9,896 results match your criteria diabetic ketoacidosis


Sodium-Glucose Cotransporter-2 Inhibitor-Associated Euglycemic Diabetic Ketoacidosis After Orthotopic Heart Transplant in a Prediabetic Patient: A Case Report.

Transplant Proc 2021 Sep 13. Epub 2021 Sep 13.

Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, California.

Postoperative euglycemic diabetic ketoacidosis (euDKA) associated with sodium-glucose cotransporter-2 (SGLT2) inhibitor use has been well-documented and carries a Food and Drug Administration recommendation to hold SGLT2 inhibitors 3 to 4 days before a planned surgical procedure. Unfortunately, many surgical procedures, such as orthotopic heart transplant (OHT), are unplanned and unpredictable. With the increasing use of SGLT2 inhibitors in diabetic and non-diabetic heart failure patients, new challenges in patient management and perioperative risk have arisen. Read More

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September 2021

Pancreatic β-cell fate in subjects with COVID-19.

Authors:
Jun Shirakawa

J Diabetes Investig 2021 Sep 16. Epub 2021 Sep 16.

Laboratory of Diabetes and Metabolic Disorders, Institute for Molecular and Cellular Regulation (IMCR), Gunma University, Maebashi, 371-8510, Japan.

Subjects with coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), are still increasing worldwide as of August 2021. The association of COVID-19 with diabetes has been reported in the context of severity, complications such as diabetic ketoacidosis, and new onset of diabetes. Impairment of insulin-producing pancreatic β-cells is a key contributing factor to the abovementioned diabetic pathogenesis by COVID-19. Read More

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September 2021

Hyperosmolar Hyperglycaemic State and Diabetic Ketoacidosis in Nivolumab-Induced Insulin-Dependent Diabetes Mellitus.

Eur J Case Rep Intern Med 2021 13;8(8):002756. Epub 2021 Aug 13.

Department of Endocrinology, Qatar Metabolic Institute Hamad Medical Corporation, Qatar.

Nivolumab is a monoclonal antibody directed against programmed cell death-1 receptor. It has an increasing application in the treatment of various advanced metastatic cancers. The incidence of autoimmune side effects associated with such agents is expected to increase. Read More

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Sodium-Glucose Co-transporter 2 Inhibitor-Associated Euglycemic Diabetic Ketoacidosis After Bariatric Surgery: A Case and Literature Review.

Cureus 2021 Aug 11;13(8):e17093. Epub 2021 Aug 11.

Nephrology, Ascension St. John Hospital, Detroit, USA.

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce cardiovascular, kidney, and overall mortality. SGLT2i are also associated with a rare adverse event, euglycemic diabetic ketoacidosis (EDKA). This report describes a case of EDKA one day after bariatric surgery in a 51-year-old female with type 2 diabetes mellitus managed with the SGLT2i, canagliflozin. Read More

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Diabetes Ketoacidosis Complicating as Wrist Drop: A Case Report on Acute Motor Neuropathy.

Cureus 2021 Aug 11;13(8):e17081. Epub 2021 Aug 11.

General Medicine, Government Medical College and Hospital, Chandigarh, IND.

Diabetic ketoacidosis (DKA) is an acute and major complication of diabetes mellitus. Neurological complications can be seen at any time during the course of illness and range from decreased consciousness to ischemic or hemorrhagic stroke. Acute neuropathy is very rare in this milieu. Read More

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Diabetes During the Fasting Month of Ramadan: Is Telemedicine as Efficient as Conventional Follow-Up? Results from a Moroccan Comparative Study.

Diabetes Metab Syndr Obes 2021 8;14:3959-3964. Epub 2021 Sep 8.

Department of Endocrinology Diabetology Metabolic Disease and Nutrition, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco.

