293 results match your criteria dka initial


New onset of diabetes in a child infected with COVID-19: a case report.

J Diabetes Metab Disord 2021 Sep 17:1-4. Epub 2021 Sep 17.

Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: Diabetic ketoacidosis (DKA) is a serious complication of type 1 diabetes. A few studies have reported that COVID-19 is associated with the development of new-onset diabetes. Here, we present an infected child with new onset diabetes leading to DKA. Read More

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September 2021

Socioeconomic and Racial Disparities in Diabetic Ketoacidosis Admissions in Youth With Type 1 Diabetes.

J Hosp Med 2021 Aug 18. Epub 2021 Aug 18.

Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Objective: We sought to determine whether census tract poverty, race, and insurance status were associated with the likelihood and severity of diabetic ketoacidosis (DKA) hospitalization among youth with type 1 diabetes (T1D).

Methods: We conducted a retrospective population-based cohort study using Cincinnati Children's Hospital electronic medical record (EMR) data from January 1, 2011, to December 31, 2017, for T1D patients ≤18 years old. The primary outcome was admission for DKA. Read More

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Strawberry pink blood: hypertriglyceridaemia and diabetic ketoacidosis secondary to poorly controlled type 2 diabetes mellitus.

BMJ Case Rep 2021 Aug 20;14(8). Epub 2021 Aug 20.

Department of Endocrinology, Changi General Hospital, Singapore.

A 54-year-old woman with insulin-requiring type 2 diabetes mellitus presented with acute shortness of breath and drowsiness on a background of polydipsia, weakness and significant weight loss. One year ago, she had decided to stop her insulin and other medications and adopt lifestyle modifications instead. Initial emergency department (ED) blood samples were highly lipaemic and appeared strawberry pink. Read More

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Lactic Acidosis in Diabetic Ketoacidosis: A Marker of Severity or Alternate Substrate for Metabolism.

Indian J Endocrinol Metab 2021 Jan-Feb;25(1):59-66. Epub 2021 Jul 21.

Department of Endocrinology, SheriKashmir Institute of Medical Sciences, Srinagar, Kashmir, India.

Purpose: The lactate level is being increasingly used as a marker of severity of illness and prognosis in multitude of critical conditions. However, its role in diabetic ketoacidosis (DKA) is not well defined.

Aim: To determine the prevalence and clinical importance along with the underlying role of metformin in lactic acidosis (LA) in patients admitted with DKA. Read More

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A Case of COVID-19-Associated Autoimmune Hemolytic Anemia With Hyperferritinemia in an Immunocompetent Host.

Cureus 2021 Jun 30;13(6):e16078. Epub 2021 Jun 30.

Internal Medicine, Mayo Hospital, Lahore, PAK.

We report an interesting case of a middle-aged gentleman who presented with diabetic ketoacidosis (DKA) and tested polymerase chain reaction (PCR) positive for COVID-19 infection. His hospital stay was complicated by acute kidney injury, hematuria, and normocytic anemia. Initial chest x-ray demonstrated bibasilar opacities. Read More

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A Multicenter Survey of Type I Diabetes Mellitus in Chinese Children.

Front Endocrinol (Lausanne) 2021 15;12:583114. Epub 2021 Jun 15.

Department of Endocrinology, Hunan Provincial Children's Hospital, Changsha, China.

Purpose: To investigate the features and treatment status of children with type 1 diabetes mellitus (T1DM) in China.

Methods: We recruited patients <14 years of age with T1DM from 33 medical centers in 25 major cities of China between January 2012 and March 2015. All patients completed a questionnaire that was conducted by their pediatric endocrinologists at all centers. Read More

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Effects of Fluid Rehydration Strategy on Correction of Acidosis and Electrolyte Abnormalities in Children With Diabetic Ketoacidosis.

Diabetes Care 2021 Sep 29;44(9):2061-2068. Epub 2021 Jun 29.

Department of Pediatrics, University of California Davis Health, University of California, Davis, School of Medicine, Sacramento.

