scholarly journals A Complicated Case of COVID-19 and Hyperglycemic Hyperosmolar Syndrome in an Adolescent Male

2021 ◽  
pp. 1-5
Author(s):  
Anisha Gohil ◽  
Stefan Malin ◽  
Kamal Abulebda ◽  
Tamara S. Hannon

Emerging data demonstrate that comorbid conditions and older age are contributing factors to COVID-19 severity in children. Studies involving youth with COVID-19 and diabetes are lacking. We report the case of a critically ill adolescent male with obesity, type 2 diabetes, and COVID-19 who presented with hyperglycemic hyperosmolar syndrome (HHS). This case highlights a challenge for clinicians in distinguishing severe complications of COVID-19 from those seen in HHS. Youth with obesity and type 2 diabetes may represent a high-risk group for severe COVID-19 disease, an entity that to date has been well-recognized in adults but remains rare in children and adolescents.

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Morten Lindhardt ◽  
Nete Tofte ◽  
Gemma Currie ◽  
Marie Frimodt-Moeller ◽  
Heiko Von der Leyen ◽  
...  

Abstract Background and Aims In the PRIORITY study, it was recently demonstrated that the urinary peptidome-based classifier CKD273 was associated with increased risk for progression to microalbuminuria. As a prespecified secondary outcome, we aim to evaluate the classifier CKD273 as a determinant of relative reductions in eGFR (CKD-EPI) of 30% and 40% from baseline, at one timepoint without requirements of confirmation. Method The ‘Proteomic prediction and Renin angiotensin aldosterone system Inhibition prevention Of early diabetic nephRopathy In TYpe 2 diabetic patients with normoalbuminuria trial’ (PRIORITY) is the first prospective observational study to evaluate the early detection of diabetic kidney disease in subjects with type 2 diabetes (T2D) and normoalbuminuria using the CKD273 classifier. Setting 1775 subjects from 15 European sites with a mean follow-up time of 2.6 years (minimum of 7 days and a maximum of 4.3 years). Patients Subjects with T2D, normoalbuminuria and estimated glomerular filtration rate (eGFR) ≥ 45 ml/min/1.73m2. Participants were stratified into high- or low-risk groups based on their CKD273 score in a urine sample at screening (high-risk defined as score > 0.154). Results In total, 12 % (n = 216) of the subjects had a high-risk proteomic pattern. Mean (SD) baseline eGFR was 88 (15) ml/min/1.73m2 in the low-risk group and 81 (17) ml/min/1.73m2 in the high-risk group (p < 0.01). Baseline median (interquartile range) urinary albumin to creatinine ratio (UACR) was 5 (3-8) mg/g and 7 (4-12) mg/g in the low-risk and high-risk groups, respectively (p < 0.01). A 30 % reduction in eGFR from baseline was seen in 42 (19.4 %) subjects in the high-risk group as compared to 62 (3.9 %) in the low-risk group (p < 0.0001). In an unadjusted Cox-model the hazard ratio (HR) for the high-risk group was 5.7, 95 % confidence interval (CI) (3.9 to 8.5; p<0.0001). After adjustment for baseline eGFR and UACR, the HR was 5.2, 95 % CI (3.4 to 7.8; p<0.0001). A 40 % reduction in eGFR was seen in 15 (6.9 %) subjects in the high-risk group whereas 22 (1.4 %) in the low-risk group developed this endpoint (p<0.0001). In an unadjusted Cox-model the HR for the high-risk group was 5.0, 95 % CI (2.6 to 9.6; p<0.0001). After adjustment for baseline eGFR and UACR, the HR was 4.8, 95 % CI (2.4 to 9.7; p<0.0001). Conclusion In normoalbuminuric subjects with T2D, the urinary proteomic classifier CKD273 predicts renal function decline of 30 % and 40 %, independent of baseline eGFR and albuminuria.


2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Lingling He ◽  
Shuan Zhang ◽  
Xiaoli Liu ◽  
Yuyong Jiang ◽  
Xianbo Wang ◽  
...  

