scholarly journals Tatalaksana Penurunan Kesadaran Pada Penderita Diabetes Mellitus

Medicinus ◽  
2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Ian Huang
Keyword(s):  
Diabetes Mellitus ◽  
Mortality Rate ◽  
Lactic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Complications Of Diabetes ◽  
Uremic Encephalopathy ◽  
Hyperosmolar Hyperglycemic State ◽  
Life Threatening

Hyperglycemic crisis (diabetic ketoacidosis or hyperosmolar hyperglycemic state), lactic acidosis, hypoglycemia, and uremic encephalopathy are life-threatening complications of diabetes mellitus (DM). Specific therapies of each condition are essential in reducing mortality rate of the complications.

scholarly journals Clinical conundrums in the management of diabetic ketoacidosis in the elderly

2019 ◽  
Vol 7 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Vishal Sehgal ◽  
Brian Ulmer
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Acute Kidney Injury ◽  
Elderly Patients ◽  
Diabetic Ketoacidosis ◽  
Kidney Injury ◽  
The Elderly ◽  
Complications Of Diabetes ◽  
Clinical Presentations ◽  
Life Threatening

Abstract One of the dreaded life-threatening complications of diabetes mellitus (DM) is diabetic ketoacidosis (DKA). American Diabetic Association (ADA) came out with 2018 guidelines on the management of DM and its complications, but these are woefully silent on the clinical conundrums that accompany DKA in elderly patients. In elderly patients, DKA is often complicated by sepsis, atrial fibrillation, polypharmacy, nonketotic hyperosmolar states, atypical clinical presentations, acute kidney injury (AKI), dementia, and noncompliance with medications. Here in we highlight these conundrums that need to be addressed to improve morbidity and mortality in elderly patients.

scholarly journals Acute metabolic complications of diabetes mellitus in a tertiary care center

2017 ◽  
Vol 4 (4) ◽  
pp. 985 ◽  
Author(s):  
Ramesh Gorghatta Hanumanthaiah ◽  
Panchakshari Prasanna Bangalore Krishnap ◽  
Dheemantha Prasad ◽  
Sheerin Farahat ◽  
Ranganath T. S.
Keyword(s):  
Diabetes Mellitus ◽  
Lactic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Care Center ◽  
Tertiary Care ◽  
Metabolic Complications ◽  
Complications Of Diabetes ◽  
Mortality And Morbidity ◽  
Metabolic Complication ◽  
A Prospective Study

Background:Diabetes mellitus (DM) is a chronic medical disorder characterized by hyperglycemia. It arises due to inability of pancreas to produce insulin, either because of impaired insulin secretion, impaired action or both. Most of the untreated or inadequately treated patients develop acute metabolic complications. These complications are associated with high mortality and morbidity. Most common among the acute metabolic complications are diabetic ketoacidosis (DKA), hyperglycemic, hyperosmolar, non-ketotic state (HHNKS), Lactic acidosis (LA) and hypoglycemia. Early diagnosis and management of DM helps in preventing these complications. This study was aimed to determine the incidence of acute metabolic complications in DM and to determine the distribution of age and sex in different metabolic complications of diabetes mellitus.Methods: A prospective study was conducted on all cases presenting to Emergency Medicine department for a period of one year from April 2014 to March 2015.Results:Out of the 1211 cases 632 were Diabetic ketoacidosis, 329 cases were hypoglycemia, 201 cases were hyperglycemic hyperosmolar nonketotic state, 12 cases were lactic acidosis. The other 37 cases had findings which were overlapping with more than one type of acute metabolic complications related to diabetes mellitus. Two cases of HHNKS were associated with attacks of hypoglycemia. In this study, diabetic ketoacidosis was the common acute metabolic complication affecting Males aged less than 15 years.Conclusions:Hypoglycemia is the commonest iatrogenic acute metabolic complications India diabetes mellitus. HHNKS affects patients aged more than 45 years. In some cases, there is considerable overlap of diabetic ketoacidosis, lactic acidosis, hypoglycemia and HHNKS.

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 Diabetic ketoacidosis in southern Jordan: five-year experience

2000 ◽  
Vol 6 (5-6) ◽  
pp. 1035-1038
Author(s):  
I. Tahboub ◽  
J. B. H. Shalan
Keyword(s):  
Diabetes Mellitus ◽  
Mortality Rate ◽  
Diabetic Ketoacidosis ◽  
Diabetic Complications ◽  
Initial Presentation ◽  
The Public

All cases of diabetic ketoacidosis admitted to Prince Zaid Hospital between 1993 and 1997 were analysed for precipitating causes and outcome. Of 167 cases, 89 were male and 78 female, with a mean age of 38 years. It was the initial presentation of diabetes mellitus in 21% of the patients. Infection and noncompliance were the leading precipitating causes but no cause was found in 14% of the patients. The mortality rate was 4.8%. Educating the public and patients about diabetic complications and therapy is the key to prevention of diabetic ketoacidosis.