Aim: During the COVID-19 pandemic, access to health care was affected by the lockdown period. To overcome this situation, telemedicine is an alternative to conventional follow-up for patients with diabetes during the fasting month of Ramadan. The aim of this study is to compare the effectiveness of telemedicine consultation of diabetic patients during Ramadan compared with conventional follow-up. Read More

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September 2021

Plasmapheresis as an Early Treatment for Severe Hypertriglyceridemia, Acute Pancreatitis, and Diabetic Ketoacidosis.

AACE Clin Case Rep 2021 Sep-Oct;7(5):315-319. Epub 2021 Apr 6.

Department of Pediatrics, Division of Pediatric Endocrinology, Yale University School of Medicine, New Haven, Connecticut.

Objective: Severe hypertriglyceridemia (SHTG; plasma triglycerides >1000 mg/dL) is a rare but serious complication in children who develop diabetic ketoacidosis (DKA) from uncontrolled or new-onset type 1 diabetes.

Methods: We present the case of a severely malnourished 16-year-old with a 10-month history of presumed type 2 diabetes managed with lifestyle modifications and metformin, who presented with SHTG, acute pancreatitis, and DKA. On examination, there was no evidence of lipemia retinalis, cutaneous xanthomas, or xanthelasma. Read More

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Mycophenolate Mofetil and Plasmapheresis: A Treatment Option for Severe Insulin Resistance caused by Insulin Antibodies.

AACE Clin Case Rep 2021 Sep-Oct;7(5):307-309. Epub 2021 Mar 13.

Division of Endocrinology, Diabetes and Metabolism, Icahn School of Medicine at Mount Sinai, New York, New York.

Objective: Insulin antibody (IA)-mediated insulin resistance (IR) is a rare condition for which immunosuppressive regimens have been described. However, these raise the risk of infection, and the drugs may not be effectively metabolized in patients with liver disease. A 61-year old male with type 2 diabetes mellitus and antibody-mediated IR who required >800 units of daily insulin presented with acute decompensation of his preexisting cirrhosis from recurrent diabetic ketoacidosis. Read More

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The Red Blood Cell Distribution Width-Albumin Ratio Was a Potential Prognostic Biomarker for Diabetic Ketoacidosis.

Int J Gen Med 2021 7;14:5375-5380. Epub 2021 Sep 7.

Department of Endocrinology, Yanbian University Hospital, Yanji, Jilin Province, People's Republic of China.

Background: The red blood cell distribution width (RDW)-albumin ratio (RA) is a new biomarker, which is d-efined as RDW divided by albumin. This study aimed at determining the prognostic values of RA for diabetic ketoacidosis (DKA).

Methods: Data were obtained from Medical Information Mart for Intensive Care Database III V1. Read More

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September 2021

First report of COVID-19-associated rhino-orbito-cerebral mucormycosis in pediatric patients with type 1 diabetes mellitus.

J Mycol Med 2021 Sep 4;31(4):101203. Epub 2021 Sep 4.

Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India. Electronic address:

Coronavirus disease 2019 (COVID-19) is a major public health problem worldwide. These patients are at increased risk of developing secondary infections due to a combination of virus- and drug-induced immunosuppression. Recently, several countries have reported an emergence of COVID-19 associated mucormycosis (CAM), particularly among patients with uncontrolled diabetes, with India reporting an alarming increase in rhino-orbito-cerebral mucormycosis (ROCM) in post-COVID cases. Read More

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September 2021

Severe Diabetic Ketoacidosis After the Second Dose of mRNA-1273 COVID-19 Vaccine.

J Diabetes Sci Technol 2021 Sep 11:19322968211043552. Epub 2021 Sep 11.

Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

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September 2021

Massive hemoptysis causing mortality in a post COVID-19 infected Asian male patient: Presenting as pulmonary mucormycosis, pulmonary tuberculosis and later sino-nasal mucormycosis.

Respir Med Case Rep 2021 4;34:101511. Epub 2021 Sep 4.

Department of Internal Medicine, Maulana Azad Medical College, New Delhi, 11002, India.

