858 results match your criteria Hyperosmolar Hyperglycemic State


[Treatment of acute diabetic metabolic crises in adults (Update 2019) : Hyperglycemic hyperosmolar state and ketoacidotic metabolic disorders].

Wien Klin Wochenschr 2019 Apr 12. Epub 2019 Apr 12.

Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.

Diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state (HHS) represent potentially life-threatening situations in adults. Therefore, rapid comprehensive diagnostic and therapeutic measures with close monitoring of vital and laboratory parameters are required. The treatment of DKA and HHS is essentially the same and replacement of the mostly substantial fluid deficit with several liters of a physiological crystalloid solution is the first and most important step. Read More

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http://link.springer.com/10.1007/s00508-018-1423-z
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http://dx.doi.org/10.1007/s00508-018-1423-zDOI Listing
April 2019
2 Reads

Muscle relaxant induced pancreatitis leading to hyperosmolar hyperglycemic state.

Oxf Med Case Reports 2019 Mar 29;2019(3):omz012. Epub 2019 Mar 29.

Little Rock Diagnostic Clinic, CHI St. Vincent, Little Rock, USA.

Muscle relaxants are commonly prescribed in the United States but may have deleterious side effects that are unrecognized by physicians. Here, we report a 55-year-old Caucasian man who developed pancreatitis and a subsequent hyperosmolar hyperglycemic state after being prescribed tizanidine. The patient had untreated hypertriglyceridemia, unbeknownst to the prescribing physician. Read More

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http://dx.doi.org/10.1093/omcr/omz012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440256PMC

Characteristics of hyperglycemic crises in an adult population in a teaching hospital in Colombia.

J Diabetes Metab Disord 2018 Dec 19;17(2):143-148. Epub 2018 Sep 19.

3Universidad Pontificia Bolivariana, Calle 78b #72a-159, Antioquia, Colombia.

Background: Hyperglycemic crisis are the most serious forms of acute decompensation of diabetes mellitus and require urgent medical attention. The epidemiological data of these conditions in Latin America are scarce and in Colombia unknown, that is why we decided to describe the clinical characteristics and factors associated with the mortality of adults who presented with hyperglycemic crises in a teaching hospital in Colombia.

Materials And Methods: Retrospective cohort study of all episodes of hyperglycemic crisis treated in Pablo Tobón Uribe Hospital in a three-year period. Read More

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https://jdmdonline.biomedcentral.com/articles/10.1007/s40200
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http://dx.doi.org/10.1007/s40200-018-0353-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405398PMC
December 2018
3 Reads

Prevalence and associated factors of hospitalization for dysglycemia among elderly type 2 diabetes patients: A nationwide study.

World J Diabetes 2019 Mar;10(3):212-223

Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, United States.

Background: The prevalence of older individuals with type 2 diabetes mellitus (T2DM) is increasing due to the aging population and improved medical care. These patients are very susceptible to disease and treatment-related hospitalizations, resulting in higher health care costs, morbidity, and decreased quality of life. However, data of treatment-related complications, especially dysglycemia-related hospitalizations, are lacking. Read More

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http://dx.doi.org/10.4239/wjd.v10.i3.212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422861PMC
March 2019
6 Reads

Diabetic ketoacidosis among adult patients with diabetes mellitus admitted to emergency unit of Hawassa university comprehensive specialized hospital.

BMC Res Notes 2019 Mar 14;12(1):137. Epub 2019 Mar 14.

College of Medicine and Health Sciences, School of Nursing, Hawassa University, P.O.BOX: 1560, Hawassa, SNNPR, Ethiopia.

Objective: This study was aimed to assess the prevalence and associated factors of diabetic ketoacidosis among adult patients admitted in emergency department of Hawassa university comprehensive specialized hospital. An institution based retrospective cross-sectional study design was conducted among 195 adult patients aged 16 years and above with known or previously unknown diabetes cases presented in the emergency unit.

Result: In our study from the total 195 patients medical record reviewed 78 (40%) developed DKA. Read More

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http://dx.doi.org/10.1186/s13104-019-4186-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419397PMC
March 2019
9 Reads

The Inflammatory and Hemostatic Cardiovascular Risk Markers During Acute Hyperglycemic Crisis in Type 1 and Type 2 Diabetes.