Objective: Fluid replacement to correct dehydration, acidosis, and electrolyte abnormalities is the cornerstone of treatment for diabetic ketoacidosis (DKA), but little is known about optimal fluid infusion rates and electrolyte content. The objective of this study was to evaluate whether different fluid protocols affect the rate of normalization of biochemical derangements during DKA treatment.

Research Design And Methods: The current analysis involved moderate or severe DKA episodes ( = 714) in children age <18 years enrolled in the Fluid Therapies Under Investigation in DKA (FLUID) Trial. Read More

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September 2021

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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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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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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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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The Vital Role of Thanatochemistry in the Postmortem Diagnostic of Diabetic Ketoacidosis-Case Report.

Diagnostics (Basel) 2021 May 29;11(6). Epub 2021 May 29.

Department of Forensic Medicine, Institute of Forensic Medicine, 700455 Iasi, Romania.

Diabetic ketoacidosis (DKA) is a lethal acute hyperglycemic complication of diabetes mellitus (DM) and it represents the initial manifestation of DM in about 15-20% of cases in adults and about 30-40% of cases in children. Postmortem diagnosis of DKA can only be made by applying thanatochemistry. Biochemistry applied postmortem is viewed with skepticism by many practitioners in the forensic field, completely lacking in many forensic services around the world, and especially in the national ones. Read More

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Ketoacidosis as a primary manifestation of COVID-19.

Pediatr Endocrinol Diabetes Metab 2021 ;27(2):146-148

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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September 2021

COVID-19 and Diabetic Ketoacidosis: Report of Eight Cases.

Cureus 2021 Mar 31;13(3):e14223. Epub 2021 Mar 31.

Hematology and Oncology, Saint Joseph's University Medical Center, Paterson, USA.

Aim To describe the clinical characteristics and outcome of hospitalized COVID-19 patients with diabetic ketoacidosis (DKA). Methods We report eight cases of diabetic ketoacidosis in COVID-19 who presented to our institution in New Jersey, USA. COVID-19 was diagnosed by nasopharyngeal swab reverse transcription polymerase chain reaction (RT-PCR). Read More

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Efficacies of programmed cell death 1 ligand 1 blockade in non-small cell lung cancer patients with acquired resistance to prior programmed cell death 1 inhibitor and development of diabetic ketoacidosis caused by two different etiologies: a retrospective case series.

Endocr J 2021 May 1;68(5):613-620. Epub 2021 May 1.

Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.

The programmed cell death 1 (PD-1)/programmed cell death 1 ligand 1 (PD-L1) axis is vital for immune resistance during tumor development, while PD-L1 inhibitors can also inhibit the PD-L1/B7-1 (CD80) interaction, indicating one of the molecular differences between PD-1 and PD-L1 inhibitors. However, the clinical benefits of PD-L1 inhibitors in patients previously treated with PD-1 inhibitors remain unknown. In this study, we retrospectively analyzed the clinical data of eight patients with non-small cell lung cancer who received the PD-L1 inhibitor atezolizumab and previously treated with the PD-1 inhibitor nivolumab. Read More

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Is Misdiagnosis of Type 1 Diabetes Mellitus in Malaysian Children a Common Phenomenon?

Front Endocrinol (Lausanne) 2021 8;12:606018. Epub 2021 Mar 8.

Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia.

Background: Children with Type 1 diabetes (T1DM) commonly present in diabetic ketoacidosis (DKA) at initial diagnosis. This is likely due to several factors, one of which includes the propensity for T1DM to be misdiagnosed. The prevalence of misdiagnosis has been reported in non-Asian children with T1DM but not in Asian cohorts. Read More

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Rhabdomyolysis plus Hypocalcemia and Diabetic Ketoacidosis as Concurrent Rare COVID-19 Manifestations.

Case Rep Med 2021 8;2021:6625086. Epub 2021 Mar 8.

Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Common manifestations of coronavirus disease 2019 (COVID-19) from its initial official introduction are mostly related to the respiratory system. However, other rarer presentations are reported nowadays. . Read More

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Use of a Flexible Catheter for the Administration of Subcutaneous Insulin in Diabetic Ketoacidosis: A Feasibility Controlled Clinical Trial.

