994 results match your criteria Pediatrics Diabetic Ketoacidosis


Diabetic ketoacidosis at presentation of type 1 diabetes in children in Canada during the COVID-19 pandemic.

Paediatr Child Health 2021 Jul 8;26(4):208-209. Epub 2021 Apr 8.

Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.

Type 1 diabetes is a common chronic illness in childhood. Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes. Early recognition of symptoms of diabetes and immediate initiation of treatment are important factors in preventing DKA at first presentation. Read More

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Case-Based Curriculum for Pediatric Residents in Diabetes Fundamentals.

MedEdPORTAL 2021 05 27;17:11157. Epub 2021 May 27.

Assistant Professor, Department of Pediatrics, Section of Diabetes and Endocrinology and Section of Nutrition, Baylor College of Medicine and Texas Children's Hospital.

Introduction: Pediatricians are at the front line to diagnose new-onset diabetes and treat acute diabetes complications in children. Pediatric residents need a strong foundation in recognizing and managing pediatric diabetes, imposing a demand for a structured, comprehensive pediatric-specific diabetes curriculum.

Methods: This three-module case-based curriculum focused on diabetes fundamentals relevant to pediatricians in the outpatient and inpatient settings. Read More

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Variability in Emergency Management of Pediatric Diabetic Ketoacidosis.

Can J Diabetes 2021 Mar 16. Epub 2021 Mar 16.

Department of Pediatrics, Queen's University, Kingston, Ontario, Canada.

Objectives: Our aim in this study was to identify pediatric patients presenting in diabetic ketoacidosis (DKA) who received initial treatment inconsistent with current guidelines, and then to track associated complications.

Methods: This retrospective chart review examined 47 pediatric patients admitted to our institution with DKA, including those transferred from community hospitals. Primary outcome measures were exposure to treatment-related risk factors for cerebral edema (CE), including administration of an intravenous (IV) insulin bolus, IV bicarbonate, insulin within 1 hour of IV fluid start and non-NPO (nil per os) status. Read More

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Forecast modeling to identify changes in pediatric emergency department utilization during the COVID-19 pandemic.

Am J Emerg Med 2021 May 21;49:142-147. Epub 2021 May 21.

Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States of America; Division of Health Informatics, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States of America.

Objective: To identify trends in pediatric emergency department (ED) utilization following the COVID-19 pandemic.

Methods: We performed a cross-sectional study from 37 geographically diverse US children's hospitals. We included ED encounters between January 1, 2010 and December 31, 2020, transformed into time-series data. Read More

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The Perfect Storm: Rapid Progression of Diabetic Ketoacidosis in Pediatric Diabetes in the Setting of COVID-19.

AACE Clin Case Rep 2021 Jun 4. Epub 2021 Jun 4.

Duke University Hospital, Department of Pediatric Critical Care 5260Y Duke North DUMC Box 3046 Durham, NC 27710.

Objective: The coronavirus disease-2019 (COVID-19) pandemic has introduced countless challenges to the medical field. While pediatric patients are reported to have lower rates of COVID-19 mortality, the presence of pre-existing conditions can heighten the severity of their clinical presentation.

Case Report: Our patient, a six year old female with known type 1 diabetes, presented with acute onset of abnormal breathing and altered mental status. Read More

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Characteristics of voluntary reporting of adverse drug events related to antipsychotics in Australia: 14-year analysis.

Ther Adv Drug Saf 2021 29;12:20420986211012854. Epub 2021 May 29.

Paediatrician, Waverley Paediatrics, Glen Waverley, Victoria, Australia.

Background: Retrospective analyses of large databases of treated patients can provide useful links to the presence of drug misuse or rare and infrequent adverse effects, such as agranulocytosis, diabetic ketoacidosis or neuroleptic malignant syndrome. The aim of this study is to describe the adverse effects to antipsychotics reported in the Australian Database of Adverse Event Notifications (DAEN).

Methods: Data were collected from the DAEN - a spontaneous reporting database. Read More

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Multicenter Trial of a Tubeless, On-Body Automated Insulin Delivery System With Customizable Glycemic Targets in Pediatric and Adult Participants With Type 1 Diabetes.

Diabetes Care 2021 Jun 7. Epub 2021 Jun 7.

Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Stanford, CA.

Objective: Advances in diabetes technology have transformed the treatment paradigm for type 1 diabetes, yet the burden of disease is significant. We report on a pivotal safety study of the first tubeless, on-body automated insulin delivery system with customizable glycemic targets.