J Med Biochem 2019 Apr 3;38(2):126-133. Epub 2019 Mar 3.

Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Background: We analyzed cardiovascular inflammatory (C-reactive protein (CRP), interleukin 6 (IL-6)), haemostatic (homocysteine) risk markers in lean and obese patients at admission and acute hyperglicemic crisis (AHC) resolving, involving diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS).

Methods: In that context, we included group A: N = 20 obese, B: N=20 lean patients with DKA; C: N = l0 obese, D: N=10 lean patients with HHS; E: N = 15 obese, F: N=15 lean controls. CRP IL-6, homocysteine were determined by ELISA. Read More

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http://dx.doi.org/10.2478/jomb-2018-0024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410996PMC
April 2019
1 Read

Moderate-Intensity Insulin Therapy Is Associated With Reduced Length of Stay in Critically Ill Patients With Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State.

Crit Care Med 2019 May;47(5):700-705

Department of Pharmacy Services, University of California Davis Medical Center, Sacramento, CA.

Objectives: Insulin infusion therapy is commonly used in the hospital setting to manage diabetic ketoacidosis and hyperosmolar hyperglycemic state. Clinical evidence suggests both hypoglycemia and glycemic variability negatively impact patient outcomes. The hypothesis of this study was that moderate-intensity insulin therapy decreases hospital length of stay and prevalence of hypoglycemia in patients with diabetic ketoacidosis and hyperosmolar hyperglycemic state. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003709DOI Listing
May 2019
1 Read

Hyperglycemic hyperosmolar state in an adolescent with type 1 diabetes mellitus.

Endocrinol Diabetes Metab Case Rep 2019 Mar 5;2019. Epub 2019 Mar 5.

Department of Pediatrics, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan.

Hyperglycemic hyperosmolar state (HHS) and diabetic ketoacidosis (DKA) are the most severe acute complications of diabetes mellitus (DM). HHS is characterized by severe hyperglycemia and hyperosmolality without significant ketosis and acidosis. A 14-year-old Japanese boy presented at the emergency room with lethargy, polyuria and polydipsia. Read More

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http://dx.doi.org/10.1530/EDM-18-0131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6432974PMC
March 2019
4 Reads

Steroid-induced Diabetes Complicating Treatment of Epidermolysis Bullosa Acquisita: A Preventable Treatment Complication Stresses the Importance of Primary Care Follow-up.

Cureus 2018 Nov 19;10(11):e3608. Epub 2018 Nov 19.

Internal Medicine, Louis Stokes Cleveland VA Medical Center/Case Western Reserve University School of Medicine, Cleveland, USA.

Epidermolysis bullosa acquisita is a rare autoimmune bullous disease involving the skin and mucosa, most commonly treated with systemic corticosteroids. This case illustrates the importance of counseling patients on medication side effects and ensuring close physician follow-up during an extended course of steroids. A 46-year-old man presented to the emergency department with weakness, fatigue, dizziness and polyuria in the setting of eight weeks of prednisone therapy for a flare-up of his bullous disease. Read More

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http://dx.doi.org/10.7759/cureus.3608DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343862PMC
November 2018
2 Reads

Improvement in renal prognosis with prompt hemodialysis in hyperosmolar hyperglycemic state-related rhabdomyolysis: A case report.

Medicine (Baltimore) 2018 Dec;97(50):e13647

Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, Taiwan.

Rationale: Acute kidney injury is common and correctable in patients with a hyperosmolar hyperglycemic state (HHS). Nevertheless, hyperglycemic crisis may also contribute to the development of rhabdomyolysis, which can worsen renal function and lead to high mortality in such patients.

Patient Concerns: Herein, we report a case of hyperosmolar hyperglycemic state-related rhabdomyolysis and acute renal failure with an excellent outcome. Read More

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http://dx.doi.org/10.1097/MD.0000000000013647DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319979PMC
December 2018
3 Reads

Rhabdomyolysis-Induced Acute Kidney Injury in Diabetic Emergency: Underdiagnosed and an Important Association to Be Aware of.

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

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http://dx.doi.org/10.1155/2018/4132738DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234448PMC
October 2018
3 Reads

Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea.

