.doi.org/10.4158/ACCR-2019-0156DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282284PMC

SEVERE INSULIN RESISTANCE WITH DIABETIC KETOACIDOSIS AFTER BRENTUXIMAB TREATMENT.

AACE Clin Case Rep 2020 Mar-Apr;6(2):e98-e100. Epub 2020 Jan 22.

Objective: To increase awareness of unusual inflammatory and other responses including severe insulin resistance (IR) associated with the use of targeted immunotherapies such as brentuximab.

Methods: We report the case of a man without any previous diagnosis of diabetes who developed diabetic ketoacidosis complicated by severe IR (unresponsive to >600 units of intravenous insulin per hour) after receiving brentuximab for Hodgkin lymphoma.

Results: Autoantibodies to the insulin receptor were not detected in the patient's serum, thus excluding a diagnosis of type B IR. Read More

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http://dx.doi.org/10.4158/ACCR-2019-0435DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282153PMC
January 2020

COVID-19 Presenting as Acute Limb Ischaemia.

Eur J Case Rep Intern Med 2020 19;7(6):001724. Epub 2020 May 19.

Cardiology, Saint Joseph's University Medical Center, Paterson, New Jersey, USA.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic that developed in late 2019 and early 2020 has caused thousands of deaths and has had an enormous impact on our health systems and economies. Coronavirus disease 2019 (COVID-19) complications include disseminated coagulation and thrombosis, but, to the best of our knowledge, the literature to date on these manifestations has been limited. Herein, we report an unusual presentation in a 43-year-old man with a medical history of diabetes and hypertension who presented with dyspnoea and acute pain in his right leg and was found to have acute limb ischaemia and diabetic ketoacidosis. Read More

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http://dx.doi.org/10.12890/2020_001724DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279913PMC

Euglycaemic diabetic ketoacidosis as a complication of SGLT-2 inhibitors: epidemiology, pathophysiology, and treatment.

Expert Opin Drug Saf 2020 Jun 10:1-10. Epub 2020 Jun 10.

Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki , Thessaloniki, Greece.

Introduction: Sodium-glucose co-transporters 2 (SGLT-2) inhibitors are a relatively novel class of oral medications for the treatment of Type 2 Diabetes Mellitus, which lower plasma glucose by inhibiting glucose reabsorption in the proximal renal tubule. Apart from their hypoglycemic action, recent data suggest these agents have additional major cardioprotective and nephroprotective properties.

Areas Covered: This review summarizes the existing data on epidemiology, pathophysiology, and treatment of euglycaemic ketoacidosis (euDKA) as a complication of SGLT-2 inhibitor use. Read More

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http://dx.doi.org/10.1080/14740338.2020.1764532DOI Listing

[Post-transplantation diabetes in kidney transplant: from the diabetologist point of view].

Rev Med Suisse 2020 Jun;16(697):1200-1205

Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne.

Post-transplantation diabetes (PTDM) exposes to increased morbidity (cardiovascular or infectious complications, early graft dysfunction) and to a risk of premature death. Recognition of risk factors is essential for early and individualized care. The management of a PTDM requires the use of oral antidiabetic treatments (metformin or DPP4 inhibitors) or GLP1 receptor agonists for their favorable effects on weight and kidney that seem ideal in this context. Read More

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[Insulin pump treatment: For whom and how to set it up on an outpatient?]

Rev Med Suisse 2020 Jun;16(697):1191-1196

Service d'endocrinologie, diabétologie et métabolisme, CHUV, 1011 Lausanne.

Pump therapy has existed for over 40 years and provides a more flexible delivery of insulin. To date, almost 25% of type 1 diabetic patients have chosen this therapeutic option. In recent years, it has also been offered to patients with type 2 insulin-requiring diabetes. Read More

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Challenges of New Approaches in Metastatic Merkel Cell Carcinoma.

Case Rep Oncol 2020 May-Aug;13(2):501-507. Epub 2020 May 12.

Medical Oncology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E, Lisbon, Portugal.

Merkel cell carcinoma is a rare and aggressive cutaneous tumor, and the use of checkpoint inhibitors immunotherapy is a recent indication in its metastatic setting, both first and second line. However, the widespread use of immunotherapy is associated with an increase of acute and late immune-mediated adverse events. We present a case of an elderly fit patient with metastatic Merkel cell carcinoma treated with pembrolizumab who developed diabetic ketoacidosis, a severe immune-mediated adverse event. Read More

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http://dx.doi.org/10.1159/000507279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265742PMC

Euglycaemic diabetic ketoacidosis in a 43-year-old woman with type 2 diabetes mellitus on SGLT-2 inhibitor (empagliflozin).

BMJ Case Rep 2020 Jun 7;13(6). Epub 2020 Jun 7.