Research Design And Methods: This single-arm, multicenter, prospective study enrolled 112 children (age 6-13. Read More

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Increase in Prevalence of Diabetic Ketoacidosis at Diagnosis Among Youth With Type 1 Diabetes: The SEARCH for Diabetes in Youth Study.

Diabetes Care 2021 Jun 7. Epub 2021 Jun 7.

Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO.

Objective: We previously reported a high (30%) but stable prevalence of diabetic ketoacidosis (DKA) at youth-onset diagnosis of type 1 diabetes (2002 and 2010). Given the changing demographics of youth-onset type 1 diabetes, we sought to evaluate temporal trends in the prevalence of DKA at diagnosis of type 1 diabetes from 2010 to 2016 among youth <20 years of age and evaluate whether any change observed was associated with changes in sociodemographic distribution of those recently diagnosed.

Research Design And Methods: We calculated prevalence of DKA within 1 month of type 1 diabetes diagnosis by year and evaluated trends over time (2010-2016) ( = 7,612 incident diabetes cases; mean [SD] age 10. Read More

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A worldwide perspective on COVID-19 and diabetes management in 22,820 children from the SWEET project: diabetic ketoacidosis rates increase and glycemic control is maintained.

Diabetes Technol Ther 2021 Jun 4. Epub 2021 Jun 4.

University Medical Centre Ljubljana, 14Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, Ljubljana, Slovenia;

Aims: To investigate the short-term effects of the first wave of COVID-19 on clinical parameters in children with type 1 diabetes (T1D) from 82 worldwide centres participating in the SWEET registry.

Methods: Aggregated data per person with T1D ≤ 21 years of age were compared between May/June 2020 (first wave), August/September 2020 (after wave) and the same periods in 2019. Hierarchic linear and logistic regression models were applied. Read More

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Prevalence and special clinical and biochemical characteristics of familial type 1 (insulin dependent) diabetes mellitus in pediatric patients in a tertiary care setting.

Int J Pediatr Adolesc Med 2021 Jun 23;8(2):107-111. Epub 2020 Nov 23.

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia.

Background And Objectives: The hereditable nature of type 1 diabetes mellitus (T1DM) makes it a condition that is in some cases shared among siblings. Studies that focus on the epidemiology of T1DM among siblings are scarce. The primary focus of the study is to estimate the prevalence of familial T1DM among siblings and the secondary focus is to identify the presence of any special clinical or biochemical characteristics specific to this entity. Read More

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Metabolomic profiling of patients with A-β+ Ketosis-Prone Diabetes during diabetic ketoacidosis.

Diabetes 2021 May 21. Epub 2021 May 21.

Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX;

When stable and near-normoglycemic, "A-β+" Ketosis-Prone Diabetes (KPD) patients manifest accelerated leucine catabolism and blunted ketone oxidation, which may underlie their proclivity to develop diabetic ketoacidosis (DKA).To understand metabolic derangements in A-β+ KPD patients during DKA, we compared serum metabolomic profiles of adults during acute hyperglycemic crises, without (n=21) or with (n=74) DKA, and healthy controls (n=17). Based on GAD65Ab status, C-peptide and clinical features, 53 DKA patients were denoted "KPD" and 21 "type 1 diabetes" (T1D); 21 non-ketotic patients were "type 2 diabetes" (T2D). Read More

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A Multi-Intervention Campaign Lowers Pediatric and Young Adult Diabetic Ketoacidosis Hospitalizations in a Canadian Province.

Can J Diabetes 2021 Apr 20. Epub 2021 Apr 20.

Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada; Janeway Pediatric Research Unit, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada; Division of Children and Women's Health, Eastern Health, St. John's, Newfoundland and Labrador, Canada. Electronic address:

Objectives: The Newfoundland and Labrador diabetic ketoacidosis Project (NLdkaP) is a multi-intervention, province-wide project aimed at lowering rates of diabetic ketoacidosis (DKA) within the pediatric and young adult populations.

Methods: The NLdkaP interventions were first selected, developed and implemented. We then conducted a retrospective study of hospitalization data over three 2-year periods: pre-, during and post-NLdkaP. Read More

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Hypertriglyceridemia with acute pancreatitis in a 14-year-old girl with diabetic ketoacidosis.

Ann Pediatr Endocrinol Metab 2021 May 14. Epub 2021 May 14.

Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Diabetic ketoacidosis (DKA) is a medically fatal condition in poorly controlled hyperglycemia or newly diagnosed diabetes mellitus. Severe hypertriglyceridemia (HTG) is an uncommon complication of DKA and can be associated with acute pancreatitis (AP). We present the clinical manifestations, laboratory findings, and management of AP associated with HTG in a 14-year-old girl with DKA. Read More

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MiniMed780G Insulin pump system with smartphone connectivity for the treatment of type 1 diabetes: overview of its safety and efficacy.