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

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http://dx.doi.org/10.3961/jpmph.18.153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283743PMC
November 2018
3 Reads

Acid-base and electrolyte disturbances in patients with diabetes mellitus.

Acta Clin Belg 2019 Feb 23;74(1):28-33. Epub 2018 Nov 23.

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

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http://dx.doi.org/10.1080/17843286.2018.1546983DOI Listing
February 2019
1 Read

Limb Ischemia in a Patient with Hyperosmolar Hyperglycemic State.

Clin Pract Cases Emerg Med 2018 Nov 17;2(4):348-352. Epub 2018 Oct 17.

University of Maryland School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.

A 61-year-old male with a recent diagnosis of pemphigus vulgaris was brought to the emergency department for altered mental status. He had recently started taking prednisone to manage his autoimmune disease and had a progressive decline in his mental status along with decreased oral intake. Evaluation revealed hyperosmolar hyperglycemic state (HHS) and occlusive arterial thrombosis, a rare but known complication of HHS. Read More

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http://dx.doi.org/10.5811/cpcem.2018.9.39920DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230346PMC
November 2018
3 Reads

Glycogen Hepatopathy: A Rare and Underrecognized Cause of Recurrent Transaminitis in Patients with Uncontrolled Type 2 Diabetes Mellitus.

Case Rep Gastroenterol 2018 May-Aug;12(2):466-472. Epub 2018 Aug 23.

Division of Gastroenterology, Department of Medicine, Bronx Lebanon Hospital Center, Bronx, New York, USA.

Glycogen hepatopathy (GH), characterized by reversible transaminitis and hepatomegaly, results from excessive accumulation of glycogen in hepatocytes. GH has been well described in the literature as a rare cause of transaminitis in children and young patients with uncontrolled type 1 diabetes mellitus and has rarely been reported in type 2 diabetic patients. Hyperglycemia and hyperinsulinemia are believed to be a metabolic substrate for hepatic glycogen accumulation and in order to cause glycogen hepatotoxicity. Read More

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https://www.karger.com/Article/FullText/492205
Publisher Site
http://dx.doi.org/10.1159/000492205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167705PMC
August 2018
13 Reads

Incidence and Outcomes of Non-ST Elevation Myocardial Infarction in Patients Hospitalized with Decompensated Diabetes.

Am J Cardiol 2018 Oct 17;122(8):1297-1302. Epub 2018 Jul 17.

Division of Cardiology, West Virginia University, Morgantown, West Virginia. Electronic address:

Single center studies suggested that non-ST elevation myocardial infarction (NSTEMI) in patients admitted with acute decompensated diabetes is associated with poor long-term prognosis. We hypothesize that acute decompensated diabetes is also associated with worse early morbidity and mortality in patients admitted with NSTEMI. Adult patients with a primary discharge diagnosis of diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) were identified in the national inpatient sample. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00029149183141
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http://dx.doi.org/10.1016/j.amjcard.2018.07.004DOI Listing
October 2018
12 Reads

Hyperglycemia crisis in head and neck cancer patients with platinum-based chemotherapy.

J Chin Med Assoc 2018 Dec 9;81(12):1060-1064. Epub 2018 Aug 9.

Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; School of Medicine, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan, ROC. Electronic address:

Background: The development of a hyperglycemic crisis in platinum-based chemotherapy-treated head and neck cancer patients, such as hyperosmolar hyperglycemic state (HHS), has been reported. Hyperglycemic crises are associated with a high risk of comorbidity and may delay cancer treatment if not promptly managed.

Methods: This is a retrospective study using cancer registry data from a tertiary medical center. Read More

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http://dx.doi.org/10.1016/j.jcma.2018.05.008DOI Listing
December 2018
11 Reads

Hyperglycemia Syndromes.

Nurs Clin North Am 2018 09;53(3):303-317

Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, USA.

Diabetes mellitus and its complications are among the leading causes of organ failure around the world. It is imperative that timely, patient-centered care is provided to avoid microvascular and macrovascular damage. People with well-controlled diabetes can live long and healthy lives through interprofessional management, emphasizing optimal, individualized care. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00296465183003
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http://dx.doi.org/10.1016/j.cnur.2018.04.001DOI Listing
September 2018
20 Reads

Successful Treatment of Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Status in an Infant with KCNJ11-Related Neonatal Diabetes Mellitus via Continuous Renal Replacement Therapy.

