scholarly journals New-Onset Diabetes with Ketoacidosis Precipitated by COVID-19 in Children: A Report of Two Cases

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Nabila Chekhlabi ◽  
Amal Haoudar ◽  
Nadia Echcharii ◽  
Said Ettair ◽  
Nezha Dini
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Asymptomatic Infection ◽  
Acute Onset ◽  
Thoracic Imaging ◽  
Intravenous Insulin ◽  
Insulin Requirements ◽  
Onset Diabetes ◽  
Potential Trigger ◽  
New Onset

Background and Aims. There is growing evidence that the 2019 coronavirus disease (COVID-19) is emerging as a potential trigger virus for the development of diabetes mellitus in children. This can occur even in patients without factors predisposing to impaired glucose metabolism. Here, we report two rare cases of diabetic ketoacidosis revealing new-onset diabetes and precipitated by COVID-19. These cases are reported in view of their rarity and originality. The relationship between type 1 diabetes mellitus and COVID-19 is discussed. Results. Two children developed symptoms suggestive of diabetic ketoacidosis preceded by polyuria, polydipsia, and asbestos. There is a documented COVID-19 infection in the parents of the 2 children. An asymptomatic infection was detected in the 2 patients on the basis of a reverse transcription polymerase chain reaction (RT-PCR) test. Thoracic imaging and inflammatory workup were negative in both cases. Both patients responded well to treatment, including rehydration regimens and intravenous insulin. On the 2nd day of their hospitalization, they were transferred to several injections of subcutaneous insulin with therapeutic and nutritional education from the parents. After about 4 weeks, their insulin requirements probably decreased due to the diabetes honeymoon. Conclusion. COVID-19 can induce acute onset diabetes and diabetic ketoacidosis in children. More research data are needed to improve our knowledge of this constellation and to guide the most appropriate therapies.

scholarly journals New onset diabetes with diabetic ketoacidosis in a child with multisystem inflammatory syndrome due to COVID-19

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Monica N. Naguib ◽  
Jennifer K. Raymond ◽  
Alaina P. Vidmar
Keyword(s):  
Metabolic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Pediatric Patients ◽  
Systolic Function ◽  
Hemodynamic Instability ◽  
Case Presentation ◽  
Onset Diabetes ◽  
Potential Trigger ◽  
Inflammatory Syndrome ◽  
New Onset

AbstractIntroductionMultisystem inflammatory syndrome in children (MIS-C) is a unique clinical complication of SARS-CoV-2 infection observed in pediatric patients. COVID-19 is emerging as a potential trigger for the development of diabetes in children. Here, we report a patient presenting with MIS-C and new onset diabetes, and discuss the implication and clinical management of these concomitant conditions.Case presentationAn eight-year-old female presented with hyperglycemia, ketosis and metabolic acidosis consistent with diabetic ketoacidosis (DKA) in the setting of fever, rash, respiratory distress, hemodynamic instability, reduced systolic function with dilation of the left anterior descending artery, and positive SARS-CoV-2 antibodies suggestive of MIS-C.

New-onset diabetes mellitus presenting with diabetic ketoacidosis after pediatric liver transplantation

2009 ◽  
Vol 13 (5) ◽  
pp. 536-539 ◽  
Author(s):  
Seyed Mohsen Dehghani ◽  
Saman Nikeghbalian ◽  
Ahad Eshraghian ◽  
Mahmood Haghighat ◽  
Mohammad Hadi Imanieh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Liver Transplantation ◽  
Diabetic Ketoacidosis ◽  
Pediatric Liver Transplantation ◽  
Pediatric Liver ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset

scholarly journals Pembrolizumab-Induced Diabetes Mellitus Presenting as Diabetic Ketoacidosis in a Patient With Metastatic Colonic Adenocarcinoma

2020 ◽  
Vol 8 ◽  
pp. 232470962095133
Author(s):  
Asim Kichloo ◽  
Michael S. Albosta ◽  
Shane McMahon ◽  
Kimberly Movsesian ◽  
Farah Wani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
T Cells ◽  
T Cell ◽  
Insulin Therapy ◽  
Diabetic Ketoacidosis ◽  
T Cell Activation ◽  
Immune Checkpoint ◽  
Colonic Adenocarcinoma ◽  
Onset Diabetes ◽  
New Onset