Aim. To establish a new score model to predict risk of death in patients with hepatocellular carcinoma and type 2 diabetes mellitus.Methods. This was a retrospective study of 147 patients with hepatocellular carcinoma and type 2 diabetes mellitus who came to Beijing Ditan Hospital between October 2008 and June 2013. Univariate and multivariate logistic regression analysis was performed to obtain the independent factors associated with death risk. A new score model was devised according to these factors.Results. A prediction score model composed of HbA1c, NLR, age, and CTP class was devised, which ranged from 0 to 7. AUROC of the score was 0.853 (P<0.001, 95% CI: 0.791–0.915). Scores 0–2, 3-4, and 5–7 identified patients as low-, medium-, and high-risk categories. The cumulative survival rate was 93.6%, 83.0%, and 74.5% in the low-risk group in 1, 2, and 3 years, while it was 64.0%, 46.0%, and 26.0% in the medium-risk group, whereas it was 24.0%, 12.0%, and 6.0% in the high-risk group, respectively. The cumulative survival rate was significantly higher in the low-risk group than that in the medium-risk group and high-risk group (P<0.001).Conclusion. The HbA1c-based score model can be used to predict death risk in patients with hepatocellular carcinoma and type 2 diabetes mellitus.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2258-PUB
Author(s):  
YIN-KAI LIAO ◽  
YI-SUN YANG ◽  
CHIEN-NING HUANG ◽  
HSIU-LING PENG

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Susan van Dieren ◽  
Andre Pascal Kengne ◽  
John Chalmers ◽  
Joline Beulens ◽  
Yvonne van der Schouw ◽  
...  

Background/Aim: Although patients with type 2 diabetes constitute a high risk group there is a gradation in cardiovascular risk which may lead to differences in outcomes and effects of treatment. The objective of this study was to assess for differences in treatment effects of the fixed combination of perindopril-indapamide across subgroups of cardiovascular risk. Methods: 11,140 patients with type 2 diabetes, participating in the ADVANCE trial, were randomized to perindopril-indapamide or matching placebo. The UKPDS risk engine was used to calculate baseline 5-year coronary heart disease risk and to stratify patients into three risk groups (0-10%; 10–15%; >15%). Endpoints were composites of major macrovascular and microvascular events. Homogeneity of treatment effects across risk subgroups were tested by adding interaction terms to the Cox models. Results: The median estimated 5-year coronary heart disease risk at baseline was 10% (IQR 7%−16%). 1000 macrovascular and 916 microvascular events were recorded during a median follow-up of 4.3 years. The relative treatment effects were similar across all risk groups for all endpoints, with no heterogeneity (all P -values for heterogeneity ≥ 0.38). The hazard ratios for combined macro- and microvascular events were 0.89 (95% confidence interval: 0.77–1.03) for the moderate-high risk group and 0.92 (0.81–1.03) for the very high risk group. The absolute risk reductions were greater in the highest risk groups, with numbers needed to treat ranging from 38 to 244. Conclusions: Reductions in relative risk achieved with the fixed combination of perindopril-indapamide among patients with type 2 diabetes were consistent across subgroups defined by baseline cardiovascular risk, but reductions in absolute risk were greatest in those with the highest initial risk. Acknowledgements: This research was supported by a program grant from the National Health and Medical Research Council of Australia, the Center for Translational Molecular Medicine (CTMM) and the Netherlands Heart Foundation, Dutch Diabetes Research Foundation and Dutch Kidney Foundation (PREDICCt).


Pancreatology ◽  
2016 ◽  
Vol 16 (2) ◽  
pp. 266-271 ◽  
Author(s):  
Dóra Illés ◽  
Viktória Terzin ◽  
Gábor Holzinger ◽  
Klára Kosár ◽  
Richárd Róka ◽  
...  

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Marina Fugmann ◽  
Michaela Breier ◽  
Marietta Rottenkolber ◽  
Friederike Banning ◽  
Uta Ferrari ◽  
...  

2016 ◽  
Vol 39 (5) ◽  
pp. 1695-1704 ◽  
Author(s):  
Nusrath M. Habiba ◽  
Kimberly G. Fulda ◽  
Riyaz Basha ◽  
Deep Shah ◽  
Shane Fernando ◽  
...  

Background/Aims: The role of lipid profile in predicting the risk of Type 2 diabetes mellitus (T2DM) in children is not clearly established. Our aim is to screen non-diabetic children aged 10-14 years for risk of developing T2DM and evaluate the association of abnormal lipids and socioeconomic status (SES). Methods: Data on race/ethnicity, family history, body mass index percentile, blood pressure and presence of neck pigmentation (acanthosis nigricans) were collected from 149 non-diabetic children. Using these factors, children were classified into low risk (<3 risk factors) and high risk (>3 risk factors) groups. Logistic regression model and chi-square tests were used to evaluate the association of blood lipid profile and demographic variables. Independent t-test was used to compare the ratio of Total Cholesterol (TC) and High Density Lipids (HDL) with T2DM risk. Results: 60% of children were at high risk for developing T2DM. HDL (p<0.001), triglycerides (p=0.02) and TC/HDL ratio (p<.001) were significantly abnormal in high risk group. Low SES showed a marginal association with high risk group. There were no gender or age differences between high and low risk groups. Conclusions: The significant determinants associated with high risk group were modifiable factors providing an opportunity for early intervention and prevention.


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