Severe Diabetic Ketoacidosis in a Child with Type-1 Diabetes, Asthma, and COVID-19

2020 ◽  
Author(s):  
Wilson A. Vasconez ◽  
Carmen L. Bustamante Escobar ◽  
Nisha Agarwal ◽  
Juan P. Solano ◽  
Janine E. Sanchez
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Insulin Infusion ◽  
Clinical Suspicion ◽  
Life Threatening ◽  
History Of ◽  
Novel Coronavirus

AbstractLittle is known about the association between novel coronavirus disease 2019 (COVID-19) and type-1 diabetes in children. A 16-year-old female with history of type-1 diabetes was admitted for life threatening diabetic ketoacidosis (DKA). She recovered from the DKA after 24 hours of insulin infusion and rehydration. On day 2, she was diagnosed with COVID-19. The DKA relapsed and required restarting insulin. She developed leukopenia, neutropenia, and high ferritin. Upon recovery she was discharged for self-quarantine. Severity of DKA in children with COVID-19 is multifactorial. Clinical suspicion of COVID should be heightened in patients who present with unexplainedly severe DKA.

MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN ASSOCIATED WITH COVID-19 IN THE 6-YEAR-OLD PATIENT WITH MANIFESTATION OF TYPE 1 DIABETES MELLITUS WITH DIABETIC KETOACIDOSIS

2021 ◽  
Vol 100 (2) ◽  
pp. 295-300
Author(s):  
Yu.V. Tikhonovich ◽  
◽  
A.Yu. Rtishchev ◽  
A.A. Glazyrina ◽  
D.Yu. Ovsyannikov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Clinical Observation ◽  
Laboratory Data ◽  
Domestic Literature ◽  
Life Threatening ◽  
Inflammatory Syndrome

For the first time in the domestic literature, the article presents a clinical observation of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 in the 6-year-old patient with manifestation of type 1 diabetes mellitus (T1DM) in the form of diabetic ketoacidosis. Anamnestic, clinical and laboratory data are presented on the basis of which two life-threatening diseases was diagnosed, as well as tactics of therapy, which made it possible to achieve a positive result. This clinical observation is compared with observations of foreign colleagues. Possible pathogenetic mechanisms of MIS-C and T1DM comorbidity are discussed.

scholarly journals COVID-19 Infection with Refractory Diabetic Ketoacidosis- A case Report

2021 ◽  
Vol 7 (2) ◽  
pp. 54-56
Author(s):  
Reshmi Mishra ◽  
◽  
Jyoti Ranjan Behera ◽  
P. Ramkumar ◽  
Mukesh Kumar Jain ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Metabolic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Vital Organ ◽  
Increased Risk ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
New Onset

Diabetic ketoacidosis is an acute life-threatening complication of type 1 diabetes. Sometimes it is the first presentation in an undiagnosed child. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) and diabetes mellitus are very much interrelated as diabetes mellitus is associated with an increased risk of severe COVID19 at the same time, many cases of new-onset diabetes had been diagnosed. Hyperglycemia, metabolic acidosis, and ketonemia are classical presentations. It is essential to correct the acidosis and fluid correction and insulin therapy in these patients, leading to vital organ dysfunction. In refractory metabolic acidosis, renal replacement therapy may help

scholarly journals Euglycemic Diabetic Ketoacidosis in Type 1 Diabetes on Insulin Pump, with Acute Appendicitis: A Case Report

2021 ◽  
Vol 5 (3) ◽  
pp. 296-298
Author(s):  
Brian Thompson ◽  
Anthony Kitchen
Keyword(s):  
Type 1 Diabetes ◽  
Case Report ◽  
Acute Appendicitis ◽  
Diabetic Ketoacidosis ◽  
Insulin Pump ◽  
Point Of Care ◽  
Altered Mental Status ◽  
History Of ◽  
Euglycemic Diabetic Ketoacidosis

