898 results match your criteria Hyperosmolar Hyperglycemic State


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

Hyperglycemic hyperosmolar state in a chimpanzee (Pan troglodytes).

J Med Primatol 2020 Jun 15. Epub 2020 Jun 15.

Saint Louis Zoo, St. Louis, MI, USA.

A 19-year-old female chimpanzee (Pan troglodytes) presented for cachexia, acute weakness, hyporexia, icterus, and polyuria. The animal was diagnosed with a hyperglycemic hyperosmolar state, which is a well-recognized syndrome in diabetic humans that is rarely diagnosed in animals. This case documents an important and likely under-reported syndrome in non-human primates. Read More

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http://dx.doi.org/10.1111/jmp.12480DOI Listing

Hemichorea-Hemiballismus as an Unusual Presentation of Hyperosmolar Hyperglycemic Syndrome.

Am J Med Case Rep 2020 5;8(6):159-161. Epub 2020 Apr 5.

Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203 USA.

Diabetes mellitus can lead to a diverse array of systemic complications. Poorly managed hyperglycemia can result in serious neurological consequences ranging from peripheral neuropathy to seizures and coma. A rare neurologic disorder seen in acute decompensated type 2 diabetes mellitus (T2DM) is hemichorea-hemiballismus (HCHB). Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236990PMC

Acute Complications of Diabetes and its Predictors among Adult Diabetic Patients at Jimma Medical Center, Southwest Ethiopia.

Diabetes Metab Syndr Obes 2020 20;13:1237-1242. Epub 2020 Apr 20.

Department of Clinical Pharmacy, School of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.

Background: Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia resulting from impairment in insulin secretion, insulin action, or both. It is responsible for a wide range of acute and chronic complications. In this study, we aimed to assess acute complications of diabetes and its predictors among adult DM patients at Jimma Medical Center (JMC), southwest Ethiopia. Read More

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http://dx.doi.org/10.2147/DMSO.S249163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182448PMC

Acute Hyperglycemic Crises with Coronavirus Disease-19: Case Reports.

Diabetes Metab J 2020 04;44(2):349-353

Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.

Since the first case was contracted by coronavirus disease-19 (COVID-19) in Daegu, Korea in February 2020, about 6,800 cases and 130 deaths have been reported on April 9, 2020. Recent studies have reported that patients with diabetes showed higher mortality and they had a worse prognosis than the group without diabetes. In poorly controlled patients with diabetes, acute hyperglycemic crises such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS) also might be precipitated by COVID-19. Read More

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http://dx.doi.org/10.4093/dmj.2020.0091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188962PMC

Managing People with Diabetes Fasting for Ramadan During the COVID-19 Pandemic: A South Asian Health Foundation Update.

Diabet Med 2020 07 5;37(7):1094-1102. Epub 2020 Jun 5.

Professor of Diabetes, University Hospital Birmingham, UK.

The month of Ramadan forms one of the five pillars of the Muslim faith. Adult Muslims are obligated to keep daily fasts from dawn to sunset, with exceptions. This year Ramadan is due to begin on 23 April 2020 and the longest fast in the UK will be approximately 18 hours in length. Read More

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http://dx.doi.org/10.1111/dme.14312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267620PMC

Salty, Sweet and Difficult to Treat: A Case of Profound Hypernatremia in the Setting of Hyperosmotic Hyperglycemic State.

Cureus 2020 Mar 15;12(3):e7278. Epub 2020 Mar 15.

Pulmonology and Critical Care, State University of New York (SUNY) Upstate Medical University Hospital, Syracuse, USA.

Hyperosmolar hyperglycemic state (HHS) is a disorder that occurs most frequently in type 2 diabetics and is associated with high mortality - up to 50%. Hypernatremia, when associated with HHS, worsens the prognosis. Encephalopathy is evident at a serum sodium level greater than 160 mOsm/kg. Read More

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http://dx.doi.org/10.7759/cureus.7278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7158592PMC

[The Management of Blood Glucose Should be Emphasized in the Treatment of COVID-19].

Sichuan Da Xue Xue Bao Yi Xue Ban 2020 Mar;51(2):146-150

Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.

Based on the higher mortality and the higher proportion of critically ill adults in coronavirus disease 2019 (COVID-19) patients with diabetes, good inpatient glycemic control is particularly important in the comprehensive treatment of COVID-19. Individualized blood glucose target goals and treatment strategies should be made according to specific circumstances of COVID-19 inpatients with diabetes. For mild patients, a strict glycemic control target (fasting plasma glucose (FPG) 4. Read More

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http://dx.doi.org/10.12182/20200360606DOI Listing

Trends in Emergency Department Visits and Inpatient Admissions for Hyperglycemic Crises in Adults With Diabetes in the U.S., 2006-2015.

