943 results match your criteria Hyperosmolar Hyperglycemic State

COVID-19 and Combined Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Coma: Report of 11 Cases.

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:23247096211021231

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

We report 11 cases of combined diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic coma (HHNK) in coronavirus 2019 patients who presented to our institution in New Jersey, USA. The median age was 47 years (range 12-88 years). Out of the 11 patients, 7 were male and 4 were female. Read More

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Diabetes emergencies around Ramadan study (DEARS) - A multi-center study of diabetes emergencies admitted before, during and after Ramadan in Malaysia.

Diabetes Res Clin Pract 2021 May 5;175:108854. Epub 2021 May 5.

Department of Medicine, Putrajaya Hospital, Malaysia.

Objective: The objective of this study was to determine admissions for diabetes emergencies among patients who fasted or planned to fast one month before, during and one month after Ramadan 2019 in public hospitals in Malaysia.

Materials And Methods: This was a cross sectional prospective study done in 18 public hospitals in Malaysia from 7/4/2019 to 2/7/2019. Data was collected prospectively with universal sampling. Read More

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An extremely high blood glucose level in a child with hyperglycemic hyperosmolar state and type 1 diabetes.

J Pediatr Endocrinol Metab 2021 May 3. Epub 2021 May 3.

Department of Emergency Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia.

Objectives: Hyperglycemic hyperosmolar state (HHS) is one of the most severe acute complications of diabetes mellitus (DM) characterized by severe hyperglycemia and hyperosmolality without significant ketosis and acidosis. What is new? Since HHS in the pediatric population is rare and potentially life-threatening, every reported case is very valuable for raising awareness among healthcare professionals.

Case Presentation: A 7-year-old boy with previously diagnosed Joubert syndrome was admitted due to vomiting, polydipsia and polyuria started several days earlier. Read More

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Commentary on Extreme Hyperglycemia in an Elderly Patient.

Clin Chem 2021 Apr;67(5):728-729

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

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COVID-19 Vaccine and Hyperosmolar Hyperglycemic State.

Cureus 2021 Mar 26;13(3):e14125. Epub 2021 Mar 26.

Endocrinology, Mercy Hospital Joplin, Joplin, USA.

Coronavirus disease 2019 (COVID-19) is a multi-system disease that causes multiple complications. It is linked to the development of new-onset diabetes or unmasking of underlying diabetes. Despite the uncertain exact mechanism, pancreatic angiotensin-converting enzyme 2 (ACE2) receptor, the main enzyme related to COVID-19 pathophysiology has been implied. Read More

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Influence of Framing: Recruitment to a Diabetes Disease Management Program From an Emergency Department Improves Enrollment and Outcomes.

Cureus 2021 Mar 25;13(3):e14116. Epub 2021 Mar 25.

Emergency Medicine, Northwell Health Long Island Jewish Medical Center, New Hyde Park, USA.

Introduction Disease management programs (DMPs) provide education, self-management skills, care coordination, and frequent clinical assessment and medication adjustment. Our health system's diabetes mellitus (DM) DMP recruited patients from an emergency department (ED) and outpatient settings (primary care physicians' [PCP] and endocrinologists' offices; cold calling patients with poorly-controlled diabetes). We investigated whether recruitment to a DMP from an ED is feasible and effective, hypothesizing such patients would have better enrollment rates, future A1c control, and ED utilization because their receptiveness to change was "framed" by their ED visit. Read More

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Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies.

Adv Ther 2021 05 7;38(5):2491-2512. Epub 2021 Apr 7.

Internal Medicine Department, Instituto de Investigación Biomedica de Malaga-IBIMA, Regional University Hospital of Malaga, Malaga, Spain.

Introduction: To assess the risk of occurrence and potential determinants of metabolic disorders in adult patients treated with second-generation antipsychotics (SGAs) under real-world practice conditions.

Methods: MEDLINE, EMBASE, and PsycInfo were searched in July 2019 from database inception. We included population-based, longitudinal, comparative studies that report the results of the outcomes of interest for adult participants, including diabetes, ketoacidosis, hyperosmolar hyperglycemic state, weight gain/obesity, dyslipidemia, hypertension, and metabolic syndrome. Read More

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A Complicated Case of COVID-19 and Hyperglycemic Hyperosmolar Syndrome in an Adolescent Male.

Horm Res Paediatr 2021 Mar 31:1-5. Epub 2021 Mar 31.

