394 results match your criteria dka presentation


Non-diabetic ketoacidosis: A case of alcoholic ketoacidosis accompanied by hyperglycemia.

Am J Emerg Med 2021 Aug 26. Epub 2021 Aug 26.

Department of Endocrinology, Xi'an Central Hospital, Xi'an, Shaanxi 710003, China. Electronic address:

Alcoholic ketoacidosis (AKA) lacks specific clinical presentation. The results of blood testing commonly show hemoconcentration, elevated β-hydroxybutyrate levels, and acidosis in patients with AKA. Herein, we report a case of AKA accompanied by hyperglycemia and review the related literature. Read More

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Severe Hypertriglyceridemia With New-Onset Type 1 Diabetes in Diabetic Ketoacidosis.

J Med Cases 2020 Dec 21;11(12):426-428. Epub 2020 Oct 21.

Section of Pediatric Endocrinology, Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.

Hypertriglyceridemia is a complication in the presentation of diabetic ketoacidosis (DKA) but has been reported in the pediatric population infrequently. We report a 13-year-old female with new onset type 1 diabetes in DKA, who developed extreme hypertriglyceridemia. Our patient's case is unique as her triglyceride levels were markedly higher than those in other reports and required a longer duration of time to resolve. Read More

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December 2020

Type 1 diabetes onset in Lombardy region, Italy, during the COVID-19 pandemic: The double-wave occurrence.

EClinicalMedicine 2021 Sep 12;39:101067. Epub 2021 Aug 12.

Pediatric Diabetology Unit, Diabetes Research Institute, Istituto Scientifico San Raffaele, Milano, Italy.

Background: The Italian Lombardy region has been the epicenter of COVID-19 since February 2020. This study analyses the epidemiology of pediatric type 1 diabetes (T1D) onset during the first two pandemic waves and three previous years.

Methods: All the 13 pediatric diabetes centers in Lombardy prospectively evaluated charts of children at T1D onset (0-17 years), during year 2020. 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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Awareness of euglycaemic diabetic ketoacidosis during pregnancy prevents recurrence of devastating outcomes: a case report of two pregnancies in one patient.

BMC Pregnancy Childbirth 2021 Aug 12;21(1):552. Epub 2021 Aug 12.

Department of Obstetrics, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.

Background: Euglycaemic diabetic ketoacidosis (DKA) during pregnancy is a life-threatening obstetric emergency. It requires early identification and prompt action. Obstetricians' knowledge about symptoms, diagnostic pitfalls and management during pregnancy and delivery need to be improved. Read More

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Serum Sodium Concentration and Mental Status in Children With Diabetic Ketoacidosis.

Pediatrics 2021 Sep 9;148(3). Epub 2021 Aug 9.

Department of Psychology, University of California, Davis, Davis, California.

Objectives: Diabetic ketoacidosis (DKA) is typically characterized by low or low-normal serum sodium concentrations, which rise as hyperglycemia resolves. In retrospective studies, researchers found associations between declines in sodium concentrations during DKA and cerebral injury. We prospectively investigated determinants of sodium concentration changes and associations with mental status alterations during DKA. Read More

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September 2021

New-onset Type 1 Diabetes Mellitus with Diabetic Ketoacidosis and Pancreatitis in a Patient with COVID-19.

Sci Afr 2021 Sep 3;13:e00915. Epub 2021 Aug 3.

Internal medicine, Faculty of medicine, Cairo university, Cairo, Egypt.

Coronavirus Disease 2019 (COVID-19) had struck the world with health and economic catastrophes and recently with unusual autoimmune presentations, including new-onset Type 1 Diabetes. Herein we present a 17-year-old male patient who presented to the outptient clinic with fever, palpitation, and cough of four-week duration; he was referred to the emergency room and was found to have DKA. CT of the chest showed ground-glass opacities suggestive of COVID-19 pneumonia, and abdominal cuts showed dilated intrahepatic biliary radicles with pancreatic loculations suggestive of pancreatitis. Read More

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September 2021

Hyperglycemia After Dolutegravir-Based Antiretroviral Therapy.

Int Med Case Rep J 2021 28;14:503-507. Epub 2021 Jul 28.

Department of Internal Medicine, University of Gondar, Gondar, North Gondar, Ethiopia.

Background: Antiretroviral therapies prolong life expectancy and improve the quality of life of HIV-infected patients. Despite the documented benefits of antiretroviral drugs, its use is not without side effects. Here, we report cases of new onset diabetes mellitus after taking a dolutegravir (DTG)-based ART regimen. Read More

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[Euglycemic diabetic ketoacidosis during pregnancy].

Ned Tijdschr Geneeskd 2021 04 29;165. Epub 2021 Apr 29.

Ziekenhuis Gelderse Vallei, afd. Interne Geneeskunde, Ede.

Background: Diabetic ketoacidosis (DKA) can have an atypical presentation during pregnancy. In the case of euglycemic DKA, relatively normal blood glucose levels can hinder a quick diagnosis.