While the developed nations are discussing giving a third dose of the COVID-19 vaccine to immunocompromised individuals, there are still challenges that are of global concern, especially in developing countries. The Delta variant which is predominantly responsible for the disease burden has now been reported in over 148 countries. The catastrophe caused in the Indian subcontinent has highlighted some associations, most notable being the unprecedented rise in the cases of mucormycosis in COVID-19 patients referred to as CAM (COVID-19 associated mucormycosis). Read More

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September 2021

A Case of New Onset Diabetes and Severe Diabetes Ketoacidosis in a Patient With COVID-19.

Cureus 2021 Aug 5;13(8):e16923. Epub 2021 Aug 5.

Internal Medicine and Endocrinology, Rutgers-New Jersey Medical School/ Trinitas Regional Medical Center, Elizabeth, USA.

Diabetic ketoacidosis (DKA) is a significant complication of poorly controlled diabetes. In diabetics, it typically occurs due to insulin deficiency resulting in lipolysis and subsequent ketone body formation and acidosis. The emergence of the COVID-19 infection has been associated with several complications, with the most prominent being pulmonary and cardiovascular-related. Read More

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An Unusual Case of the "Terrible Triad" in a Transgender Woman.

Cureus 2021 Aug 4;13(8):e16869. Epub 2021 Aug 4.

Endocrinology, Diabetes and Metabolism, Johns Hopkins University, Baltimore, USA.

With the increasing use of sodium-glucose cotransporter-2 inhibitors for type 2 diabetes and heart failure, clinicians need to understand how to treat euglycemic diabetic ketoacidosis (DKA), which is a potential side effect of the medication. The disease triad of euglycemic ketoacidosis, acute pancreatitis, and hypertriglyceridemia (HTG) has complex pathogenesis, and often the trigger of the triad is unknown. Here, we present an unusual case of euglycemic DKA in a transitioning transgender woman on canagliflozin who was treated with 10% dextrose and insulin infusions and apheresis. Read More

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Perioperative challenges in management of diabetic patients undergoing non-cardiac surgery.

World J Diabetes 2021 Aug;12(8):1255-1266

Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH 44195, United States.

Prediabetes and diabetes are important disease processes which have several perioperative implications. About one third of the United States population is considered to have prediabetes. The prevalence in surgical patients is even higher. Read More

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Some characteristics of hyperglycaemic crisis differ between patients with and without COVID-19 at a safety-net hospital in a cross-sectional study.

Ann Med 2021 12;53(1):1642-1645

Section of Endocrinology, Diabetes, and Metabolism, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.

Objective: To compare patients with DKA, hyperglycaemic hyperosmolar syndrome (HHS), or mixed DKA-HHS and COVID-19 [COVID (+)] to COVID-19-negative (-) [COVID (-)] patients with DKA/HHS from a low-income, racially/ethnically diverse catchment area.

Methods: A cross-sectional study was conducted with patients admitted to an urban academic medical center between 1 March and 30 July 2020. Eligible patients met lab criteria for either DKA or HHS. Read More

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December 2021

Predictors and outcomes of recurrent diabetic ketoacidosis in Israeli adults.

Diabetes Metab Syndr 2021 Sep 3;15(5):102276. Epub 2021 Sep 3.

Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel.

Aims: To identify risk factors for recurrent episodes of DKA that may allow the development of an effective prevention strategies.

Methods: Retrospective analysis of admissions for DKA in adult patients between 2004, and 2017 in a tertiary hospital. The clinical characteristics and outcomes of DKA of patients were stratified into an isolated episode of DKA (group 1) and recurrent episodes (group 2). Read More

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September 2021

New-Onset Pediatric Diabetes Complicated By Diabetic Ketoacidosis and Invasive Rhinocerebral Mucormycosis With Internal Carotid Artery Occlusion.

J Emerg Med 2021 Sep 8. Epub 2021 Sep 8.

Boston University School of Medicine, Boston, Massachusetts; Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts.

