32 results match your criteria preventing dka


Invasive Klebsiella pneumoniae Syndrome in Qatar: A Case Report.

Cureus 2021 May 13;13(5):e15015. Epub 2021 May 13.

Internal Medicine, Hamad Medical Corporation, Doha, QAT.

is a Gram-negative bacteria that can infect most of the body's organs, from the lungs to the central nervous system. It is notorious for causing pneumonia in alcoholic, diabetic, and hospitalized patients. It is now emerging as a cause of abscesses involving multiple organs. 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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Use of Sodium-Glucose Co-Transporter-2 Inhibitors in Type 1 Diabetics: Are the Benefits Worth the Risks?

Cureus 2020 Aug 27;12(8):e10076. Epub 2020 Aug 27.

Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

The mainstay of treatment for type 1 diabetes is insulin. The use of insulin for tight glycemic control is the key to preventing micro- and macrovascular complications, but it can also lead to hypoglycemic episodes. Therefore, there is a need for the introduction of a drug that can maintain glucose levels within a safe range without increasing the risk of hypoglycemia. Read More

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Diabetic Ketoacidosis in COVID-19: Unique Concerns and Considerations.

J Clin Endocrinol Metab 2020 08;105(8)

Brigham and Women's Hospital and Harvard Medical School, Division of Endocrinology, Diabetes and Hypertension, Boston, Massachusetts.

Context: While individuals with diabetes appear to be at similar risk for SARS-CoV-2 infection to those without diabetes, they are more likely to suffer severe consequences, including death. Diabetic ketoacidosis (DKA) is a common and potentially lethal acute complication of diabetes arising from a relative insulin deficiency, which occurs more often in those with type 1 diabetes and in the setting of moderate to severe illness. Early reports indicate that among patients with pre-existing diabetes, DKA may be a common complication of severe COVID-19 and a poor prognostic sign. Read More

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The Silver Lining to COVID-19: Avoiding Diabetic Ketoacidosis Admissions with Telehealth.

Diabetes Technol Ther 2020 Jun 5;22(6):449-453. Epub 2020 May 5.

Professor of Medicine and Pediatrics, Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado, USA.

The Stay at Home order in Colorado and The Stay Safe at Home order in California during COVID-19 pandemic have forced a majority of the endocrinologists/diabetologists to adapt to providing diabetes care remotely through telehealth. This may provide increased access to diabetes health care in certain settings. However, health care disparities continue to challenge availability of diabetes technologies for underprivileged communities. Read More

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Effect of Chronic Pancreatitis on Complications and Mortality in DM Patients: A 10-year Nationwide Cohort Study.

J Clin Endocrinol Metab 2020 03;105(3)

Department of Nephrology, Chi-Mei Medical Center, Tainan, Taiwan.

Context: Chronic pancreatitis (CP), is a long-term inflammation of the pancreatic parenchyma, and might increase risk of a hyperglycemia crisis or hypoglycemia in patients with diabetes mellitus (DM); however, the relationship has not been previously investigated.

Objective: To investigate the risk of diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), hypoglycemia, and long-term outcomes in DM patients with CP.

Design: A population-based cohort study. Read More

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Two cases of ketosis-prone diabetes mellitus in Korean adolescents.

Ann Pediatr Endocrinol Metab 2019 Dec 31;24(4):257-261. Epub 2019 Dec 31.

Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea.

In recent years, reports of diabetes mellitus (DM) cases that do not fit the traditional classification system have increased in prevalence. While insulin deficiency appears as type 1 DM (T1DM), the new type also has the clinical features of type 2 DM (T2DM); as such, this new type of DM is called ketosis-prone diabetes (KPD) and is correlated with findings of severe hyperglycemia and ketoacidosis. To provide a clear, clinical classification of DM, new classification systems are being studied. Read More

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December 2019

Air occlusion in insulin pumps of children and adolescents with type 1 diabetes.

J Pediatr Endocrinol Metab 2020 Feb;33(2):179-184

Eastern Virginia Medical School/Children's Hospital of the King's Daughters, Department of Pediatrics, Division of Pediatric Endocrinology, Norfolk, VA, USA.

Background Insulin pumps are a frequently used technology among youth with type 1 diabetes. Air bubbles within insulin pump tubing are common, preventing insulin delivery and increasing the risk of large glycemic excursions and diabetic ketoacidosis (DKA). We sought to determine the prevalence of air bubbles in insulin pump tubing and identify factors associated with clinically significant air bubbles. Read More

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February 2020

A Quality Initiative Reducing Adverse Outcomes in Pediatric Patients with DKA During Intrafacility Transit.

Pediatr Qual Saf 2019 Jul-Aug;4(4):e194. Epub 2019 Jul 22.

Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio.