Case Description: A 34-year-old DM1 patient, 31 weeks pregnant, was admitted because of reduced fetal movements and nausea. Read More

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Mesenteric Lymphadenitis Due to COVID-19 in an Adult.

Cureus 2021 Jun 24;13(6):e15897. Epub 2021 Jun 24.

Emergency Medicine, Hamad Medical Corporation, Doha, QAT.

Coronavirus disease 2019 (COVID-19) is an infectious disease that can present with a wide range of symptoms. Abdominal pain is less common than other symptoms but is more frequent among patients with severe disease. Various abdominal imaging findings are described in the literature for children and adults with COVID-19 infection. Read More

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Diabetic ketoacidosis in pediatric patients with type 1- and type 2 diabetes during the COVID-19 pandemic.

Metabolism 2021 09 30;122:154842. Epub 2021 Jul 30.

Clinic for Pediatrics I, Pediatric Endocrinology, University Hospital Halle (Saale), Germany. Electronic address:

Background: COVID-19 pandemic caused families to stay home and cancel everyday activities. Hospital admissions decreased, affecting changes in diagnoses and management of chronic disease in children.

Aims: We analyzed how the first lockdown influenced clinical presentation and manifestation of children with diabetes mellitus (DM) in a German University Hospital. Read More

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September 2021

Changes in the presentation of newly diagnosed type 1 diabetes in children during the COVID-19 pandemic in a tertiary center in Southern Turkey.

J Pediatr Endocrinol Metab 2021 Jul 21. Epub 2021 Jul 21.

Division of Pediatric Endocrinology, Cukurova University Faculty of Medicine, Adana, Turkey.

Objectives: The COVID-19 pandemic is a global health problem with high morbidity and mortality. This study aimed to investigate patients who were diagnosed with type 1 diabetes during the pandemic and evaluate the effect of the pandemic on the clinical findings of these patients by comparing them with findings from a year prior.

Methods: Patients diagnosed with type 1 diabetes mellitus between 2019 and 2021 were separated into two groups: Patients diagnosed prepandemic and those diagnosed during the pandemic. Read More

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The SARS-CoV-2 pandemic is associated with increased severity of presentation of childhood onset type 1 diabetes mellitus: A multi-centre study of the first COVID-19 wave.

Diabet Med 2021 09 18;38(9):e14640. Epub 2021 Jul 18.

Department of Paediatric Endocrinology and Diabetes, Great Ormond Street Hospital, London, UK.

Objective: Children are usually mildly affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19). However, the pandemic has caused collateral damage to those with non-COVID-19 diseases. We aimed to determine the impact of the COVID-19 pandemic on the presentation of newly diagnosed childhood onset type 1 diabetes. Read More

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September 2021

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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Presentation of newly diagnosed type 1 diabetes in children and young people during COVID-19: a national UK survey.

BMJ Paediatr Open 2020 2;4(1):e000884. Epub 2020 Nov 2.

Department of Paediatrics, Nottingham University Hospitals NHS Trust, Nottingham, UK.

In the UK, there have been reports of significant reductions in paediatric emergency attendances and visits to the general practitioners due to COVID-19. A national survey undertaken by the UK Association of Children's Diabetes Clinicians found that the proportion of new-onset type 1 diabetes (T1D) presenting with diabetes ketoacidosis (DKA) during this COVID-19 pandemic was higher than previously reported, and there has been an increase in presentation of severe DKA at diagnosis in children and young people under the age of 18 years. Delayed presentations of T1D have been documented in up 20% of units with reasons for delayed presentation ranging from fear of contracting COVID-19 to an inability to contact or access a medical provider for timely evaluation. Read More

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November 2020

A Severe Case of Diabetic Ketoacidosis and New-Onset Type 1 Diabetes Mellitus Associated with Anti-Glutamic Acid Decarboxylase Antibodies Following Immunotherapy with Pembrolizumab.

Am J Case Rep 2021 Jun 29;22:e931702. Epub 2021 Jun 29.

Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA.

BACKGROUND Immune checkpoint inhibitors (ICIs) are a novel class of antibodies, which have been increasingly utilized in cancer immunotherapies. Pembrolizumab is a humanized IgG4 monoclonal antibody, which acts against programmed cell death (PD)-1 receptors to help restore the body's T-cell and immune response. CASE REPORT In this case, we present a 51-year-old woman with a past medical history of lung adenocarcinoma and triple-positive breast cancer who was actively receiving therapy with pembrolizumab. Read More

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Diabetic ketoacidosis precipitated by atypical coronavirus disease in a newly diagnosed diabetic girl.

J Taibah Univ Med Sci 2021 Aug 16;16(4):628-631. Epub 2021 Feb 16.

Department of Pediatrics, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, KSA.

Viral infections have a well-known influence on the pathophysiology of type 1 diabetes mellitus (T1DM). There is scant data about the impact of COVID-19 T1DM and diabetic ketoacidosis (DKA) on paediatric patients. This case presents a newly diagnosed paediatric patient with T1DM and DKA who was found to have SARS-CoV-2 without any respiratory symptoms. Read More

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Clinical and Biochemical Characteristics and Treatment Outcomes of Ketosis-Prone Diabetes: The Remission Prone Diabetes.