Diabetes Ther 2018 Oct 9;9(5):2179-2184. Epub 2018 Aug 9.

Department of Endocrinology, Metabolism and Genetic Disorders, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.

Neonatal diabetes mellitus (NDM) is a rare monogenic disorder presenting as uncontrolled hyperglycemia during the first 6 months of life. Hyperglycemic hyperosmolar state (HHS) is quite rare in NDM patients, and reported experience with this condition is limited. Continuous renal replacement therapy (CRRT) is frequently used as a mode of dialytic treatment in critically ill patients with acute renal failure, but has seldom been used in patients with diabetic ketoacidosis (DKA) and HHS. Read More

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http://dx.doi.org/10.1007/s13300-018-0484-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167281PMC
October 2018
15 Reads

Pediatric Diabetic Ketoacidosis With Hyperosmolarity: Clinical Characteristics and Outcomes.

Endocr Pract 2018 08 7;24(8):726-732. Epub 2018 Aug 7.

Objective: Studies of hyperglycemic emergencies with hyperosmolality, including hyperglycemic hyperosmolar state (HHS) and "mixed presentation" with features of diabetic ketoacidosis (DKA) and HHS, are lacking in children. Objectives were to determine the incidence of DKA, HHS, and mixed presentation in a pediatric population, to characterize complications, and to assess accuracy of associated diagnosis codes.

Methods: Retrospective cohort study of 411 hyperglycemic emergencies in pediatric patients hospitalized between 2009 and 2014. Read More

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http://dx.doi.org/10.4158/EP-2018-0120DOI Listing
August 2018
24 Reads

Impact of acute diabetes decompensation on outcomes of diabetic patients admitted with ST-elevation myocardial infarction.

Diabetol Metab Syndr 2018 17;10:57. Epub 2018 Jul 17.

2Division of Cardiology, West Virginia University, Morgantown, WV USA.

Background: Acute hyperglycemia is associated with worse outcomes in diabetic patients admitted with ST-elevation myocardial infarction (STEMI). However, the impact of full-scale decompensated diabetes on STEMI outcomes has not been investigated.

Methods: We utilized the national inpatient sample (2003-2014) to identify adult diabetic patients admitted with STEMI. Read More

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https://dmsjournal.biomedcentral.com/articles/10.1186/s13098
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http://dx.doi.org/10.1186/s13098-018-0357-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050700PMC
July 2018
10 Reads

Delirium and Psychotic Symptoms Associated with Hyperglycemia in a Patient with Poorly controlled Type 2 Diabetes Mellitus.

Innov Clin Neurosci 2018 Jun;15(5-6):30-33

Dr. Lopes is with the Faculty of Medicine at the University of Porto in Porto, Portugal.

Delirium, acute confusional states, and secondary psychosis have been associated with several medical conditions, including endocrine disorders. In the context of diabetes mellitus (DM), it has been mostly related to hypoglycemia and rarely occurs in association with hyperglycemia, outside of the context of a hyperglycemic hyperosmolar state or diabetic ketoacidosis. Here, we describe a case of delirium and psychotic symptoms associated with hyperglycemia in a patient with poorly controlled Type 2 DM as an attempt to alert clinicians to this rare association. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040722PMC
June 2018
25 Reads

Osmotic demyelination syndrome due to hyperosmolar hyperglycemia.

Cleve Clin J Med 2018 Jul;85(7):511-513

Chairman, Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.3949/ccjm.85a.17020DOI Listing
July 2018
4 Reads

Diazoxide toxicity in a child with persistent hyperinsulinemic hypoglycemia of infancy: mixed hyperglycemic hyperosmolar coma and ketoacidosis.

J Pediatr Endocrinol Metab 2018 Aug;31(8):943-945

Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Background: Persistent hyperinsulinemic hypoglycemia of infancy (PHHI), also known as congenital hyperinsulinism, has been known to go into spontaneous remission, with patients developing diabetes in later life. A temporary phase of hyperglycemia is, however, rarely reported.