Introduction: Treatment of diabetic ketoacidosis (DKA) requires close and timely monitoring to prevent serious adverse events. This quality improvement project details how our institution improved blood glucose monitoring around hospital admission. The project aimed to increase the blood glucose assessments for children with DKA receiving insulin in the emergency department (ED) within 30 minutes before transitioning to an inpatient unit. Read More

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Commentary: SGLT inhibitors in type 1 diabetes: Place in therapy and a risk mitigation strategy for preventing diabetic ketoacidosis - the STOP DKA protocol.

Authors:
Marc S Rendell

Diabetes Obes Metab 2019 10 15;21(10):2189-2191. Epub 2019 Aug 15.

The Association of Diabetes Investigators, Versailles, California, USA.

In the accompanying article, Goldenberg et al. review the promotion of diabetic ketoacidosis by SGLT2 inihibitors. They have carried out a metanalysis showing a 3. Read More

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October 2019

Sodium-glucose co-transporter inhibitors, their role in type 1 diabetes treatment and a risk mitigation strategy for preventing diabetic ketoacidosis: The STOP DKA Protocol.

Diabetes Obes Metab 2019 10 30;21(10):2192-2202. Epub 2019 Jun 30.

Lunenfeld-Tanenbaum Research Institute, Mt Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

Recent phase 3 clinical trials have evaluated the impact of adding sodium-glucose co-transporter (SGLT) inhibitors to the type 1 diabetes armamentarium. These trials studied SGLT2 inhibitors (dapagliflozin and empagliflozin) and a dual SGLT1 and SGLT2 inhibitor (sotagliflozin), and demonstrated that these oral non-insulin antihyperglycaemic medications are able not only to improve glycaemic control, but also to reduce body weight and extend time in range without increasing rates of hypoglycaemia in type 1 diabetes. Diabetic ketoacidosis (DKA) is a feature of type 1 diabetes and the risk is increased when SGLT inhibitors are used in type 1 diabetes. Read More

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October 2019

The Incidence of Diabetic Ketoacidosis During "Emerging Adulthood" in the USA and Canada: a Population-Based Study.

J Gen Intern Med 2019 07 7;34(7):1244-1250. Epub 2019 May 7.

Cambridge Health Alliance/Harvard Medical School, 1493 Cambridge Street, Cambridge, MA, 02138, USA.

Background: As children with diabetes transition to adulthood, they may be especially vulnerable to diabetic ketoacidosis (DKA). Cross-national comparisons may inform efforts to avoid this complication.

Objective: To compare DKA hospitalization rates in the USA and Manitoba, Canada, during the vulnerable years known as "emerging adulthood. Read More

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The journey from gene knockout to clinical medicine: telotristat and sotagliflozin.

Authors:
Marc S Rendell

Drug Des Devel Ther 2019 6;13:817-824. Epub 2019 Mar 6.

Association of Diabetes Investigators, Omaha, NE 68131, USA,

Gene knockout has been a powerful technique to evaluate the physiologic role of selected gene products. Lexicon pioneered high-throughput gene knockout technology and went further in designing agents to inhibit products of gene expression. Two agents have entered late-stage development. Read More

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Acute Management of Diabetic Ketoacidosis in Adults at 3 Teaching Hospitals in Canada: A Multicentre, Retrospective Cohort Study.

Can J Diabetes 2019 Jul 17;43(5):309-315.e2. Epub 2018 Nov 17.

Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. Electronic address:

Objectives: Diabetic ketoacidosis (DKA) is a common acute complication of diabetes mellitus and is associated with significant morbidity and mortality. There is currently a paucity of data concerning the Canadian experience with DKA. We aimed to characterize the acute management and course of DKA at several Canadian hospitals. Read More

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Reversible Blindness as Presenting Manifestation of Severe Diabetic Ketoacidosis.

Am J Med Sci 2019 02 4;357(2):164-167. Epub 2018 Oct 4.

Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

The presenting symptoms of diabetic ketoacidosis (DKA) include abdominal pain, polyuria and nausea. Diabetes has well known chronic ocular complications like glaucoma, cataracts and retinopathy. We report a case of reversible blindness as a presenting manifestation of DKA that has been reported in literature only 3 times previously. Read More

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February 2019

SGLT2 Inhibitor-associated Diabetic Ketoacidosis: Clinical Review and Recommendations for Prevention and Diagnosis.

Clin Ther 2016 Dec;38(12):2654-2664.e1

Division of Endocrinology and Metabolism, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.

Purpose: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the newest class of antihyperglycemic agents available on the market. Regulator warnings and concerns regarding the risk of developing diabetic ketoacidosis (DKA), however, have dampened enthusiasm for the class despite the combined glycemic, blood pressure, and occasional weight benefits of SGLT2 inhibitors. With the goal of improving patient safety, a cross-Canada expert panel and writing group were convened to review the evidence to-date on reported SGLT2 inhibitor-related DKA incidents and to offer recommendations for preventing and recognizing patients with SGLT2 inhibitor-associated DKA. Read More

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December 2016

Low socioeconomic status is associated with adverse events in children and teens on insulin pumps under a universal access program: a population-based cohort study.