Expert Rev Med Devices 2021 May 31:1-6. Epub 2021 May 31.

Department of Medicine, Renaissance School of Medicine at Stony Brook University, NY, USA.

: Despite significant advances in diabetes care over the last three decades, the majority of people living with T1D are not meeting established metabolic goals. Automated insulin delivery can help achieve these metabolic goals (HbA1c and TIR).: This review examines the new features and available data regarding safety and efficacy of the MiniMed™ 780 G, a second-generation advanced hybrid closed-loop system. Read More

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Ketoacidosis as a primary manifestation of COVID-19.

Pediatr Endocrinol Diabetes Metab 2021 May 19. Epub 2021 May 19.

Dental School, Zahedan University of Medical Sciences, Zahedan, Iran.

Introduction: Diabetic ketoacidosis is the most important metabolic emergency in children. Children mimic many syndromes with a combination of nonspecific symptoms during the COVID-19 pandemic. Many syndromes are triggered by changes in children's body conditions. Read More

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Barriers to Technology Use and Endocrinology Care for Underserved Communities With Type 1 Diabetes.

Diabetes Care 2021 May 17. Epub 2021 May 17.

Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University, Stanford, CA.

Objective: Disparities in type 1 diabetes related to use of technologies like continuous glucose monitors (CGMs) and utilization of diabetes care are pronounced based on socioeconomic status (SES), race, and ethnicity. However, systematic reports of perspectives from patients in vulnerable communities regarding barriers are limited.

Research Design And Methods: To better understand barriers, focus groups were conducted in Florida and California with adults ≥18 years old with type 1 diabetes with selection criteria including hospitalization for diabetic ketoacidosis, HbA >9%, and/or receiving care at a Federally Qualified Health Center. Read More

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Frequency of Autoantibody-Negative Type 1 Diabetes in Children, Adolescents, and Young Adults During the First Wave of the COVID-19 Pandemic in Germany.

Diabetes Care 2021 May 14. Epub 2021 May 14.

German Center for Diabetes Research (DZD) , Munich-Neuherberg, Germany.

Objective: The aim of this study was to investigate the frequency of newly diagnosed type 1 diabetes without evidence of autoimmunity and the respective frequencies of ketoacidosis in children, adolescents, and young adults during the coronavirus disease 2019 (COVID-19) pandemic in Germany compared with the previous decade.

Research Design And Methods: Based on data from the German Diabetes Prospective Follow-up Registry (DPV), we compared data from 715 children, adolescents, and young adults, newly diagnosed with type 1 diabetes during the COVID-19 pandemic in Germany between 1 March and 30 June 2020, with data from 5,428 children, adolescents, and young adults of the same periods from 2011 to 2019. Adjusted differences and relative risks (RRs) of negative β-cell autoantibody test results and diabetic ketoacidosis were estimated using multivariable log-binomial regression analysis. Read More

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Delayed referral is common even when new-onset diabetes is suspected in children. A Swedish prospective observational study of diabetic ketoacidosis at onset of Type 1 diabetes.

Pediatr Diabetes 2021 May 12. Epub 2021 May 12.

Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

Objective: Delayed treatment for new-onset diabetes Type 1 (T1D) can lead to diabetic ketoacidosis (DKA) with potentially devastating consequences. This prospective observational study aimed to characterize pediatric patients with DKA at hospital admission, regarding parental awareness of diabetes-related symptoms and delayed referrals from primary health care providers to pediatric emergency wards.

Research Design And Methods: Patients 0-18 years admitted to hospital with new-onset T1D and DKA between 2015 and 2017 were invited to participate. Read More

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Fluid and electrolyte therapy in childhood diabetic ketoacidosis management: A rationale for new national guideline.

Diabet Med 2021 May 8:e14595. Epub 2021 May 8.

Paediatric Department, Southport and Ormskirk NHS Trust, Ormskirk, UK.

Fluid and electrolyte therapy in childhood diabetic ketoacidosis (DKA) management has been controversial. Previous National Institute for Health and Care Excellence (NICE) 2015 guidance advocated a restricted fluid regimen while more recent guidelines have advocated a more liberal approach to fluid replacement in DKA. At the core of the debate is the need to avoid developing cerebral oedema as a complication. Read More

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National Trends in Pediatric Admissions for Diabetic Ketoacidosis, 2006-2016.

J Clin Endocrinol Metab 2021 May 4. Epub 2021 May 4.

Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles.

Background And Objectives: Diabetic ketoacidosis (DKA) rates in the US are rising. Prior studies suggest higher rates in younger populations, but no studies have evaluated national trends in pediatric populations and differences by subgroups. As such, we sought to examine national trends in pediatric DKA. 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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Myocardial injury in a pediatric patient with diabetic ketoacidosis: A case report.

Medicine (Baltimore) 2021 Apr;100(17):e25702

Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

Rationale: Diabetic ketoacidosis (DKA) can cause several complications. Among them, cardiac complications are the most fatal and difficult to detect. Cardiac markers are prognostic factors for morbidity and mortality in adult patients with DKA. Read More

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Spike in Diabetic Ketoacidosis Rates in Pediatric Type 2 Diabetes During the COVID-19 Pandemic.

Diabetes Care 2021 Apr 26. Epub 2021 Apr 26.

Diabetes & Obesity Program, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) on the incidence of new-onset type 2 diabetes and diabetic ketoacidosis (DKA) is unclear. It is unknown whether the coincidence of DKA noted in adult patients with type 2 diabetes is an issue for youth during the coronavirus disease 2019 pandemic.

Research Design And Methods: A retrospective single-center medical record review was conducted in a large, urban children's hospital of pediatric subjects presenting with new-onset type 2 diabetes between March and August of 2018 to 2020. Read More

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Clinical characteristics and outcome of hospitalized children and adolescent patients with type 1 diabetes during the COVID-19 pandemic: data from a single center surveillance study in Egypt.

J Pediatr Endocrinol Metab 2021 Apr 22. Epub 2021 Apr 22.

Division of Pediatric and Adolescent Diabetes Unit (PADU), Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Objectives: COVID-19 pandemic significantly impacted the diagnosis of type 1 diabetes and its acute complications. Thus, the study aimed to evaluate the characteristics of pediatric patients with type 1 diabetes hospitalized during the first wave of the pandemic and the prevalence of new onset diabetes among patients with evidence of COVID-19 infection.

Methods: A single-center surveillance study included all patients with diabetes admitted to Children's Hospital, Ain Shams University, in Egypt between May to August 2020. Read More

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Application of Nano-Insulin Pump in Children with Diabetic Ketoacidosis.

J Nanosci Nanotechnol 2021 10;21(10):5051-5056

Department of Pediatrics, The First Affiliated Hospital of Jiamusi University, Jiamusi 154000, Heilongjiang, PR China.

Type 1 diabetes is an insulin-dependent type of diabetes that is most common among children. Due to absolute deficiency of insulin in patients, diabetic ketoacidosis (DKA) can easily ensue. Insulin pump can simulate the physiological secretion of islet, but increases the risk of pain and infection in children due to its traumatic effect. Read More

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October 2021

The Impact of COVID-19 Pandemic Lockdown on the Incidence of New-Onset Type 1 Diabetes and Ketoacidosis Among Saudi Children.

Front Endocrinol (Lausanne) 2021 1;12:669302. Epub 2021 Apr 1.

Pediatric Endocrinology Division, Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Background: Overburdened healthcare systems during the coronavirus disease (COVID-19) pandemic led to suboptimal chronic disease management, including that of pediatric type 1 diabetes mellitus (T1DM). The pandemic also caused delayed detection of new-onset diabetes in children; this increased the risk and severity of diabetic ketoacidosis (DKA). We therefore investigated the frequency of new-onset pediatric T1DM and DKA in Saudi Arabia during the COVID-19 pandemic and compared it to the same period in 2019. Read More

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Acute Kidney Injury in Children with Diabetic Ketoacidosis: Risk Factors and Outcome.

Indian J Pediatr 2021 06 16;88(6):542-543. Epub 2021 Apr 16.

Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India.

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Rapid Adoption of Telemedicine Along with Emergent Use of Continuous Glucose Monitors in the Ambulatory Care of Young Persons with New-Onset Type 1 Diabetes in the Time of COVID-19: A Case Series.

Telemed J E Health 2021 Apr 15. Epub 2021 Apr 15.

Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Boston, Massachusetts, USA.

The COVID-19 pandemic has caused strain on hospital systems and potential delay in diagnosis of type 1 diabetes (T1D). Outpatient diagnosis and treatment of metabolically stable young persons with new-onset T1D have been shown to be equivalent to inpatient. We describe an approach to outpatient management of newly diagnosed T1D during the COVID-19 pandemic using an interdisciplinary team, telemedicine, and diabetes technologies including rapid implementation of continuous glucose monitoring (CGM). Read More

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