Diabetes Care 2020 May 11;43(5):1057-1064. Epub 2020 Mar 11.

Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Objective: To report U.S. national population-based rates and trends in diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) among adults, in both the emergency department (ED) and inpatient settings. Read More

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http://dx.doi.org/10.2337/dc19-2449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171947PMC

[A case of Langerhans cell histiocytosis with hyperosmolar hyperglycemic syndrome].

Zhonghua Nei Ke Za Zhi 2020 Mar;59(3):232-234

Department of Endocrinology, Hainan General Hospital, Haikou 570311, China.

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http://dx.doi.org/10.3760/cma.j.issn.0578-1426.2020.03.014DOI Listing

Diabetic hyperglycemic emergencies: a systematic approach

Emerg Med Pract 2020 02 1;22(2):1-20. Epub 2020 Feb 1.

Professor and Chair, Department of Emergency Medicine, Vanderbilt University Medical Center; Medical Director, Metro Nashville Fire Department and International Airport, Nashville, TN

For patients presenting with suspected diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS) understanding of the etiology and pathophysiology will ensure optimal emergency management. Morbidity and mortality is most often due to the underlying precipitating cause, which may include infection, infarction/ischemia, noncompliance with insulin therapy, pregnancy, and dietary indiscretion. Current guidelines are based primarily on expert opinion and consensus statements, but more recent evidence suggests that recommendations related to arterial blood gas, insulin bolus, and IV fluid replacement should be re-evaluated. Read More

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February 2020

Effect of Chronic Pancreatitis on Complications and Mortality in DM Patients: A 10-year Nationwide Cohort Study.

J Clin Endocrinol Metab 2020 Mar;105(3)

Department of Nephrology, Chi-Mei Medical Center, Tainan, Taiwan.

Context: Chronic pancreatitis (CP), is a long-term inflammation of the pancreatic parenchyma, and might increase risk of a hyperglycemia crisis or hypoglycemia in patients with diabetes mellitus (DM); however, the relationship has not been previously investigated.

Objective: To investigate the risk of diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), hypoglycemia, and long-term outcomes in DM patients with CP.

Design: A population-based cohort study. Read More

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http://dx.doi.org/10.1210/clinem/dgaa035DOI Listing

Seasonal variation of diabetes with hyperosmolarity hospitalizations and its characteristics in mainland Portugal.

Prim Care Diabetes 2020 Jan 11. Epub 2020 Jan 11.

MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS - Center for Health Technology and Services Research, Porto, Portugal.

Aims: The family physician devotes a part of his care to the surveillance of diabetic patients. Hyperosmolarity is a severe acute complication. The aim of this study was to analyse seasonal variation of type 2 diabetes with hyperosmolarity hospitalizations, regarding their occurrence, mortality, length of stay, Charlson comorbidity index and its factors. Read More

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http://dx.doi.org/10.1016/j.pcd.2019.12.011DOI Listing
January 2020

Antibody-Mediated Extreme Insulin Resistance: The Importance of Pre-Treatment Screening.

Case Rep Endocrinol 2019 16;2019:8562546. Epub 2019 Nov 16.

Division of Endocrinology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.

We report the case of a 56 year-old Hispanic male with a 10-year history of type 2 diabetes who presented with abrupt onset of hyperglycemia resistant to escalating doses of intravenous insulin infusion (>2500 units daily). He was diagnosed with antibody-mediated insulin resistance given the presence of hyperglycemia despite receiving >200 units insulin/day, a lack of identifiable precipitants for diabetic ketoacidosis or hyperosmolar hyperglycemic state, and elevated insulin antibodies. He underwent pre-immunomodulatory therapy screening for infections, rheumatologic disorders, and malignancy, which uncovered a new diagnosis of latent tuberculosis. Read More

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http://dx.doi.org/10.1155/2019/8562546DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885187PMC
November 2019

An atypical hyperosmolar hyperglycemic state and diabetic ketoacidosis induced by sodium-glucose cotransporter-2 inhibitors: A case report.

J Formos Med Assoc 2019 Dec 5. Epub 2019 Dec 5.

Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital/I-Shou University, No. 1, Yida Road, Kaohsiung City, 824, Taiwan. Electronic address:

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have become the best choice of second-line oral antidiabetic drugs for patients with heart or chronic kidney disease. However, it is not clear how safe this treatment is for elderly patients, especially Asians, who are known to be more insulin deficient than Caucasian individuals with a similar insulin resistance. Here, we report a case concerning an elderly patient with type 2 diabetes mellitus without insulin dependence, whose antidiabetic medication had recently been changed to include an SGLT-2 inhibitor. Read More

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http://dx.doi.org/10.1016/j.jfma.2019.11.015DOI Listing
December 2019

Simultaneous Diagnosis of Emphysematous Osteomyelitis and Emphysematous Pyelonephritis in a Diabetic Patient.

Am J Case Rep 2019 Dec 2;20:1793-1796. Epub 2019 Dec 2.

Department of Internal Medicine, KAT General Hospital of Attica, Kifissia, Greece.

BACKGROUND Emphysematous osteomyelitis of the spine is characterized by intravertebral or intraosseous air. Emphysematous pyelonephritis (EP) is the infection of the renal parenchyma and perirenal tissues caused by gas forming microorganisms and thus is characterized by gas formation. Prompt diagnosis and initiation of necessary treatment is crucial, as both entities are associated with high mortality rates. Read More

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http://dx.doi.org/10.12659/AJCR.920006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913288PMC
December 2019

Acetazolamide-Associated Hyperosmolar Hyperglycemic Nonketotic Syndrome.

Am J Ther 2019 Aug 20. Epub 2019 Aug 20.

Department of Internal MedicineDetroit Medical Center, Wayne State UniversityDetroit, MI.

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http://dx.doi.org/10.1097/MJT.0000000000001050DOI Listing

Clinical Outcomes in Patients With Isolated or Combined Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State: A Retrospective, Hospital-Based Cohort Study.

Diabetes Care 2020 Feb 8;43(2):349-357. Epub 2019 Nov 8.

Department of Medicine/Endocrinology, Emory University, Atlanta, GA.

Objective: Many patients with hyperglycemic crises present with combined features of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). The implications of concomitant acidosis and hyperosmolality are not well known. We investigated hospital outcomes in patients with isolated or combined hyperglycemic crises. Read More

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http://dx.doi.org/10.2337/dc19-1168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971788PMC
February 2020
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The Significance of an Increased Beta-Hydroxybutyrate at Presentation to the Emergency Department in Patients with Diabetes in the Absence of a Hyperglycemic Emergency.

J Diabetes Res 2019 10;2019:7387128. Epub 2019 Oct 10.

Emergency Department, Prince of Wales Hospital, Randwick, NSW, Australia.

The significance of hyperketonemia in adults with diabetes presenting to the emergency department with acute illness, not due to a diabetic hyperglycemic emergency, has not been well characterized. Adult patients with diabetes presenting to the emergency department who had venous blood gas and beta-hydroxybutyrate levels measured whilst in the emergency department were retrospectively evaluated for the relationship between BHB and clinical outcomes. Over 6 months, 404 patients with diabetes had at least one beta-hydroxybutyrate level measured in the emergency department. Read More

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http://dx.doi.org/10.1155/2019/7387128DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811785PMC

Trends in Hyperglycemic Crisis Hospitalizations and in- and out-of-Hospital Mortality in the Last Decade Based on Korean National Health Insurance Claims Data.

Endocrinol Metab (Seoul) 2019 09;34(3):275-281

Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Background: Hyperglycemic crisis is a metabolic emergency associated with diabetes mellitus. However, accurate epidemiologic information on cases of hyperglycemic crisis in Korea remains scarce. We evaluated trends in hyperglycemic crisis hospitalizations and in- and out-of-hospital mortality in Korea. Read More

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http://dx.doi.org/10.3803/EnM.2019.34.3.275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769342PMC
September 2019
3 Reads

Hospital admissions for hyperglycemic emergencies in young adults at an inner-city hospital.

Diabetes Res Clin Pract 2019 Nov 24;157:107869. Epub 2019 Sep 24.

Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States; Rollins School of Public Health, Emory University, Atlanta, GA, United States.

Aims: There is limited information characterizing young adults (18-35 years) (YA) with diabetes, especially those admitted for hyperglycemic emergencies. The study aims were to examine associations of patient-level characteristics with hyperglycemic emergency hospitalization and to identify variations based on diabetes type and glycemic control.

Methods: We conducted retrospective analysis of 273 YA admitted to an inner-city hospital with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic nonketotic syndrome (HHS). Read More

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http://dx.doi.org/10.1016/j.diabres.2019.107869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6914263PMC
November 2019
8 Reads
2.538 Impact Factor

The authors reply.