BMJ Open Diabetes Res Care 2016 22;4(1):e000239. Epub 2016 Jun 22.

Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Sickkids Research Institute; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.

Objective: To describe adverse events in pediatric insulin pump users since universal funding in Ontario and to explore the role of socioeconomic status and 24-hour support.

Research Design And Methods: Population-based cohort study of youth (<19 years) with type 1 diabetes (n=3193) under a universal access program in Ontario, Canada, from 2006 to 2013. We linked 2012 survey data from 33 pediatric diabetes centers to health administrative databases. Read More

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Screening for T1D risk to reduce DKA is not economically viable.

Pediatr Diabetes 2015 Dec 22;16(8):565-72. Epub 2015 Sep 22.

Department of Pediatrics, University of Florida, 1600 SW Archer Road, Gainesville, FL, 32608, USA.

Background: Children at high risk for developing type 1 diabetes (T1D) can be identified on the basis of human leukocyte antigen (HLA) genotype and the subsequent development of islet cell autoantibodies. Several studies have documented reduced incidence of diabetic ketoacidosis (DKA) in new-onset T1D when high-risk children are identified at an early age. Many have questioned whether general population screening for T1D risk should be standard of practice. Read More

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December 2015

Reducing episodes of diabetic ketoacidosis within a youth population: a focus group study with patients and families.

BMC Res Notes 2015 Sep 1;8:395. Epub 2015 Sep 1.

Division of Pediatrics, Faculty of Medicine, Janeway Child Health Care Centre, Memorial University of Newfoundland, St. John's, NL, Canada.

Background: Diabetic ketoacidosis (DKA) is the most common cause of morbidity and mortality for youth with type 1 diabetes mellitus (T1DM). This article reports qualitative data from focus groups with youth and parents of youth with T1DM on the barriers that they identify to DKA prevention and resources that may aid youth better manage their diabetes.

Methods: Four focus groups were held in three communities, two rural and one urban, in the Canadian province of Newfoundland and Labrador (NL) with adolescents and parents of youth with diabetes. Read More

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September 2015

Preventing Diabetic Ketoacidosis.

Pediatr Clin North Am 2015 Aug 30;62(4):857-71. Epub 2015 May 30.

Paediatric Endocrinology Service, Starship Children's Hospital, Auckland District Health Board, 2 Park Road, Auckland, 1023, New Zealand; Liggins Institute, University of Auckland, 85 Park Road, Auckland, 1023, New Zealand.

Diabetic ketoacidosis (DKA) is a major cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM). This article examines the factors associated with DKA in children with T1DM, both at first presentation and in recurrent cases. The challenge for future research is to find effective ways to improve primary care physician and general community awareness of T1DM to reduce DKA at presentation and develop practical, cost-effective programs to reduce recurrent DKA. Read More

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[Hyperosmolar hyperglycemic state].

Vnitr Lek 2015 May;61(5):451-7

The hyperglycemic hyperosmolar state (HHS) is a serious acute complication of diabetes decompensation, especially in type 2 diabetes (T2DM), and with critical prognosis. Primary characteristics of HHS include extreme hyperglycemia, severe dehydration (with prerenal hyperazotaemia), plasma hyperosmolarity, frequent disorders of consciousness, absent or minimum ketoacidosis (with higher values, only found in combined forms). Both DKA and HHS have a common pathogenetic mechanism, but both states are opposite extreme deviations, and the boundaries between them are not entirely clear. Read More

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Medically facilitated discharge of adult diabetic ketoacidosis admissions: precipitants and average length of stay.

N Z Med J 2014 Apr 11;127(1392):86-94. Epub 2014 Apr 11.

Diabetes Centre, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand.

Aims: To assess the impact of medically facilitated discharge by a specialist registrar on diabetic ketoacidosis (DKA) length of stay (LOS) and to collect data from these DKA admissions for a descriptive summary of their clinical and biochemical characteristics.

Method: DKA admissions were identified through the electronic patient management system, Monday to Friday over a 9 month period. The admitting team was then offered assistance with discharge planning ('study intervention'). Read More

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Predictors of diabetic ketoacidosis in children and adolescents with type 1 diabetes. Experience from a large multicentre database.

Pediatr Diabetes 2011 Jun 6;12(4 Pt 1):307-12. Epub 2011 Apr 6.

Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria.

Objective: Diabetic ketoacidosis (DKA) remains a major cause of hospitalization and death in children and adolescents with established type 1 diabetes despite DKA preventing strategies. The aim of the study was to determine incidence and risk factors for DKA in a large cohort of young diabetic patients.