Hosp Pediatr 2021 Apr 9;11(4):396-400. Epub 2021 Mar 9.

Hospital General de Niños Pedro de Elizalde, Buenos Aires, Argentina.

Background: Although intravenous insulin administration is the standard of care in diabetic ketoacidosis (DKA), subcutaneous insulin administration could be a suitable alternative in resource-limited settings, but pain caused by hourly insulin applications are limiting factors for using it, especially in children. We aimed to assess whether the use of a flexible subcutaneous catheter improves comfort in patients with DKA compared with the usual hourly injections' treatment. We also compared the evolution of metabolic variables in patients with DKA using both insulin administration systems. Read More

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Sodium-glucose cotransporter 2 inhibitors as an add-on therapy to insulin for type 1 diabetes mellitus: Meta-analysis of randomized controlled trials.

Acta Diabetol 2021 Jul 2;58(7):869-880. Epub 2021 Mar 2.

Department of Endocrinology, Taihe Hospital, Hubei University of Medical, Shiyan, 442000, China.

Aims: The aim was to systematically review the efficacy and safety of sodium-glucose cotransporter inhibitor (SGLT2i) as an adjunct to insulin at different follow-up durations in randomized, double-blind clinical trials in patients with type 1 diabetes.

Methods: We conducted a search on Medline, Embase, and the Cochrane Library for relevant studies published before May 2020. According to the duration of follow-up, the subgroup analysis included four periods: 1-4, 12-18, 24-26, and 52 weeks. Read More

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The Two-bag System for Intravenous Fluid Management of Children with Diabetic Ketoacidosis: Experience from a Community-Based Hospital.

Glob Pediatr Health 2021 24;8:2333794X21991532. Epub 2021 Jan 24.

Hurley Medical Center, Flint, MI, USA.

Intravenous fluid (IVF) administration using the two-bag system compared with the one-bag system in children with diabetic ketoacidosis (DKA) admitted between January 1, 2015 and December 31, 2016. Retrospective cohort study. Community-based hospital. Read More

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January 2021

Sweet and Salty: Diabetic Ketoacidosis in a Patient With Nephrogenic Diabetes Insipidus.

Cureus 2021 Jan 13;13(1):e12682. Epub 2021 Jan 13.

Medicine, Louis Stokes Cleveland VA Medical Center/Case Western Reserve University School of Medicine, Cleveland, USA.

The co-existence of nephrogenic diabetes insipidus (NDI) with diabetes mellitus (DM) in a patient that presents in diabetic ketoacidosis (DKA) is rare and, to our knowledge, has not been described even in case reports. We report the case of a 16-year-old male with known NDI who presented to the pediatric emergency department (ED) for one day with generalized weakness and decreased appetite, found to be in moderate DKA from new-onset DM. The initial management of his dehydration and hyperosmolar state presented a unique challenge. Read More

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January 2021

Euglycemic diabetic ketoacidosis associated with SGLT2i use: Case series.

Am J Emerg Med 2021 06 24;44:11-13. Epub 2021 Jan 24.

Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Emergency Medicine, Division of Critical Care, University of Michigan, Ann Arbor, MI, USA.

Introduction: Euglycemic diabetic ketoacidosis (EuDKA) associated with Sodium-Glucose Cotransporter-2 inhibitor (SGLT2i) use has been described but remains poorly understood. Data on Emergency Department (ED) presentation, resource utilization, and safety outcomes for these patients are lacking. We report a case series of patients diagnosed with EuDKA in the ED. Read More

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COVID-19 and Diabetic Ketoacidosis: A Single Center Experience.

Cureus 2021 Jan 30;13(1):e13000. Epub 2021 Jan 30.

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

Background And Objectives:  To describe the clinical characteristics and outcomes of hospitalized coronavirus disease 2019 (COVID-19) patients with diabetic ketoacidosis (DKA) -- a single center tertiary hospital experience.