Immunotherapy drugs are gaining popularity in the treatment of certain malignancies due to the success of these agents in recent clinical trials. Pembrolizumab is an immune checkpoint inhibitor that acts via binding to programmed cell death 1 (PD-1) receptors on T-cells, allowing for the constitutive activation of T-cells to fight malignant tumor cells. Immune checkpoint molecules such as PD-1 act to inhibit T-cell function, promoting tolerance to self-antigens. Inhibition of these molecules may lead to increased T-cell activation against cancer cells, but also against healthy tissue, leading to the side effects of these medications known as immune-related adverse events. In this article, we present the case of a 77-year-old female with a history of metastatic colonic adenocarcinoma presenting with new-onset diabetes mellitus and diabetic ketoacidosis in the setting of receiving pembrolizumab chemotherapy. Our patient was treated with hydration, insulin therapy, and management of her electrolytes, ultimately being discharged with the need for home insulin therapy to manage her new-onset diabetes. There are no current guidelines for the management or surveillance of patients receiving pembrolizumab chemotherapy, and further research should be done to determine which patients are at highest risk to developing this rare but potentially lethal side effect.

New-Onset Diabetes Mellitus and Diabetic Ketoacidosis Associated With Olanzapine Treatment

1999 ◽  
Vol 40 (5) ◽  
pp. 438-443 ◽  
Author(s):  
Lee E. Goldstein ◽  
Jonathan Sporn ◽  
Susan Brown ◽  
Helen Kim ◽  
Joan Finkelstein ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Olanzapine Treatment ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset

scholarly journals Comparing Disease Severity: Diabetic Ketoacidosis in Local and Tourist Children With New-Onset Diabetes Mellitus

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A450-A451
Author(s):  
Autumn Hinds ◽  
Mauri Carakushansky ◽  
Timothy Maul ◽  
Kenneth Alexander ◽  
Shilpa Gurnurkar
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Risk Factor ◽  
Diabetic Ketoacidosis ◽  
Illness Severity ◽  
Delay In Diagnosis ◽  
Central Florida ◽  
Onset Diabetes ◽  
Significant Difference ◽  
New Onset

Abstract Introduction: Approximately 30% of youth present with diabetic ketoacidosis (DKA) at the time of diagnosis of type 1 diabetes mellitus (DM). DKA severity can be mild to severe, impacting hospitalization duration as severity worsens, or even result in death. A delay in care from onset of symptoms results in greater illness severity. Travel has been a proposed risk factor for illness severity in general; one study identified ruptured appendicitis as a more frequent complication in children vacationing from their hometown. Identifying travel as a potential risk factor for severe DKA is necessary. There is no research highlighting the association between vacation and severity of DKA in new onset diabetics. Central Florida is one of the major vacation destinations and is home to a diverse population, so offers a unique study population. The goal of this novel study was to investigate the association between travel and severity of DKA in new onset diabetics. Methods: A retrospective chart review of children admitted to a children’s hospital in Central Florida with both new onset diabetes and DKA from October 2012-March 2020 was conducted. Patients that did not meet criteria for DKA based on venous pH (pH) < 7.3 or bicarbonate (HCO3) < 15 mmol/l were excluded. Patients were divided into two groups by primary residence: locals versus tourists. The severity of DKA was determined as either mild (pH < 7.3 or HCO3 10 to < 15), moderate (pH < 7.2 or HCO3 5–9), or severe (pH < 7.1 or HCO3 < 5), and compared between local versus tourist children with Chi-squared testing. Results: There was no significant difference in DKA severity between locals and tourists. 33% of local children presented in severe DKA compared to 29% of tourist children (p=0.809). The percentage of children overall presenting with moderate or severe DKA was about 70%. Gender and admission status had a statistically significant correlation to DKA severity. More females presented in severe DKA than males (56 % versus 44%, p=0.029), and patients transferred from an outside facility versus directly admitted from the emergency department had a higher percentage of severe DKA (76% versus 24%, p=0.002). Conclusion: This study is the first in the literature to report that travel does not seem to be a contributing risk factor to the severity of DKA. We did find that more than half of all new onset diabetics presented in moderate or severe DKA, indicating that there is currently a frequent delay in diagnosis of children with new onset diabetes. A higher rate of severe DKA was noted in patients transferred from an outside facility versus children admitted directly to the ICU from our emergency department, which may likely be due to challenging access to a specialty pediatric hospital among patients living in remote areas. We propose that future studies investigate this relationship further to guide interventions that can significantly reduce the rate of severe DKA on presentation.

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