Methods: This investigation uses the dpv-wiss base containing data on 28 770 patients with type 1 diabetes <20yr, from Germany and Austria. Read More

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Prevention of diabetic ketoacidosis and self-monitoring of ketone bodies: an overview.

Curr Med Res Opin 2009 May;25(5):1197-207

IMIB Institute for Medical Informatics and Biostatistics, Basel, Switzerland.

Objective: Diabetic ketoacidosis (DKA) is associated with significant morbidity and mortality. Self-monitoring of ketone bodies by diabetes patients can be done using blood or urine. We compared the two self-monitoring methods and summarized recent developments in the epidemiology and management of DKA. Read More

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Recent advances in childhood diabetes mellitus.

Authors:
O O Ayoola

Ann Ib Postgrad Med 2008 Dec;6(2):9-20

Department of Paediatrics, University College Hospital, Ibadan & Endocrine Sciences Research Group, University of Manchester, United Kingdom.

Diabetes mellitus (DM) is a syndrome characterized by disturbed metabolism of carbohydrate, protein, and fat. It is a chronic metabolic disorder caused by an absolute or relative deficiency of insulin. It presents with very different medical and psychosocial issues in children. Read More

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December 2008

Epidemiology and management of type 1 diabetes mellitus at the ain shams university pediatric hospital.

J Egypt Public Health Assoc 2008 ;83(1-2):107-32

* Community Medicine Department,Faculty of Medicine, Ain-Shams University, Egypt.

Unlabelled: Type 1 diabetes mellitus is the most common metabolic disease in childhood. An interplay between genetic susceptibility and environmental factors (triggering or suppressive) may account for the pathogenesis of type 1 diabetes The diabetes control and complications trial (DCCT) showed the importance of strict metabolic control in delaying and preventing complications. The aim of this work was to describe the epidemiological features of type 1 diabetes mellitus (the pattern of seasonality at birth and at diagnosis, the initial symptoms of presentation, and the precipitating factors) and to compare the frequency of occurrence of long term complications (as microalbuminuria, and diabetic neuropathy and retinopathy) in relation to different insulin regimens among children attending pediatric hospital at Ain Shams University. Read More

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November 2015

Diabetic ketoacidosis associated with aripiprazole.

Pharmacotherapy 2008 Sep;28(9):1198-202

School of Medicine, University of Maryland, Baltimore, Maryland, USA.

Metabolic adverse effects such as hyperglycemia, alterations in insulin sensitivity, and weight gain are known to be potential complications of atypical antipsychotic therapy. In certain cases, hyperglycemia may be so profound that diabetic ketoacidosis (DKA) or hyperosmolar coma may result. Aripiprazole, approved by the United States Food and Drug Administration in 2002, appears to have fewer metabolic adverse effects than other atypical antipsychotics. Read More

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September 2008

Preventing a drop in effective plasma osmolality to minimize the likelihood of cerebral edema during treatment of children with diabetic ketoacidosis.

J Pediatr 2007 May;150(5):467-73

Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.

Objectives: To test whether a drop in effective plasma osmolality (P(Eff osm); 2 x plasma sodium [P(Na)] + plasma glucose concentrations) during therapy for diabetic ketoacidosis (DKA) is associated with an increased risk of cerebral edema (CE), and whether the development of hypernatremia to prevent a drop in the P(Eff osm) is dangerous.

Study Design: This study is a retrospective comparison of a CE group (n = 12) and non-CE groups with hypernatremia (n = 44) and without hypernatremia (n = 13).

Results: The development of CE (at 6. Read More

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The management of diabetic ketoacidosis.

Acute Med 2007 ;6(1):3-8

Level 2 Secretariat John Radcliffe Hospital Oxford OX3 9DU.

This article reviews the management of diabetic ketoacidosis (DKA) in adults with a focus on the three basic principles of treatment: intravenous fluid therapy, intravenous insulin administration and potassium replacement. The recommendations are modelled on the national guidance for the management of DKA in children. We highlight the importance of being alert to signs of life-threatening complications of the condition such as cerebral oedema and adult respiratory distress syndrome (ARDS). Read More

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October 2012

Clinical pictures of type 2 diabetes in Thai children and adolescents is highly related to features of metabolic syndrome.

J Med Assoc Thai 2005 Nov;88 Suppl 8:S169-75

Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Prevalence of type 2 diabetes (T2DM) in children and adolescents has increased, parallelled to the increased prevalence of obesity around the world. The objectives of this study are (1) to identify the clinical presenting features of T2DM in Thai children and adolescents, and (2) to identify evidence of feature of metabolic syndrome in these affected. We analyzed 26 T2DM patients who were treated by Pediatric endocrinologists in our hospital. Read More

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November 2005