Background: Diabetic ketoacidosis (DKA) has increased in prevalence in the emergency department (ED) in recent years. The complications of DKA are life threatening and necessitate rapid identification and management. Pediatric complications include cerebral edema, venous thrombosis, acute kidney injury, and severe infections including necrotizing fasciitis and mucormycosis. Read More

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September 2021

Metabolic emergencies in pregnancy.

Clin Med (Lond) 2021 Sep;21(5):e438-e440

diabetologist and endocrinologist, St Thomas' Hospital, London, UK.

In pregnancy, women are more likely to develop certain metabolic disturbances as a result of the physiological changes that occur. Diabetic ketoacidosis and hypoglycaemia occur at increased frequency in women with pre-existing and gestational diabetes, and starvation ketoacidosis can present towards the end of pregnancy and can cause severe illness. Peripartum hyponatraemia is increasingly recognised and can be associated with maternal and neonatal morbidity. Read More

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September 2021

Benchmarking care outcomes for young adults with type 1 diabetes in Australia after transition to adult care.

Endocrinol Diabetes Metab 2021 Sep 9:e00295. Epub 2021 Sep 9.

Sydney Medical School, University of Sydney, Sydney, NSW, Australia.

Aim: To determine advantages conferred by a youth-specific transition clinic model for young adults with type 1 diabetes (T1D) at Westmead Hospital (WH) as compared with Australian registry data.

Methods: Prospectively collected data included age, diabetes duration, visit frequency, post code, BMI, mode of insulin delivery, continuous glucose monitoring, HbA1c, albumin creatinine ratio, BP, retinopathy and diabetic ketoacidosis (DKA) for all WH T1D clinic attendees aged 16-25 between January 2017 and June 2018 (n = 269). Results were compared with data collected during the same time period from 2 separate Australian data registries, one longitudinal (Australasian Diabetes Data Network, ADDN) and one a spot survey (the Australian National Diabetes Audit, ANDA). Read More

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September 2021

Type 1 diabetes in an adolescent with social problems and mental disorders - case report.

Pediatr Endocrinol Diabetes Metab 2021 Sep 9. Epub 2021 Sep 9.

Department of Pediatrics, Institute of Medical Sciences, University of Opole, Poland.

Discontinuation of type 1 diabetes (T1DM) treatment (interruption of insulin therapy) rapidly leads to diabetic ketoacidosis (DKA) which is a life-threatening condition. Our case report is intended to draw attention to persons with T1DM and significant social/psychological problems. They typically, due to the lack of legal regulations, "fall out of the system", which should provide in such cases additional assistance in care conditioning proper treatment. Read More

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September 2021

Protocol for a prospective, international cohort study on the Management and Outcomes of Perioperative Care among European Diabetic Patients (MOPED).

BMJ Open 2021 09 6;11(9):e044394. Epub 2021 Sep 6.

Universität Münster, Münster, UK.

Introduction: Diabetes is common (about 20 million patients in Europe) and patients with diabetes have more surgical interventions than the general population. There are plausible pathophysiological and clinical mechanisms suggesting that patients with diabetes are at an increased risk of postoperative complications. When postoperative complications occur in the general population, they increase major adverse events and subsequently increase 1-year mortality. Read More

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September 2021

[A case of fulminant type 1 diabetes mellitus in an elderly patient who developed cardiopulmonary arrest from diabetic ketoacidosis and whose imaging course was monitored].

Nihon Ronen Igakkai Zasshi 2021 ;58(3):482-488

Department of Internal Medicine, Mitoyo General Hospital.

A 71-year-old man with a history of hypertension and nephrosclerosis visited a primary care doctor for a regular visit. After a few days of vomiting and diarrhea, gastroenteritis was suspected and he was prescribed medication for these symptoms by his previous doctor. The next morning, he visited our hospital complaining of malaise and abdominal distention. Read More

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September 2021

Efficacy / safety balance of DPP-4 inhibitors versus SGLT2 inhibitors in elderly patients with type 2 diabetes.