Crit Care Med 2019 10;47(10):e851

Department of Pharmacy Services, University of California, Davis Health, Sacramento, CA University of California, Davis Health, Sacramento, CA.

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http://dx.doi.org/10.1097/CCM.0000000000003952DOI Listing
October 2019

The "Underwater Part of the Iceberg" of Insulin Administration for Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State: Electrolytics Disorders.

Crit Care Med 2019 10;47(10):e850-e851

Intensive Care Unit, Poissy Saint Germain Hospital, 9-10 rue du champ Gaillard, Poissy, France, INSERM U-1018, CESP, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, Villejuif, France, and French Intensive Renal Network (FIRN), Poissy, France Intensive Care Unit, Poissy Saint Germain Hospital, 9-10 rue du champ Gaillard, Poissy, France French Intensive Renal Network (FIRN), Poissy, France, Renal Intensive Care Unit and Kidney Transplantation, Tenon Hospital, Assistance Publique Hôpitaux de Paris, Paris, France, and Medicine Faculty, Sorbonne University, Paris, France French Intensive Renal Network (FIRN), Poissy, France, and Nephrology and Renal Transplantation, Conception Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France.

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http://dx.doi.org/10.1097/CCM.0000000000003923DOI Listing
October 2019
6 Reads

Choice of crystalloid fluid in the treatment of hyperglycemic emergencies: a systematic review protocol.

Syst Rev 2019 09 3;8(1):228. Epub 2019 Sep 3.

Department of Medicine, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 5B2, Canada.

Background: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are life-threatening complications of diabetes mellitus which require prompt treatment with large volume crystalloid fluid administration. A variety of crystalloid fluids is currently available for use and differs in their composition and ion concentrations. While there are potential pros and cons for different crystalloid fluids, it remains unknown if any particular fluid confers a clinical outcome benefit over others in the treatment of hyperglycemic emergencies. Read More

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http://dx.doi.org/10.1186/s13643-019-1130-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720374PMC
September 2019
3 Reads

Care of Children and Adolescents with Diabetes Mellitus and Hyperglycemia in the Inpatient Setting.

Curr Diab Rep 2019 08 23;19(10):85. Epub 2019 Aug 23.

Weill Cornell Medicine, Division of Pediatric Endocrinology, NY Presbyterian Hospital, 505 East 70 Street, New York, NY, 10021, USA.

Purpose Of Review: Children and adolescents with acute hyperglycemia and diabetes mellitus frequently have acute, potentially life-threatening presentations which require high-acuity care in an inpatient and often intensive care setting. This review discusses the evaluation and care of hyperglycemia and diabetes mellitus in hospitalized children in both critical and non-critical care settings, highlighting important differences in their care relative to adults.

Recent Findings: Diabetic ketoacidosis remains highly prevalent at diagnosis among children with type 1 diabetes, and hyperglycemic hyperosmolar state is increasingly prevalent among children with type 2 diabetes. Read More

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http://dx.doi.org/10.1007/s11892-019-1205-7DOI Listing
August 2019
3 Reads

The authors reply.

Crit Care Med 2019 09;47(9):e793-e794

Department of Pharmacy Services, University of California, Davis Health, Sacramento, CA.

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http://dx.doi.org/10.1097/CCM.0000000000003885DOI Listing
September 2019
2 Reads

"High-Intensity" May Not Be the Intent of "Low-Dose" Insulin: Request for Full Protocol.

Crit Care Med 2019 09;47(9):e793-e795

Department of Pharmacy, HSHS St. John's Hospital, Springfield, IL.

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http://dx.doi.org/10.1097/CCM.0000000000003845DOI Listing
September 2019
1 Read

Hyperosmolar hyperglycemic syndrome in pediatric patients.

Emergencias 2019 Ago;31(4):295-296

Servicio de Urgencias, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, España.

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May 2020
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Hyperosmolar hyperglycaemic state (HHS) as the first manifestationof type 2 diabetes in a child.

Pediatr Endocrinol Diabetes Metab 2019 ;25(2):85-89

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

Hyperglycaemic hyperosmolar state (HHS) may occur in young patients with type 1 and type 2 diabetes and in infants with hyperglycaemia. Hyperglycaemic hyperosmolar state is characterised by extremely high glucose concentration, which, by increasing osmotic diuresis, intensifies dehydration. Hyperglycaemic hyperosmolar state criteria include the following: plasma glucose > 600 mg/dl, venous pH > 7. Read More

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http://dx.doi.org/10.5114/pedm.2019.85819DOI Listing
February 2020
2 Reads

Glycemic Disturbances in Pheochromocytoma and Paraganglioma.

