822 results match your criteria Hyperosmolar Hyperglycemic State
Pediatr Diabetes 2018 Jun 13. Epub 2018 Jun 13.
Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile.
Recommendations concerning fluid management have been modified to reflect recent findings from a randomized controlled clinical trial showing no difference in cerebral injury in patients rehydrated at different rates with either 0.45% or 0.9% saline. Read More
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
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
Curr Diabetes Rev 2018 Mar 19. Epub 2018 Mar 19.
Department of Translational Medicine, Universita del Piemonte Orientale - Via Solaroli 17 28100 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 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 indentify 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
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
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
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
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.
Exp Clin Endocrinol Diabetes 2017 Nov 17. 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.
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. The studied population included 261 749 adults. HHS was diagnosed in patients with plasma glucose >33. Read More
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
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
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
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
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
CJEM 2018 Mar 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
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
Int J Emerg Med 2017 Dec 12;10(1):23. Epub 2017 Jul 12.
The Department of Emergency Medicine, The University of Ottawa, Ottawa, ON, Canada.
Background: Patients with poorly controlled diabetes mellitus may present repeatedly to the emergency department (ED) for management and treatment of hyperglycemic episodes, including diabetic ketoacidosis and hyperosmolar hyperglycemic state. The objective of this study was to identify risk factors that predict unplanned recurrent ED visits for hyperglycemia in patients with diabetes within 30 days of initial presentation.
Methods: We conducted a 1-year health records review of patients ≥18 years presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, diabetic ketoacidosis, or hyperosmolar hyperglycemic state. Read More
Cureus 2017 Jun 3;9(6):e1305. Epub 2017 Jun 3.
Nephrology, Shifa International Hospital, Islamabad, Pakistan.
Carbon monoxide poisoning is common and carries significant morbidity and mortality. The nervous system, particularly the brain, is frequently affected by it, owing to its high metabolic activity and oxygen requirements. Carbon monoxide damages the nervous system by both hypoxic and inflammatory mechanisms. Read More
Curr Diab Rep 2017 Aug;17(8):56
Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02215, USA.
Purpose Of Review: Hyperglycemia in the emergency department (ED) is being recognized as a public health problem and presents a clinical challenge. This review critically summarizes available evidence on the burden, etiology, diagnosis, and practical management strategies for hyperglycemia in the ED.
Recent Findings: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are hyperglycemic emergencies that commonly present to the ED. Read More
Medicine (Baltimore) 2017 Jun;96(25):e7369
Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Rationale: A hyperosmolar hyperglycemic state (HHS) is a rare presentation of a hyperglycemic crisis in children with diabetes mellitus. As this condition can be fatal and has high morbidity, early recognition and proper management are necessary for a better outcome. Here, we report a rare case of HHS as the first presentation of type 1 diabetes mellitus (T1DM) in a 7-year-old girl. Read More
Brain Nerve 2017 Jun;69(6):671-672
Department of Neurology, Tochigi Medical Center Shimotsuga.
Acta Diabetol 2017 Oct 8;54(10):969-973. Epub 2017 Jun 8.
Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, 325000, Zhejiang, People's Republic of China.
Rev Bras Anestesiol 2018 Jan - Feb;68(1):75-86. Epub 2017 May 30.
Hospital Santa Genoveva, Centro de Ensino e Treinamento, Uberlândia, MG, Brasil.
Diabetes mellitus (DM) is characterized by alteration in carbohydrate metabolism, leading to hyperglycemia and increased perioperative morbidity and mortality. It evolves with diverse and progressive physiological changes, and the anesthetic management requires attention regarding this disease interference in multiple organ systems and their respective complications. Patient's history, physical examination, and complementary exams are important in the preoperative management, particularly glycosylated hemoglobin (HbA1c), which has a strong predictive value for complications associated with diabetes. Read More
Continuum (Minneap Minn) 2017 06;23(3, Neurology of Systemic Disease):778-801
Purpose Of Review: This article provides an overview of endocrine emergencies with potentially devastating neurologic manifestations that may be fatal if left untreated. Pituitary apoplexy, adrenal crisis, myxedema coma, thyroid storm, acute hypercalcemia and hypocalcemia, hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state), and acute hypoglycemia are discussed, with an emphasis on identifying the signs and symptoms as well as diagnosing and managing these clinical entities.
Recent Findings: To identify the optimal management of endocrine emergencies, using formal clinical diagnostic criteria and grading scales such as those recently proposed for pituitary apoplexy will be beneficial in future prospective studies. Read More
Diabetes Res Clin Pract 2017 Jun 9;128:1-5. Epub 2017 Apr 9.
Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. Electronic address:
"Diabetic striatopathy" is characterized by dyskinesias with basal ganglia hyperintensities on neuroimaging. It is usually reported in elderly females with hyperglycemic hyperosmolar state and rare in patients with diabetic ketoacidosis. Here, we report two young males with diabetic ketoacidosis presenting as striatopathy, along with review of literature. Read More
Med Clin North Am 2017 May;101(3):587-606
Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, 69 Jesse Hill Jr. Drive Southeast, 2nd Floor, Atlanta, GA 30303, USA. Electronic address:
Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are the most serious and life-threatening hyperglycemic emergencies in diabetes. DKA is more common in young people with type 1 diabetes and HHS in adult and elderly patients with type 2 diabetes. Features of the 2 disorders with ketoacidosis and hyperosmolality may coexist. Read More
Curr Diab Rep 2017 05;17(5):33
Division of Endo, Metabolism & Lipids, Emory University School of Medicine, Atlanta, GA, USA.