Materials And Methods:  A retrospective study was conducted among patients admitted to our hospital in the United States between March 1and June 15, 2020 with DKA and severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection known as COVID-19. We compared the baseline characteristics, laboratory data, and clinical course between survivors and nonsurvivors to identify the risk factors associated with mortality in the patients with DKA. Read More

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January 2021

A Case of Concomitant COVID-19 Infection-Induced Acute Respiratory Distress Syndrome and Diabetic Ketoacidosis: Another Challenge in Fluid Management.

Cureus 2020 Nov 30;12(11):e11805. Epub 2020 Nov 30.

Department of Pulmonary and Critical Care Medicine, Bassett Medical Center, Cooperstown, USA.

Coronavirus disease 2019 (COVID-19) has been announced as a pandemic worldwide. The respiratory tract is a target organ system, where infection can result in serious complications, like acute respiratory distress syndrome (ARDS). Management of this condition is more challenging in individuals with diabetes who developed diabetic ketoacidosis. Read More

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November 2020

[Remote monitoring and treatment of children and adolescents with type 1 diabetes].

Probl Endokrinol (Mosk) 2020 Sep 28;66(4):50-60. Epub 2020 Sep 28.

Endocrinology Research Centre.

Rationale: Continuous subcutaneous insulin infusion (CSII) is an effective method for optimizing glycemic control in children with type 1 diabetes mellitus (DM1). However, the use of CSII does not always result in adequate glycemic control. Telehealth can be applied as one of the methods to improve the effectiveness of treatment. Read More

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September 2020

[The efficacy of outpatient monitoring of children and adolescents with type 1 diabetes with regular use of professional continuous glucose monitoring].

Probl Endokrinol (Mosk) 2020 08 4;66(1):14-22. Epub 2020 Aug 4.

Regional Children Clinical Hospital named after N.V. Dmitrieva.

Background: According to research, only 38% of patients reach glycated hemoglobin targets. It is possible to improve the effectiveness of medical care for children with T1D using modern technologies, including continuous glucose monitoring (CGM).

Aims: To evaluate the effectiveness of outpatient monitoring of children and adolescents with T1D with regular use of professional continuous glucose monitoring. Read More

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Kayexalate-induced colitis and rectal stricture.

BMJ Case Rep 2020 Dec 13;13(12). Epub 2020 Dec 13.

Gastroenterology, Dayton VA Medical Center, Dayton, Ohio, USA.

A 57-year-old man underwent emergency laparoscopic loop colostomy for acute recto-sigmoid obstruction. He was hospitalised 2 months previously, at another facility for diabetic ketoacidosis (DKA) and hyperkalaemia. He had no gastrointestinal symptoms prior to the hospitalisation. Read More

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December 2020

Frequency and Risk Factors of Acute Kidney Injury During Diabetic Ketoacidosis in Children and Association With Neurocognitive Outcomes.

JAMA Netw Open 2020 12 1;3(12):e2025481. Epub 2020 Dec 1.

Department of Pediatrics, University of California, Davis School of Medicine, Sacramento.

Importance: Acute kidney injury (AKI) occurs commonly during diabetic ketoacidosis (DKA) in children, but the underlying mechanisms and associations are unclear.

Objective: To investigate risk factors for AKI and its association with neurocognitive outcomes in pediatric DKA.

Design, Setting, And Participants: This cohort study was a secondary analysis of data from the Pediatric Emergency Care Applied Research Network Fluid Therapies Under Investigation in DKA Study, a prospective, multicenter, randomized clinical trial comparing fluid protocols for pediatric DKA in 13 US hospitals. Read More

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December 2020

The Impact of a New Best Practice Advisory on the Management of Diabetic Ketoacidosis.

Curr Diabetes Rev 2021 ;17(5):e110320187540

Critical Care, Saint Luke's Health System, Kansas City, MO, 64111, Missouri, United States.

Background: According to the Center for Disease Control and Prevention, diabetic ketoacidosis (DKA) hospitalization rates have been steadily increasing. Due to the increasing incidence and the economic impact associated with its morbidity and treatment, effective management is key. We aimed to streamline the management of DKA in our intensive care units (ICU) by implementing a Best-Practice Advisory (BPA) that notifies providers when DKA has resolved. Read More

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