Case Presentation: We describe a 16-month-old child, a known case of diazoxide responsive PHHI, presenting with mixed hyperglycemic hyperosmolar coma and ketoacidosis with rhabdomyolysis while on diazoxide treatment. Read More

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http://dx.doi.org/10.1515/jpem-2018-0112DOI Listing
August 2018
12 Reads

Validation of Predicting Hyperglycemic Crisis Death Score: A Risk Stratification Tool for Appropriate Disposition of Hyperglycemic Crisis Patients from the Emergency Department.

J Emerg Trauma Shock 2018 Apr-Jun;11(2):104-110

Department of Emergency Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.

Context: Predicting hyperglycemic crisis death (PHD) score is a simple, rapid tool with six independent mortality predictors to calculate 30-day mortality and appropriately dispose patients to Intensive Care Unit (ICU) or ward.

Aims: This study aimed at validating the efficiency of PHD score as a decision rule for prognosticating 30-day mortality and classifying hyperglycemic crisis patients for appropriate disposition from the emergency department (ED).

Materials And Methods: This is a prospective, observational study done in the ED of a teaching hospital over 14 months. Read More

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http://dx.doi.org/10.4103/JETS.JETS_2_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994862PMC
June 2018
21 Reads

ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state.

Pediatr Diabetes 2018 10;19 Suppl 27:155-177

Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile.

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http://doi.wiley.com/10.1111/pedi.12701
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http://dx.doi.org/10.1111/pedi.12701DOI Listing
October 2018
83 Reads

Recurrent hospitalizations for severe hypoglycemia and hyperglycemia among U.S. adults with diabetes.

J Diabetes Complications 2018 Jul 24;32(7):693-701. Epub 2018 Apr 24.

Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States; Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 200 First Street SW, Rochester, MN 55905, United States; OptumLabs, 1 Main Street, 10th Floor, Cambridge, MA 02142, United States.

Aims: Examine 30-day readmissions for recurrent hypoglycemia and hyperglycemia in a national cohort of adults with diabetes.

Methods: Retrospective analysis of data from OptumLabs Data Warehouse for all adults with diabetes hospitalized January 1, 2009 to December 31, 2014 with a principal diagnosis of hypoglycemia or hyperglycemia. We examined the rates and risk factors of 30-day readmissions for hypoglycemia and hyperglycemia. Read More

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http://dx.doi.org/10.1016/j.jdiacomp.2018.04.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015781PMC
July 2018
6 Reads

Spectrum of hyperosmolar hyperglycaemic state in neurology practice.

Indian J Med Res 2017 Nov;146(Supplement):S1-S7

Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Background & Objectives: Hyperosmolar hyperglycaemic state (HHS) is a medical emergency, but there is a paucity of studies reporting the spectrum of neurological manifestations of HHS. We, therefore, report the neurological spectrum, triggering factors and outcome of HHS in general neurology practice.

Methods: The records of the patients with HHS were extracted from computerized hospital information system and those managed currently were prospectively included. Read More

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http://dx.doi.org/10.4103/ijmr.IJMR_57_15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890590PMC
November 2017
13 Reads

Role of CHADS-VASc score in predicting new-onset atrial fibrillation in patients with type 2 diabetes mellitus with and without hyperosmolar hyperglycaemic state: real-world data from a nationwide cohort.

BMJ Open 2018 03 22;8(3):e020065. Epub 2018 Mar 22.

Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.

Purpose: The objective of the current study was to explore the role of CHADS-VASc score in predicting incidence of atrial fibrillation (AF) in patients with type 2 diabetes mellitus (DM). Furthermore, the use of the CHADS-VASc score for stratifying new-onset AF risk in patients with DM and with/without hyperosmolar hyperglycaemic state (HHS) was also compared.

Methods: The study subjects were identified from Longitudinal Health Insurance Database provided by the National Health Research Institutes. Read More

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http://dx.doi.org/10.1136/bmjopen-2017-020065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875622PMC
March 2018
3 Reads

Hyperglycemic Hyperosmolar State: A Pragmatic Approach to Properly Manage Sodium Derangements.

Curr Diabetes Rev 2018 ;14(6):534-541

Department of Translational Medicine, Universita del Piemonte Orientale, Novara, Italy.