Introduction: Recently, euglycemic diabetic ketoacidosis has been an increasing topic of discussion within emergency medicine literature. Euglycemic diabetic ketoacidosis can easily be missed, as a normal point-of-care glucose often mistakenly precludes the work-up of diabetic ketoacidosis. Case Report: A 16-year-old female with a past medical history of type 1 diabetes presented to the emergency department with altered mental status, vomiting, and abdominal pain. She was diagnosed with euglycemic diabetic ketoacidosis. Conclusion: Reported cases of euglycemic diabetic ketoacidosis are most frequently attributed to sodium glucose cotransporter-2 inhibitors, but other potential causes have been discussed in the literature. In this patient, a starvation state with continued insulin use in the setting of acute appendicitis led to her condition.

scholarly journals Hypertriglyceridemia-induced acute pancreatitis with diabetic ketoacidosis: A rare presentation of type 1 diabetes mellitus

2017 ◽  
Vol 9 (04) ◽  
pp. 329-331 ◽  
Author(s):  
Prabhat Kumar ◽  
Abhishek Sakwariya ◽  
Amit Ranjan Sultania ◽  
Renu Dabas
Keyword(s):  
Diabetes Mellitus ◽  
Acute Pancreatitis ◽  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Insulin Infusion ◽  
Rare Presentation ◽  
Chronic Hyperglycemia ◽  
Severe Hypertriglyceridemia ◽  
Peptide Level

AbstractDiabetic ketoacidosis (DKA) is a frequently encountered complication of diabetes mellitus. DKA is an insulin deficit state and results in moderate to severe hypertriglyceridemia (HTG). HTG is the third leading cause of acute pancreatitis (AP) and often goes unnoticed. The triad of DKA, HTG, and AP is rarely seen, and literature on the same is sparse. We report a case of AP which was due to DKA-induced secondary HTG in an adult with previously undiagnosed type 1 diabetes. His HbA1c was significantly raised, and C-peptide level was low, confirming chronic hyperglycemia. He was treated successfully with insulin infusion, intravenous crystalloid, and analgesics.

scholarly journals Diabetic ketoacidosis in pregnancy

2018 ◽  
Vol 7 (7) ◽  
pp. 2945
Author(s):  
Rosália S. Coutada ◽  
Soraia S. Cunha ◽  
Elisabete S. Gonçalves ◽  
Ana P. Gama ◽  
João P. Silva ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Pregnant Woman ◽  
Diabetic Ketoacidosis ◽  
Perinatal Mortality ◽  
Aggressive Treatment ◽  
Mortality And Morbidity ◽  
Threatening Condition ◽  
Life Threatening ◽  
In Pregnancy

Diabetic ketoacidosis in pregnancy is a rare but potential life-threatening condition for the mother and the fetus. It tends to occur latter in pregnancy and is more common in patients with pregestational diabetes. Obstetricians should be aware of the events that can trigger diabetic ketoacidosis in pregnancy. Prompt recognition and aggressive treatment of this condition are essential in order to reduce perinatal mortality and morbidity. The authors present a case of a pregnant woman with type 1 diabetes with a poor surveillance of pregnancy and noncompliance to treatment that develops severe diabetic ketoacidosis at 34 weeks of gestation.

scholarly journals Rapid onset type-1 diabetes and diabetic ketoacidosis secondary to nivolumab immunotherapy: a review of existing literature

2019 ◽  
Vol 12 (8) ◽  
pp. e229568 ◽  
Author(s):  
Hafez Mohammad Ammar Abdullah ◽  
Radowan Elnair ◽  
Uzma Ikhtiar Khan ◽  
Muhammad Omar ◽  
Oscar L Morey-Vargas
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Death Receptor ◽  
Rapid Onset ◽  
Acute Onset ◽  
Fulminant Type 1 Diabetes ◽  
Life Threatening ◽  
Cell Death Receptor ◽  
Fulminant Type

Nivolumab is a programmed cell death receptor (PD-1) inhibitor that is increasingly used for various malignancies, both as a first line agent and as salvage therapy. Being a PD-1/PD-1 ligand checkpoint inhibitor, it is known to cause autoimmune inflammation of various organs and has been associated with thyroiditis, insulitis, colitis, hepatitis and encephalitis to name a few. There are increasing reports of nivolumab leading to acute onset fulminant type 1 diabetes and diabetic ketoacidosis (DKA). We present a case of a 68-year-old man who developed DKA after 2 doses of nivolumab for metastatic melanoma. He was found to have type 1 diabetes, but no diabetes related antibodies were positive. He recovered from diabetes and continues to use insulin 1 year after his diagnosis. This case and associated review illustrates the importance of educating and monitoring patients who start nivolumab therapy regarding this potentially life threatening complication.