Division of Endocrinology & Diabetes, Department of Pediatrics, Riley Hospital for Children at IU Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Emerging data demonstrate that comorbid conditions and older age are contributing factors to COVID-19 severity in children. Studies involving youth with COVID-19 and diabetes are lacking. We report the case of a critically ill adolescent male with obesity, type 2 diabetes, and COVID-19 who presented with hyperglycemic hyperosmolar syndrome (HHS). Read More

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[Hyperosmolar Hyperglycemic State (HHS) with extreme hyperglycemia and hyperglycemia-induced hyponatremia in a patient with previously known diabetes mellitus type 2].

Lakartidningen 2021 03 26;118. Epub 2021 Mar 26.

överläkare, VO internmedicin, Visby lasarett.

This case report covers a patient presenting unconscious to the emergency department with a serum glucose level of 125.6 mmol/L and an associated hyperglycemia-induced hyponatremia with a sodium level of 101 mmol/L. The glucose level is, to our knowledge, one of the most extreme values described in medical literature. Read More

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Diabetes-related acute metabolic emergencies in COVID-19 patients: a systematic review and meta-analysis.

Diabetol Int 2021 Mar 23:1-15. Epub 2021 Mar 23.

Department of Anatomy and Surgical Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Aims: COVID-19 is associated with diabetic ketoacidosis (DKA), hyperglycaemic hyperosmolar state (HHS) and euglycaemic DKA (EDKA); however, evidence regarding parameters affecting outcome and mortality rates is scarce.

Methods: A systematic literature review was conducted using EMBASE, PubMed/Medline, and Google Scholar from January 2020 to 7 January 2021 to identify all studies describing clinical profile, outcome and mortality rates regarding DKA, HHS, DKA/HHS and EDKA cases in COVID-19 patients. The appropriate Joanna Briggs Institute tools were used for quality assessment; quality of evidence was approached using GRADE. Read More

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Capecitabine-induced hyperosmolar hyperglycaemic state.

BMJ Case Rep 2021 Mar 24;14(3). Epub 2021 Mar 24.

Medicine, Division of Endocrinology, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada

An elderly woman with metastatic breast cancer was admitted with hyperglycaemic hyperosmolar state (HHS) and an elevated haemoglobin A1C. For 1 week, she had experienced confusion, nausea and frequent urination. Preceding this, she had completed seven cycles of capecitabine chemotherapy for her breast cancer. Read More

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Prolonged Altered Mental Status in a Diabetic Hemodialysis Patient.

Cureus 2021 Feb 4;13(2):e13132. Epub 2021 Feb 4.

Internal Medicine/Nephrology, Metropolitan Hospital Center, New York Medical College, New York, USA.

Osmotic demyelination syndrome (ODS) is a demyelinating disorder of the central nervous system. It usually occurs with rapid correction of severe chronic hyponatremia. ODS is rarely seen as a complication of hyperglycemia. Read More

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February 2021

Neurological Complications of Endocrine Emergencies.

Curr Neurol Neurosci Rep 2021 03 11;21(5):21. Epub 2021 Mar 11.

Department of Neurology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.

Purpose Of Review: Endocrine disorders are the result of insufficient or excessive hormonal production. The clinical course is long, and the manifestations are nonspecific due to the systemic effect of hormones across many organs and systems including the nervous system. This is a narrative review of the recent evidence of the diagnosis and treatment approach of these medical and neurological emergencies. Read More

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50 Years Ago in TheJournalofPediatrics: Diazoxide-Induced Hyperosmolar Nonketotic Coma: Contemporary Genetic Insights.

J Pediatr 2021 03;230:31

Division of Neonatal-Perinatal Medicine, Women and Infant's Hospital of Rhode Island, Providence, Rhode Island.

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Hyperglycemic Crisis Characteristics and Outcome of Care in Adult Patients without and with a History of Diabetes in Tigrai, Ethiopia: Comparative Study.

Diabetes Metab Syndr Obes 2021 9;14:547-556. Epub 2021 Feb 9.

Department of Community Health and Preventive Medicines, Addis Ababa University, Addis Ababa, Ethiopia.

Objective: To compare hyperglycemic crisis characteristics and outcomes of care in adult patients without and with a history of diabetes in Tigrai, Ethiopia.

Methods: A retrospective record review of diabetes patients, 196 without and 393 with a history of diabetes who had been treated in the medical wards from September 1/2017 to August 31/2018, aged 18 years and above was included. An independent-samples -test/Mann-Whitney tests, χ-test, and logistic regression analysis were used to analyze the data using SPSS version 25. Read More

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February 2021

Heterogeneity in presentation of hyperglycaemia during COVID-19 pandemic: A proposed classification.

Diabetes Metab Syndr 2021 Jan-Feb;15(1):403-406. Epub 2021 Jan 31.

Centre of Nutrition & Metabolic Research (C-NET), National Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, India; Diabetes Foundation (India), SDA, New Delhi, India; Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chirag Enclave, Nehru Place, New Delhi, India.