Authors:
André J Scheen

Diabetes Metab 2021 Sep 2:101275. Epub 2021 Sep 2.

Division of Clinical Pharmacology, Centre for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium; Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Liège, Liège, Belgium. Electronic address:

Dipeptidyl peptidase-4 inhibitors (DPP-4is) and sodium-glucose cotransporter type 2 inhibitors (SGLT2is) offer new options for the oral management of type 2 diabetes mellitus (T2DM), with the advantage in the elderly population to be devoid of a high risk of hypoglycaemia. SGLT2is have also shown benefits regarding cardiovascular (heart failure) and renal protection, including in patients with T2DM aged ≥ 65 years while DPP-4is have only proved cardiovascular and renal safety without superiority compared with placebo. The glucose-lowering efficacy of the two pharmacological classes is almost similar including in older patients with T2DM. Read More

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September 2021

Improving the Quality of Clinical Care of Children with Diabetic Ketoacidosis in General Emergency Departments Following a Collaborative Improvement Program with an Academic Medical Center.

J Pediatr 2021 Sep 2. Epub 2021 Sep 2.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health, Indianapolis, IN. Electronic address:

Objectives: To evaluate the impact of a collaborative initiative between a group of general emergency departments (EDs) and an academic medical center on the process of care provided to patients with Diabetic Ketoacidosis (DKA) across these EDs.

Study Design: A retrospective cohort study (January 2015 to December 2018) of all pediatric patients <18 years who presented with DKA to participating EDs and were subsequently admitted to the pediatric intensive care unit at the AMC. Our multi-faceted intervention included simulation with post-simulation debriefing, targeted assessment reports, distribution of DKA best practices, pediatric DKA module, and scheduled check-in visits. Read More

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September 2021

Accuracy of a breath ketone analyzer to detect ketosis in adults and children with type 1 diabetes.

J Diabetes Complications 2021 Aug 27:108030. Epub 2021 Aug 27.

Barbara Davis Center, University of Colorado, Aurora, CO,USA.

Objective: To assess the accuracy of a breath ketone analyzer to detect ketosis in adults and children with type 1 diabetes.

Research Design And Methods: This is a proof-of-concept, prospective study comparing breath ketone analyzer and blood ketone meter to detect ketosis.

Results: A total of 500 measurements from 19 adults and children with type 1 diabetes were analyzed. Read More

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Temporal trends in emergency admissions for diabetic ketoacidosis in people with diabetes in England before and during the COVID-19 pandemic: a population-based study.

Lancet Diabetes Endocrinol 2021 Oct 2;9(10):671-680. Epub 2021 Sep 2.

National Diabetes Audit Programme, NHS England and NHS Improvement, London, UK; Division of Metabolism, Digestion, and Reproduction, Imperial College London, London, UK; Department of Diabetes and Endocrinology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK; NHS England and NHS Improvement, London UK. Electronic address:

Background: Diabetic ketoacidosis (DKA) has been reported to be increasing in frequency during the COVID-19 pandemic. We aimed to examine the rates of DKA hospital admissions and the patient demographics associated with DKA during the pandemic compared with in prepandemic years.

Methods: Using a comprehensive, multiethnic, national dataset, the Secondary Uses Service repository, we extracted all emergency hospital admissions in England coded with DKA from March 1 to June 30, 2020 (first wave of the pandemic), July 1 to Oct 31, 2020 (post-first wave), and Nov 1, 2020, to Feb 28, 2021 (second wave), and compared these with DKA admissions in the equivalent periods in 2017-20. Read More

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October 2021

Diabetic ketoacidosis risk during the COVID-19 pandemic.

Lancet Diabetes Endocrinol 2021 Oct 2;9(10):643-644. Epub 2021 Sep 2.

Center of Diabetes and Metabolism, Emory University School of Medicine, Atlanta, GA 30303, USA. Electronic address:

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October 2021