scholarly journals Prevalence and Associated Factors of Diabetic ketoacidosis among Patients Living with Type 1 Diabetes in Makkah Al-Mukarramah City

2021 ◽  
Vol 20 (11) ◽  
Author(s):  
Raghad Alhajaji ◽  
Khalid Almasodi ◽  
Afaf Alhajaji ◽  
Ahmad Alturkstani ◽  
Mayada Samkari
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Hba1c Level ◽  
Past History ◽  
Postgraduate Education ◽  
Cross Sectional ◽  
Female Patients ◽  
History Of

Objective: To assess magnitude of diabetic ketoacidosis (DKA) among type-1 diabetics and to identify associated risk factors. Methods: A cross-sectional study was conducted among 236 type-1 diabetics in Makkah Al-Mukarramah City, Saudi Arabia. Results: Among participants, 59.3% were males, 44.1% were diabetic for more than 5 years, while 70.8% reported past history of DKA. The main causes of DKA were gfirst presentation of the diseaseh (40.9%), and gdiscontinued treatmenth (37%). The HbA1c among 53.6% was above 9%. Almost all cases who experienced DKA were hospitalised (98.8%). Out of them, 9 (5.4%) suffered complications. Female patients were more likely to suffer from episodes of DKA than males (76% and 68.3%, respectively). Most patients whose parentsf highest education was primary level had DKA more frequently than those whose parentsf had postgraduate education. Patients with unemployed fathers had significantly higher frequency of DKA (p=0.004). Ketoacidosis was significantly more frequent among patients with parentsf consanguinity (p<0.001). Patients who had their current HbA1c level exceeding 9% had positive history of DKA compared to those with HbA1c level .7% (87.9% and 28.6%, respectively, p<0.001). Conclusion: Most type-1 diabetics experience DKA, mainly with their first presentation of disease or due to discontinuation of treatment. DKA tends to occur more frequently among female patients, those with less educated parents or when their parents are relatives. Key words: Type 1 diabetes, diabetic ketoacidosis, magnitude, risk factors.

scholarly journals Diabetic Ketoacidosis and Mortality in People With Type 1 Diabetes and Eating Disorders

2021 ◽  
Author(s):  
Nicole K. Gibbings ◽  
Paul A. Kurdyak ◽  
Patricia A. Colton ◽  
Baiju R. Shah
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Young Adults ◽  
Confidence Interval ◽  
Diabetic Ketoacidosis ◽  
Hazard Ratio ◽  
Adolescents And Young Adults ◽  
All Cause Mortality ◽  
History Of

Objective: To determine the risk of diabetic ketoacidosis (DKA) and all-cause mortality among adolescents and young adults with type 1 diabetes with and without an eating disorder. <p>Research Design and Methods: Using population-level healthcare administrative data covering the entire population of Ontario, Canada, all people with type 1 diabetes aged 10 to 39 as of January 2014 were identified. Individuals with a history of eating disorders were age/sex matched 10:1 with individuals without eating disorders. All individuals were followed for 6 years for hospitalization/emergency department visits for diabetic ketoacidosis, and for all-cause mortality.</p> <p>Results: We studied 168 people with eating disorders and 1680 age/sex-matched people without eating disorders. Among adolescents and young adults with type 1 diabetes, 168 (0.8%) had a history of eating disorders. The crude incidence of diabetic ketoacidosis was 112.5 per 1,000 patient-years in people with eating disorders, versus 30.8 in people without eating disorders. After adjustment for baseline differences, the subdistribution hazard ratio comparing people with and without eating disorders was 3.30 (95% confidence interval 2.58-4.23, p<0.0001). All-cause mortality was 16.0 per 1,000 person-years in people with eating disorders, versus 2.5 in people without eating disorders. The adjusted hazard ratio was 5.80 (95% confidence interval 3.04-11.08, p<0.0001). </p> <p>Conclusions: Adolescents and young adults with type 1 diabetes and eating disorders have more than triple the risk of diabetic ketoacidosis and nearly 6-fold increased risk of death compared to their peers without eating disorders.</p>

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