Introduction: Although hypovolemia remains the most relevant problem during acute decompensated diabetes in its clinical manifestations (diabetic ketoacidosis, DKA, and hyperglycemic hyperosmolar state, HHS), the electrolyte derangements caused by the global hydroelectrolytic imbalance usually complicate the clinical picture at presentation and may be worsened by the treatment itself.

Aim: This review article is focused on the management of dysnatremias during hyperglycemic hyperosmolar state with the aim of providing clinicians a useful tool to early identify the sodium derangement in order to address properly its treatment.

Discussion: The plasma sodium concentration is modified by most of the therapeutic measures commonly required in such patients and the physician needs to consider these interactions when treating HHS. Read More

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http://www.eurekaselect.com/160560/article
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http://dx.doi.org/10.2174/1573399814666180320091451DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237920PMC
February 2019
11 Reads

[Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State].

Dtsch Med Wochenschr 2018 Mar 15;143(6):384-391. Epub 2018 Mar 15.

Background:  Diabetic ketoacidosis and the hyperosmolar hyperglycemic state are the most serious diabetic emergencies. Before the discovery of insulin in 1921 by Banting and Best the diagnosis of type 1 diabetes was fatal ending in diabetic ketoacidosis equivalent to a torturous death. Today, mortality from diabetic ketoacidosis is low at approximately 2 %. Read More

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http://dx.doi.org/10.1055/s-0043-114493DOI Listing
March 2018
6 Reads

Clinical Features and Prognosis of Type 2 Myocardial Infarction in Acutely Decompensated Diabetic Patients.

Am J Med 2018 Jul 5;131(7):820-828. Epub 2018 Mar 5.

Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisc; University of Wisconsin School of Medicine and Public Health, Milwaukee.

Background: After the introduction of the universal definition of myocardial infarction, the incidence and diagnosis of type 2 myocardial infarction have risen dramatically, yet there are no clear guidelines on clinical management. Diabetic patients are at high risk for developing type 2 myocardial infarction when admitted in a decompensated state, and they are also at high risk for future cardiovascular events.

Methods: We performed a retrospective analysis of 1058 patients admitted with diabetic ketoacidosis or hyperosmolar hyperglycemic state between 2011 and 2016. Read More

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http://dx.doi.org/10.1016/j.amjmed.2018.02.007DOI Listing
July 2018
8 Reads

Hyperosmolar Hyperglycemic State.

Authors:
Gregg D Stoner

Am Fam Physician 2017 Dec;96(11):729-736

University of Illinois College of Medicine, Peoria, IL, USA.

Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common. Other causes include certain medications, nonadherence to therapy, undiagnosed diabetes mellitus, substance abuse, and coexisting disease. Read More

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December 2017
9 Reads

New onset diabetes after nivolumab treatment.

BMJ Case Rep 2018 Jan 29;2018. Epub 2018 Jan 29.

Department of Endocrinology, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.

The authors describe a case of a life-threatening diabetic emergency 25 days after initiation of nivolumab (3 mg/kg) for stage 4 lung adenocarcinoma. She was admitted to the emergency department, with hyperglycaemia-related signs and symptoms, such as polyuria, polydipsia, weight loss, confusion, asthenia, dehydration, hypotension and Kussmaul respiratory pattern. Her body mass index was 21. Read More

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http://dx.doi.org/10.1136/bcr-2017-220999DOI Listing
January 2018
8 Reads

Altered Mental Status in an Elderly Male.

J Emerg Med 2018 Feb 11;54(2):232-237. Epub 2017 Dec 11.

Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts.

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http://dx.doi.org/10.1016/j.jemermed.2017.11.025DOI Listing
February 2018
12 Reads

[Severe emergencies in patients with diabetes].

MMW Fortschr Med 2017 Dec;159(21-22):77-82

Klinik für Endokrinologie, Diabetologie, Angiologie und Innere Medizin, Notfallzentrum, Klinikum Neuperlach - Städt., Klinikum München GmbH, Oskar-Maria-Graf-Ring 51, D-81737, München, Deutschland.

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http://dx.doi.org/10.1007/s15006-017-0398-4DOI Listing
December 2017
4 Reads

Thrombocytopenia-associated multi-organ failure secondary to hyperglycemic, hyperosmolar non-ketotic syndrome: A case report.

Pediatr Diabetes 2018 05 22;19(3):574-577. Epub 2017 Nov 22.