Diabetes and hyperglycemia occurring during COVID-19 era have implications for COVID-19 related morbidity/mortality. In this brief review, we have attempted to categorise and classify such heterogenous hyperglycemic states. During COVID-19 pandemic broadly two types of hyperglycemia were seen: one in patients without COVID-19 infection and second in patients with COVID-19 infection. Read More

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Cholinergic Crisis Owing to Distigmine Bromide Complicated by Hyperosmolar Hyperglycemic State.

Intern Med 2021 Feb 15. Epub 2021 Feb 15.

Department of Internal Medicine, Diabetes Center, Okayama Saiseikai General Hospital, Japan.

Distigmine bromide is widely used to treat neurogenic bladder and causes cholinergic crisis, a serious side effect. We herein report about a patient with distigmine bromide-induced cholinergic crisis complicated by a hyperosmolar hyperglycemic state (HHS). On admission, the patient was diagnosed with HHS based on the medical history and laboratory test results. Read More

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February 2021

Comparative study of emphysematous pyelonephritis and pyelonephritis in type 2 diabetes: a single-centre experience.

J Diabetes Metab Disord 2020 Dec 28;19(2):1273-1282. Epub 2020 Sep 28.

Department of Microbiology, Govt. Medical College, Srinagar, J&K India.

Purpose: Emphysematous pyelonephritis (EPN) patients with type 2 diabetes (T2D) have severe complications and high morbidity with poor prognosis as compared to Pyelonephritis. The aim was to study clinical features, microbiological profile, complications of EPN and pyelonephritis in T2D patients.

Methods: This was a hospital-based prospective study done on 200 T2D patients with upper UTI. Read More

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December 2020

Hyperglycaemic hyperosmolar state: first presentation of type 1 diabetes mellitus in an adolescent with complex medical needs.

BMJ Case Rep 2021 Feb 4;14(2). Epub 2021 Feb 4.

Paediatrics, Northampton General Hospital NHS Trust, Northampton, Northamptonshire, UK.

This is a case of hyperglycaemic hyperosmolar state (HHS) as first presentation of type 1 diabetes mellitus in a 14-year-old girl with background complex medical needs. She presented with marked hyperglycaemia (56 mmol/L) without significant ketonaemia (2.6 mmol/L) and serum hyperosmolality (426 mOsm/kg). Read More

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February 2021

COVID-19 and emergencies in patients with diabetes: two case reports.

J Med Case Rep 2021 Feb 2;15(1):57. Epub 2021 Feb 2.

Department of Internal Medicine, Indira Gandhi Memorial Hospital, Male', Maldives.

Background: Maldives reported its first Coronavirus disease 2019 (COVID-19) case on March 7th, 2020. Since then more than 9400 positive cases and 33 deaths have been reported. Recently studies have shown that COVID-19 patients with diabetes had a poor prognosis and a higher mortality rate when compared to the non-diabetic patients. Read More

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February 2021

Four Cases of Maturity Onset Diabetes of the Young (MODY) Type 5 Associated with Mutations in the Hepatocyte Nuclear Factor 1 Beta (HNF1B) Gene Presenting in a 13-Year-Old Boy and in Adult Men Aged 33, 34, and 35 Years in Poland.

Am J Case Rep 2021 Feb 2;22:e928994. Epub 2021 Feb 2.

Department of Pediatrics, Univiersity of Zielona Góra, Zielona Góra, Poland.

BACKGROUND Maturity onset diabetes of the young (MODY) usually presents in patients under the age of 25 years and is an autosomal dominant condition associated with mutations in the hepatocyte nuclear factor 1 alpha gene, glucokinase gene, or hepatocyte nuclear factor 4 alpha gene. This report is of a series of 4 cases from Poland of MODY type 5 associated with mutations in the hepatocyte nuclear factor 1 beta (HNF1B) gene, including a 13-year-old boy and adult men aged 33, 34, and 35 years. CASE REPORT Three cases were diagnosed late, in patients in their mid-thirties. Read More

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February 2021

Reversible cerebral vasoconstriction syndrome associated with hyperosmolar hyperglycaemic state: A case report and literature review.

J Clin Neurosci 2021 Feb 6;84:38-41. Epub 2021 Jan 6.