Cureus 2019 Apr 27;11(4):e4551. Epub 2019 Apr 27.

Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA.

In this review article, we aimed to analyze the available data on pheochromocytomas and paragangliomas as it pertains to their not as well-recognized association with significant glycemic abnormalities in the preoperative, perioperative, and postoperative settings as well as how they should be managed clinically. Pheochromocytomas are rare adrenal tumors that account for about 0.1% of hypertension. Read More

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http://dx.doi.org/10.7759/cureus.4551DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592834PMC
April 2019
5 Reads

Full recovery from extreme hypernatremia in an elderly woman with hyperosmolar hyperglycemic syndrome and abnormal electroencephalogram.

SAGE Open Med Case Rep 2019 14;7:2050313X19848887. Epub 2019 May 14.

Department of Internal Medicine, Orlando Regional Healthcare, Orlando, FL, USA.

Background: Hyperosmolar hyperglycemic state is a life-threatening endocrine disorder that most commonly affects adults with type 2 diabetes mellitus. The condition results from an osmotic diuresis-induced loss of water exceeding that of sodium. Altered mental status, hypernatremia and hyperglycemia are characteristic features at presentation. Read More

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http://dx.doi.org/10.1177/2050313X19848887DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537048PMC
May 2019
20 Reads

Temporal Trends in the Prevalence of Diabetes Decompensation (Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State) Among Adult Patients Hospitalized with Diabetes Mellitus: A Nationwide Analysis Stratified by Age, Gender, and Race.

Cureus 2019 Apr 1;11(4):e4353. Epub 2019 Apr 1.

Hospitalist, Covenant Medical Center, Waterloo, USA.

Background Disproportionate change in the burden of diabetes mellitus across various subgroups has been reported in the United States. However, changing landscape of the prevalence and mortality of decompensated diabetes (diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS)) remains indistinct across various age, gender, and racial groups of hospitalized diabetics. Methods The National Inpatient Sample (NIS) datasets (2007-2014) were sought to assess the prevalence and temporal trends in decompensated diabetes stratified by age, gender, and race and related in-hospital outcomes among the adult patients hospitalized with diabetes using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Read More

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http://dx.doi.org/10.7759/cureus.4353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550510PMC
April 2019
5 Reads

Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients.

BMJ 2019 05 29;365:l1114. Epub 2019 May 29.

Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome (HHS) are life threatening complications that occur in patients with diabetes. In addition to timely identification of the precipitating cause, the first step in acute management of these disorders includes aggressive administration of intravenous fluids with appropriate replacement of electrolytes (primarily potassium). In patients with diabetic ketoacidosis, this is always followed by administration of insulin, usually via an intravenous insulin infusion that is continued until resolution of ketonemia, but potentially via the subcutaneous route in mild cases. Read More

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http://dx.doi.org/10.1136/bmj.l1114DOI Listing
May 2019
9 Reads

Hyperglycaemic presentations in type 2 diabetes

Aust J Gen Pract 2019 05;48(5):263-267

MBBS, BMedSc, MPHTM, FAFPHM, FRACGP, FACRRM, Clinical Senior Lecturer, Rural Clinical School of Western Australia, Broome, WA

Background: Hyperosmolar hyperglycaemic state (HHS) is a syndrome that occurs in patients with type 2 diabetes mellitus (T2DM) and is comparable to diabetic ketoacidosis (DKA) seen in patients with type 1 diabetes. For a general practitioner working in a rural emergency department, recognition of HHS in a patient presenting with the triad of severe dehydration, hyperglycaemia and hyperosmolality is important to guide management and plan for disposition.

Objectives: This article reviews the hyperglycaemic states that can occur in patients with T2DM. Read More

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http://dx.doi.org/10.31128/AJGP-12-18-4785DOI Listing
May 2019
4 Reads

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

Wien Klin Wochenschr 2019 May;131(Suppl 1):196-199

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
May 2019
20 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
March 2019
10 Reads

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
Publisher Site
http://dx.doi.org/10.1007/s40200-018-0353-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405398PMC
December 2018
11 Reads

Non-ketotic hyperosmolar hyperglycemic chorea.

Rev Assoc Med Bras (1992) 2019 Feb;65(2):127-129

Professor of Neurology, Movement Disorders Division, Irmandade Santa Casa de Misericórdia of Porto Alegre, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brasil.

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http://dx.doi.org/10.1590/1806-9282.65.2.127DOI Listing
February 2019
4 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
13 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
31 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
9 Reads

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 05;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
7 Reads

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
31 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
8 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
12 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
10 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
13 Reads