Int J Endocrinol Metab 2021 Apr 7;19(2):e106799. Epub 2021 Mar 7.

Department of Medicine, MR Medical College, Gulbarga, India.

Background: Diabetic ketoacidosis (DKA) is one of the severe acute complications of diabetes. It has long been considered a key clinical characteristic of type 1 diabetes mellitus (T1DM) with severe and irreversible deficient insulin levels. Ketosis-prone diabetes (KPD) has pathophysiology close to T2DM but shows signs and symptoms associated with T1DM. Read More

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Diabetes ketoacidosis recovery in youth with newly diagnosed and established type 1 diabetes.

Pediatr Res 2021 Jun 19. Epub 2021 Jun 19.

The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.

Background: The objective of this study was to describe the differences in metabolic parameters and in time to recovery from diabetes ketoacidosis (DKA), between children and adolescents with newly diagnosed diabetes compared with established type 1 diabetes (T1DM).

Methods: This was a single-center, retrospective study. The cohort consists of 356 children and adolescents with T1DM who had DKA during 2008-2018. Read More

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Coexistence of diabetic ketoacidosis and thyrotoxicosis: a jeopardy of two endocrine emergencies.

BMJ Case Rep 2021 Jun 15;14(6). Epub 2021 Jun 15.

Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan.

Simultaneous occurrences of diabetic ketoacidosis (DKA) and thyroid storm have long been known, but only a few cases have been reported to date. Both these endocrine emergencies demand timely diagnosis and management to prevent adverse outcomes. Due to the similarities in their clinical presentation, DKA can mask the diagnosis of thyroid storm and vice versa. Read More

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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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A rare case of diabetic ketoacidosis presenting with severe hypertriglyceridemia requiring plasmapheresis in an adult with type-2 diabetes mellitus: Case report.

Medicine (Baltimore) 2021 Jun;100(23):e26237

Internal Medicine Residency Program, UPMC Pinnacle Harrisburg Hospital.

Introduction: Severe hypertriglyceridemia (HTG) is a rare complication of insulin resistance. Its presentation with diabetic ketoacidosis (DKA) has been reported in a few cases, where most patients have type-1 diabetes mellitus (DM). Our case represents a unique presentation of DKA associated with severe HTG above 10,000 mg/dL in an adult with type-2 DM. 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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Rucaparib maintenance treatment for recurrent ovarian carcinoma: the effects of progression-free interval and prior therapies on efficacy and safety in the randomized phase III trial ARIEL3.

Int J Gynecol Cancer 2021 07 8;31(7):949-958. Epub 2021 Jun 8.

Department of Oncology, UCL Cancer Institute, University College London and UCL Hospitals, London, UK.

Introduction: In ARIEL3 (NCT01968213), the poly(adenosine diphosphate-ribose) polymerase inhibitor rucaparib significantly improved progression-free survival versus placebo regardless of biomarker status when used as maintenance treatment for recurrent ovarian cancer. The aim of the current analyses was to evaluate the efficacy and safety of rucaparib in subgroups based on progression-free interval following penultimate platinum, number of prior chemotherapies, and prior use of bevacizumab.

Methods: Patients were randomized 2:1 to rucaparib 600 mg twice daily or placebo. Read More

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Searching for the Culprit: When Diabetic Ketoacidosis Presents With Insulin Autoantibodies.

AACE Clin Case Rep 2021 Mar-Apr;7(2):158-162. Epub 2020 Dec 28.

Department of Medicine, St. Joseph's University Medical Center, Paterson, New Jersey.

Objective: The main objective was to describe and review a unique case that presented with diabetic ketoacidosis, positive insulin autoantibodies (IAAbs, which are found in Hirata disease and are usually present with hypoglycemia), and laboratory findings characteristic of type B insulin resistance syndrome (TBIRS) and systemic lupus erythematosus. Confirmation of TBIRS was obtained in Germany as immunoassay for insulin receptor antibodies (IRAbs) is not available in the United States.

Methods: A literature review on TBIRS and cases that present with IAAbs and IRAbs simultaneously was conducted. Read More

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December 2020

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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Domino effect of pituitary growth hormone tumor complicated by diabetic ketoacidosis and pituitary apoplexy: a case report.

BMC Endocr Disord 2021 May 26;21(1):109. Epub 2021 May 26.

Department of Emergency Medicine, Zhejiang Provincial People's Hospital (People's Hospital of Hangzhou Medical College), 158 Shangtang Road, 310014, Hangzhou, Zhejiang, People's Republic of China.

Background: Patients with growth hormone (GH)-secreting adenoma usually develop glucose intolerance. GH increases metabolic rate and, when secreted aberrantly, may result in metabolic syndrome. Herein, we examine the associations of pituitary tumor-induced secretion of hormone with insulin resistance and metabolic syndrome, and determine the relation of pituitary tumor apoplexy-induced diabetic ketoacidosis (DKA) and acute pancreatitis. 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