Pediatric Nephrology, Baylor College of Medicine, Houston, Texas.

Thrombocytopenia associated multi-organ failure (TAMOF) is a clinical syndrome with features of new onset thrombocytopenia, increased lactate dehydrogenase, and multi-organ failure in critically ill patients. TAMOF can be the initial presentation of an underlying disease process or can develop during the course of illness either during the hospital stay. TAMOF has a high mortality rate if not treated; therefore, early detection is critical. Read More

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http://dx.doi.org/10.1111/pedi.12608DOI Listing
May 2018
8 Reads

The Impact of Hyperosmolarity on Long-Term Outcome in Patients Presenting with Severe Hyperglycemic Crisis: A Population Based Study.

Exp Clin Endocrinol Diabetes 2018 Sep 17;126(9):564-569. Epub 2017 Nov 17.

Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso", University Hospital Center "Sestre Milosrdnice", University of Zagreb School of Medicine, Zagreb, Croatia.

Aims: We compared characteristics of patients with hyperglycemic hyperosmolar state (HHS) and patients with severe hyperglycemia without the signs of hyperosmolarity and ketoacidosis; analyzed long-term all-cause mortality and potential prognostic factors.

Methods: The studied population included 261 749 adults. HHS was diagnosed in patients with plasma glucose >33. Read More

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http://dx.doi.org/10.1055/s-0043-117416DOI Listing
September 2018
12 Reads

End-Stage Renal Disease Increases Rates of Adverse Glucose Events When Treating Diabetic Ketoacidosis or Hyperosmolar Hyperglycemic State.

Clin Diabetes 2017 Oct;35(4):202-208

Methodist University Hospital, Memphis, TN.

Treatment guidelines for diabetic emergencies are well described in patients with normal to moderately impaired kidney function. However, management of patients with end-stage renal disease (ESRD) is an ongoing challenge. This article describes a retrospective study comparing the rates of adverse glucose events (defined as hypoglycemia or a decrease in glucose >200 mg/dL/h) between patients with ESRD and those with normal kidney function who were admitted with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). Read More

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http://dx.doi.org/10.2337/cd16-0060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669126PMC
October 2017
21 Reads

Hyperglycemic Hyperosmolar State During Induction Chemotherapy for Acute Lymphoblastic Leukemia.

Pediatr Emerg Care 2017 Dec;33(12):e172-e174

We present the case of a 16-year-old boy who presented with fatigue, polyuria, and polydipsia while on chemotherapy for his relapsed acute lymphoblastic leukemia (ALL). Blood gas examination confirmed the diagnosis of hyperosmolar hyperglycemic state. The etiology for his hyperglycemia was most likely a result of oral glucocorticoid therapy combined with asparaginase therapy-both are a cornerstone of induction chemotherapy for ALL. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001331DOI Listing
December 2017
13 Reads

Active cocaine use does not increase the likelihood of hyperglycemic crisis.

J Clin Transl Endocrinol 2017 Sep 1;9:1-7. Epub 2017 Jun 1.

Section of Endocrinology, Diabetes and Nutrition, Boston Medical Center, Boston University School of Medicine, 732 Harrison Avenue, 2nd Floor, MA 02118, United States.

Objective: Hyperglycemic crisis encompasses a group of diabetes emergencies characterized by insulin deficiency with high morbidity and mortality. Cocaine use is increasingly prevalent in the United States and may be associated with increased risk of diabetic ketoacidosis. The objective was to determine if active cocaine use at hospital admission could be considered a risk factor for development of hyperglycemic crisis. Read More

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http://dx.doi.org/10.1016/j.jcte.2017.05.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5651291PMC
September 2017
12 Reads

Severe complications after initial management of hyperglycemic hyperosmolar syndrome and diabetic ketoacidosis with a standard diabetic ketoacidosis protocol.

J Pediatr Endocrinol Metab 2017 Oct;30(11):1141-1145

.