Internal Medicine, CHI Health Creighton University Medical Center Bergan Mercy, Omaha, Nebraska, USA

We report a case of euglycaemic diabetic ketoacidosis (EDKA) in a 43-year-old woman with type 2 diabetes mellitus who presented to the emergency department with problems of vomiting, cough, shortness of breath and generalised weakness after following a ketogenic diet for 2 weeks. Therapy with sodium glucose transport protein-2 empagliflozin had been started 2 months prior. Initial evaluation revealed high anion gap metabolic acidosis with blood glucose level of 169 mg/dL. Read More

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http://dx.doi.org/10.1136/bcr-2020-235117DOI Listing

Improving outcomes among young adults with type 1 diabetes: the D1 Now randomized pilot study protocol.

Diabet Med 2020 Jun 8. Epub 2020 Jun 8.

School of Medicine, National University of Ireland Galway, Galway, Ireland.

Background: Young adults (aged 18-25 years) living with type 1 diabetes mellitus often have sub-optimal glycaemic levels, which can increase their risk of long-term diabetes complications. Informed by health psychology theory and using a young adult-centred approach (public and patient involvement), we have developed a complex intervention, entitled D1 Now, to improve outcomes in this target group. The D1 Now intervention has three components: (1) a support worker; 2) an interactive messaging system; and 3) an agenda-setting tool for use during clinic consultations. Read More

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http://dx.doi.org/10.1111/dme.14337DOI Listing

Psychological care in children and adolescents with type 1 diabetes in a real-world setting and associations with metabolic control.

Pediatr Diabetes 2020 Jun 7. Epub 2020 Jun 7.

Institute for Epidemiology und Medical Biometry, ZIBMT, University Ulm, Ulm, Germany.

Background: International guidelines recommend psychosocial care for children and adolescents with type 1 diabetes.

Objective: To assess psychological care in children and adolescents with type 1 diabetes in a real-world-setting and to evaluate associations with metabolic outcome.

Methods: Delivery of psychological care, HbA1c, and rates of severe hypoglycaemia and diabetic ketoacidosis (DKA) in children and adolescents with type 1 diabetes from 199 diabetes-care-centres participating in the German diabetes survey DPV were analysed. Read More

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http://dx.doi.org/10.1111/pedi.13065DOI Listing

Transperitoneal laparoscopic adrenalectomy for the resection of large size pheochromocytoma: Case report and literature review.

Int J Surg Case Rep 2020 23;71:353-359. Epub 2020 May 23.

Fundación Santa Fe de Bogotá Hospital, General Surgery Department, Cra 7 # 117- 15, Bogota, Colombia.

Introduction: Pheochromocytomas are rare neuroendocrine tumors that form in chromaffin cells of the neural crest during the embryological period. In the overall population, incidence rate is 0.1%; lack of early diagnosis or adequate treatment can lead to life-threatening complications. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.05.027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270531PMC

The Effect of Ethnicity in the Rate of Beta Cell Functional Loss in the First 3 Years After Type 1 Diabetes Diagnosis.

J Clin Endocrinol Metab 2020 Jun 5. Epub 2020 Jun 5.

Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Objective: We set forth to compare ethnicities for metabolic and immunological characteristics at the clinical diagnosis of type 1 diabetes (T1D), and assess the effect of ethnicity on beta cell functional loss within three years after clinical diagnosis.

Research Methods And Design: We studied participants in TrialNet New Onset Intervention Trials (n=624, median age=14.4 years, 58% male, 8. Read More

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http://dx.doi.org/10.1210/clinem/dgaa348DOI Listing

T1D progression is associated with loss of CD3CD56 regulatory T cells that control CD8 T cell effector functions.

Nat Metab 2020 Feb 17;2(2):142-152. Epub 2020 Feb 17.

Laboratorio di Immunologia, Istituto per l'Endocrinologia e l'Oncologia Sperimentale "G. Salvatore", Consiglio Nazionale delle Ricerche, Naples 80131, Italy.

An unresolved issue in autoimmunity is the lack of surrogate biomarkers of immunological self-tolerance for disease monitoring. Here, we show that peripheral frequency of a regulatory T cell population, characterized by the co-expression of CD3 and CD56 molecules (T), is reduced in subjects with new-onset type 1 diabetes (T1D). In three independent T1D cohorts, we find that low frequency of circulating T cells is associated with reduced β-cell function and with the presence of diabetic ketoacidosis. Read More

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http://dx.doi.org/10.1038/s42255-020-0173-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272221PMC
February 2020

Relationship of C-peptide levels to duration of Type 1 diabetes - A study from Sindh, Pakistan.

Pak J Med Sci 2020 May-Jun;36(4):765-769

Abdul Basit, FRCP, Professor of Medicine (BMU), Director (BIDE), Baqai Institute of Diabetology and Endocrinology (BIDE), Karachi, Pakistan. Baqai Medical University (BMU), Karachi, Pakistan.

Objective: To determine the relationship of C-peptide levels with duration of type 1 diabetes mellitus.

Methods: This prospective study was conducted at Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University (BMU), Karachi-Pakistan from December 2013 to December 2015. A total of 184 subjects were recruited during the study period, 100 in Group-A and 84 in Group-B. Read More

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http://dx.doi.org/10.12669/pjms.36.4.1531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260921PMC