Department of Neurosurgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3000, Australia; Department of Surgery, University of Melbourne, Parkville, VIC 3010, Australia. Electronic address:

Reversible cerebral vasoconstriction syndrome (RCVS) is an uncommon disorder characterised by thunderclap headache and self-resolving angiographic vasospasm in the presence or absence of neurological deficit. We present the first case of RCVS likely precipitated by a complex array of confounding factors including a hyperosmolar hyperglycaemic state (HHS), induction chemotherapy with cyclophosphamide, non-Hodgkin's lymphoma, pancytopenia and previous blood transfusions. However, the clinical presentation in this case of altered conscious state followed by thunderclap headache was highly suggestive of HHS being the crucial inciting factor. Read More

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February 2021

Recurrent hyperglycemic hyperosmolar state after re-administration of dose-reduced ceritinib, an anaplastic lymphoma kinase inhibitor.

Diabetol Int 2021 Jan 2;12(1):126-129. Epub 2020 Jun 2.

Department of Diabetes and Endocrinology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602 Japan.

Ceritinib is a second-generation anaplastic lymphoma kinase (ALK) inhibitor with clinical activity in crizotinib-resistant ALK-positive non-small cell lung cancer and in treatment-naïve ALK-positive disease. Hyperglycemia is a known adverse event, but the mechanism by which ceritinib causes hyperglycemia is unknown, and whether ceritinib causes hyperglycemic emergencies is unclear. Here, we report the case of a patient with a hyperglycemic hyperosmolar state (HHS) recurrence after the re-administration of dose-reduced ceritinib. Read More

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January 2021

Similar Cardiovascular Outcomes Between Insulin Detemir and Insulin Glargine In Type 2 Diabetic Patients With Extremely Atherosclerotic Cardiovascular Disease Risks.

Endocr Pract 2020 Aug;26(8):818-829

the Division of Endocrinology and Metabolism, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; the College of Medicine, Chang Gung University, Taoyuan, Taiwan.. Electronic address:

Objective: The cardiovascular outcomes of insulin detemir in patients with type 2 diabetes mellitus (T2DM) after acute coronary syndrome (ACS) or acute ischemic stroke (AIS) are unclear. The aim of our real-life cohort study was to evaluate the cardiovascular outcomes of insulin detemir (IDet) versus insulin glargine (IGlar) in T2DM patients after ACS or AIS.

Methods: A retrospective cohort study was conducted between June 1, 2005, and December 31, 2013, utilizing the Taiwan National Health Insurance Research Database. Read More

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Extreme Hyperglycemia in an Elderly Patient.

Clin Chem 2021 Apr;67(5):724-728

Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, AZ, USA.

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Clinical profiles, outcomes and risk factors among type 2 diabetic inpatients with diabetic ketoacidosis and hyperglycemic hyperosmolar state: a hospital-based analysis over a 6-year period.

BMC Endocr Disord 2020 Dec 14;20(1):182. Epub 2020 Dec 14.

Department of Endocrinology, Tongji Hospital of Tongji University, Tongji University School of Medicine, Shanghai, 200065, China.

Objective: Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the two most common hyperglycemic emergencies (HEs) associated with diabetes mellitus. Individuals with HEs can present with combined features of DKA and HHS. The objective of this study is to assess the clinical characteristics, therapeutic outcomes, and associated predisposing factors of type 2 diabetic patients with isolated or combined HEs in China. Read More

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December 2020

Ocular flutter and myoclonus in hyperosmolar hyperglycemic state.

Acta Neurol Belg 2021 Apr 10;121(2):595-596. Epub 2020 Nov 10.

Neurology Department, Leuven University Hospital, Leuven, Belgium.

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Mesenteric venous thrombosis: A lethal complication of hyperglycemic crises.

Am J Health Syst Pharm 2021 01;78(2):105-107

Robert Wood Johnson University Hospital Somerset, Somerville, NJ.

Purpose: Although hyperglycemic crises can lead to a hypercoagulable state, few instances of associated mesenteric venous thrombosis (MVT) have been reported. Worsening abdominal pain in the context of shock requiring vasopressor support should prompt urgent further investigation.

Summary: A 44-year-old Hispanic male arrived at an emergency department with chief complaints of lethargy, polydipsia, and polyuria. Read More

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January 2021


AACE Clin Case Rep 2020 Sep-Oct;6(5):e265-e268. Epub 2020 Sep 21.

Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania.

Objective: Recognize a rare endocrinological side effect of a drug, budesonide, which surfaced as a result of a major procedure.

Methods: We describe a patient who presented with hyperglycemic hyperosmolar state (HHS) likely as a result of the bypass of first-pass metabolism due to budesonide treatment after a transjugular intrahepatic portosystemic shunt (TIPS) procedure.

Results: A 62-year-old female with history of combined variable immunodeficiency complicated by colitis (managed by 9 mg budesonide by mouth daily) and refractory ascites secondary to non-cirrhotic portal hypertension (status post-TIPS 3 weeks prior) presented to the hospital with HHS. Read More

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September 2020