Purpose Of Review: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies that cause high morbidity and mortality. Their treatment differs in the UK and USA. This review delineates the differences in diagnosis and treatment between the two countries. Read More
Int J Emerg Med 2017 Dec 21;10(1):12. Epub 2017 Mar 21.
Emergency Department, Centre Hospitalier Universitaire de Kigali, University of Rwanda, Butare, Rwanda.
Background: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS.
Case Presentation: A 26-year-old Rwandan man was admitted to the emergency department in coma, with a glycemia of 600 mg/dl. Read More
Glob Pediatr Health 2016 30;3:2333794X16671391. Epub 2016 Nov 30.
University of Alabama at Birmingham, AL, USA.
Metabolism 2017 03 25;68:43-54. Epub 2016 Nov 25.
Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Hyperglycaemic emergencies are associated with significant morbi-mortality and healthcare costs. Management consists on fluid replacement, insulin therapy, and electrolyte correction. However, some areas of patient management remain debatable. Read More
J Clin Med Res 2017 Jan 24;9(1):35-39. Epub 2016 Nov 24.
University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, USA.
Background: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are two serious, preventable complications of diabetes mellitus. Analysis of variables associated with recurrent DKA and HHS admission has the potential to improve patient outcomes by identifying possible areas for intervention. The aim of this study was to evaluate potential predictors of recurrent DKA or HHS admission. Read More
Turk J Emerg Med 2016 Jun 8;16(2):75-76. Epub 2016 May 8.
Dicle University, School of Medicine, Department of Endocrinology and Metabolism, Diyarbakir, Turkey.
Mediastinitis is a serious infection involving mediastinal spaces after cervical infections spread along the facial planes. A late diagnosis of mediastinitis may result in death. Here we present a diabetic patient suffered from mediastinit accompanied with hyperosmolar nonketotic coma. Read More
PLoS One 2016 22;11(11):e0165905. Epub 2016 Nov 22.
Directorate of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Introduction: Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa.
Objective: To evaluate the 31-year trend in diabetic admissions and mortality rates in central Ghana. Read More
J Diabetes Investig 2017 May 6;8(3):392-394. Epub 2017 Jan 6.
Department of Endocrinology and Metabolism, Tsukuba University Hospital Mito Clinical Education and Training Center, Mito Kyodo General Hospital, Mito, Ibaraki, Japan.
A 27-year-old woman with panic disorder taking 20 mg olanzapine daily for 4 months was admitted to Mito Kyodo General Hospital, Mito, Ibaraki, Japan, because of disturbed consciousness with fever, hyperglycemia, hyperosmolarity and elevated creatine phosphokinase. She was diagnosed with a hyperosmolar hyperglycemic state and neuroleptic malignant syndrome. Brain magnetic resonance imaging showed transiently restricted diffusion in the splenium of the corpus callosum, with a high signal intensity on diffusion-weighted imaging. Read More
Nurse Pract 2016 Dec;41(12):1-4
Susan J. Appel is a professor at Capstone College of Nursing, University of Alabama, Tuscaloosa, Ala.
Methodist Debakey Cardiovasc J 2016 Sep;12(3):184-185
Houston Methodist Hospital, Houston, Texas.
Korean J Intern Med 2016 Nov 12;31(6):1187-1190. Epub 2016 Mar 12.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Br J Hosp Med (Lond) 2016 Sep;77(9):C130-3
Consultant Physician in the Department of Endocrinology, Lister Hospital, Stevenage.
Endocrinol Metab (Seoul) 2016 Sep 1;31(3):424-432. Epub 2016 Sep 1.
Department of Medicine, King George's Medical College, Lucknow, India.
Background: Diabetic ketoacidosis (DKA) is characterized by a biochemical triad of hyperglycemia, acidosis, and ketonemia. This condition is life-threatening despite improvements in diabetic care. The purpose of this study was to evaluate the clinical and biochemical prognostic markers of DKA. Read More
Nihon Naika Gakkai Zasshi 2016 Apr;105(4):690-7
J Diabetes 2017 Feb 31;9(2):208-209. Epub 2016 Aug 31.
Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Ischemic stroke is an uncommon complication among adults with DKA, that confers a worse prognosis. Traditional risk factors for stroke including older age, stroke history, hypertension and hyperlipidemia appear to predict the risk of IS in these patients. Demographic and clinical characteristics of patients with diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome patients, with and without cerebral edema. Read More
Environ Int 2016 09 6;94:642-648. Epub 2016 Jul 6.
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
This study aimed to investigate the association of admissions for diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) with ambient temperature and season, respectively in patients with diabetes mellitus (DM), after excluding known co-morbidities that predispose onset of acute hyperglycemia events. This was a time series correlation analysis based on medical claims of 40,084 and 33,947 episodes of admission for DKA and HHS, respectively over a 14-year period in Taiwan. These episodes were not accompanied by co-morbidities known to trigger incidence of DKA and HHS. Read More
Vnitr Lek 2016 Jan;62(1):72-3
Vnitr Lek 2016 Jan;62(1):72
Nihon Rinsho 2016 Apr;74 Suppl 2:92-6
Arq Neuropsiquiatr 2016 Apr;74(4):354-5
Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Am J Emerg Med 2016 Oct 17;34(10):2058.e1-2058.e2. Epub 2016 Mar 17.
Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Endocrinol Nutr 2016 May 22;63(5):252-3. Epub 2016 Mar 22.
Unidad de Metabolismo Infantil/Endocrinología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid, España.
Korean J Intern Med 2017 09 10;32(5):936-938. Epub 2016 Mar 10.
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.