Hyperglycemic hyperosmolar syndrome (HHS) is a clinical entity not identical to diabetic ketoacidosis (DKA), and with a markedly higher mortality. Children with HHS can also present with concomitant DKA. Patients with HHS (with or without DKA) are profoundly dehydrated but often receive inadequate fluid resuscitation as well as intravenous insulin therapy based on traditional DKA protocols, and this can lead to devastating consequences. Read More

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http://www.degruyter.com/view/j/jpem.2017.30.issue-11/jpem-2
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http://dx.doi.org/10.1515/jpem-2017-0183DOI Listing
October 2017
6 Reads

Effectiveness of levodopa treatment for diabetic chorea with reduced striatal accumulation in dopamine transporter SPECT: a case report.

Rinsho Shinkeigaku 2017 10 28;57(10):591-594. Epub 2017 Sep 28.

Department of Neurology, Kasugai City Hospital.

We report the case of a 77-year-old woman with diabetic chorea, which presented as hemiballism of the right limbs. Initial blood examination revealed that sugar and hemoglobin A1c levels were 732 mg/dl and 12.2%, respectively. Read More

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http://dx.doi.org/10.5692/clinicalneurol.cn-001041DOI Listing
October 2017
7 Reads

[Endocrine and diabetic emergencies].

Authors:
H Lehnert M Reincke

Internist (Berl) 2017 10;58(10):1009-1010

Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336, München, Deutschland.

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http://dx.doi.org/10.1007/s00108-017-0319-8DOI Listing
October 2017
5 Reads

Background characteristics and clinical features of elderly patients with hyperglycemic hyperosmolar syndrome.

Nihon Ronen Igakkai Zasshi 2017 ;54(3):349-355

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital.

Aim: Few reports have described the characteristics of hyperglycemic hyperosmolar syndrome (HHS) in the elderly. We investigated the background characteristics and clinical features of 14 elderly patients with HHS.

Methods: HHS was diagnosed based on a blood glucose level of >600 mg/dL and an effective plasma osmolality [2 (Na) + glu/18] of >320 mOsm/kg. Read More

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http://dx.doi.org/10.3143/geriatrics.54.349DOI Listing
January 2019
56 Reads

[Diabetic emergencies : Hypoglycemia, ketoacidotic and hyperglycemic hyperosmolar nonketotic coma].

Internist (Berl) 2017 Oct;58(10):1020-1028

Präsidium der Universität zu Lübeck, Universität zu Lübeck, Lübeck, Deutschland.

The diabetic emergencies diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS) and hypoglycemia represent severe and potentially life-threatening complications of diabetes mellitus that require prompt diagnostics and treatment. Absolute or relative insulin insufficiency is characteristic of DKA und HHS along with severe dehydration. They differ by the prevalence of ketone bodies and the severity of acidosis; however, the treatment regimens are similar. Read More

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http://dx.doi.org/10.1007/s00108-017-0317-xDOI Listing
October 2017
15 Reads

Sentinel visits in emergency department patients with diabetes mellitus as a warning sign for hyperglycemic emergencies.

CJEM 2018 03 25;20(2):230-237. Epub 2017 Jul 25.

‡Department of Emergency Medicine,University of Ottawa,Ottawa,ON.

Objectives: Patients with poorly controlled diabetes mellitus may have a sentinel emergency department (ED) visit for a precipitating condition prior to presenting for a hyperglycemic emergency, such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). This study's objective was to describe the epidemiology and outcomes of patients with a sentinel ED visit prior to their hyperglycemic emergency visit.

Methods: This was a 1-year health records review of patients≥18 years old presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, DKA, or HHS. Read More

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http://dx.doi.org/10.1017/cem.2017.338DOI Listing
March 2018
38 Reads

Emergency Department Management of Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State in Adults: National Survey of Attitudes and Practice.

Can J Diabetes 2018 Jun 19;42(3):229-236. Epub 2017 Jul 19.

The University of Ottawa, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Objectives: In 2013, the Canadian Diabetes Association, now Diabetes Canada, published national clinical practice guidelines for the effective management of diabetic ketoacidosis and hyperosmolar hyperglycemic states in adults. We sought to determine emergency physician compliance rates and attitudes toward these guidelines and to identify potential barriers to their use in Canadian emergency departments.

Methods: An online survey consisting of questions related to the awareness and use of the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada was distributed to 500 randomly selected members of the Canadian Association of Emergency Physicians. Read More

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http://dx.doi.org/10.1016/j.jcjd.2017.05.005DOI Listing
June 2018
33 Reads