Frequency, clinical characteristics, biochemical findings and outcomes of DKA at the onset of type-1 DM in young children and adolescents living in a developing country – an experience from a pediatric emergency department

2019 ◽  
Vol 32 (2) ◽  
pp. 115-119 ◽  
Author(s):  
Amna Jawaid ◽  
Arjumand Sohaila ◽  
Nadia Mohammad ◽  
Unaib Rabbani
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Developing Countries ◽  
Type 1 Diabetes ◽  
Mortality Rate ◽  
Children And Adolescents ◽  
Diabetic Ketoacidosis ◽  
Clinical Characteristics ◽  
Incidence And Mortality

Abstract Background As per the International Society for Pediatrics and Adolescent Diabetes (ISPAD) census, diabetic ketoacidosis (DKA) is the most frequent cause of diabetes-related death. In developing countries, DKA-related mortality rate ranges from 6% to 24% (Onyiriuka AN, Ifebi E. Ketoacidosis at diagnosis of type 1 diabetes in children and adolescents: frequency and clinical characteristics. J Diabetes Metab Disord 2013;12:47) in contrast to 0.15%–0.31% in the Western world (Poovazhagi V. Risk factors for mortality in children with diabetic ketoacidosis from developing countries. World J Diabetes 2014;5:932–93.). In developing countries like Pakistan, the situation is more perplexing owing to uncertain or under-reported statistics about the spectrum of the disease and its prevalence, coupled with limited access to medical care and experts as well as less awareness. These limitations restrict our ability to develop interventions that are patient-centered. Our main objective was to determine the severity, clinical features, bio-chemical findings and outcomes of DKA in children aged 1 month to 16 years. Subjects and methods This retrospective study included the analysis of medical and laboratory records from patients’ medical charts and the electronic database of all children aged 1 month to 16 years with newly diagnosed type-1 diabetes mellitus (T1DM) complicated with ketoacidosis, who presented to the emergency department (ED) at the Aga Khan University Hospital (AKUH), between January 2009 and December 2014. Results Diabetes mellitus complicated with DKA was the predominant diagnosis (n=113 [75.83%]) among endocrine diseases in children visiting the ED. Our study witnessed an increase in the incidence of DKA particularly after 5 years of age, with more severity in females. In our study, the mortality rate was 3.4%. Conclusions Considering the high incidence and mortality rate, it is emphasized that DKA should be considered in differential diagnosis. An awareness campaign for both general pediatricians and physicians as well as for the public is needed for better outcomes.

scholarly journals Fructose-induced severe hypertriglyceridemia and diabetes mellitus: a cautionary tale

2021 ◽  
Vol 2021 ◽  
Author(s):  
Ana Dugic ◽  
Michael Kryk ◽  
Claudia Mellenthin ◽  
Christoph Braig ◽  
Lorenzo Catanese ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Fruit Juice ◽  
Metabolic Effects ◽  
Newly Diagnosed ◽  
Severe Hypertriglyceridemia ◽  
Hyperosmolar Hyperglycemic State

Summary Drinking fruit juice is an increasingly popular health trend, as it is widely perceived as a source of vitamins and nutrients. However, high fructose load in fruit beverages can have harmful metabolic effects. When consumed in high amounts, fructose is linked with hypertriglyceridemia, fatty liver and insulin resistance. We present an unusual case of a patient with severe asymptomatic hypertriglyceridemia (triglycerides of 9182 mg/dL) and newly diagnosed type 2 diabetes mellitus, who reported a daily intake of 15 L of fruit juice over several weeks before presentation. The patient was referred to our emergency department with blood glucose of 527 mg/dL and glycated hemoglobin (HbA1c) of 17.3%. Interestingly, features of diabetic ketoacidosis or hyperosmolar hyperglycemic state were absent. The patient was overweight with an otherwise unremarkable physical exam. Lipase levels, liver function tests and inflammatory markers were closely monitored and remained unremarkable. The initial therapeutic approach included i.v. volume resuscitation, insulin and heparin. Additionally, plasmapheresis was performed to prevent potentially fatal complications of hypertriglyceridemia. The patient was counseled on balanced nutrition and detrimental effects of fruit beverages. He was discharged home 6 days after admission. At a 2-week follow-up visit, his triglyceride level was 419 mg/dL, total cholesterol was 221 mg/dL and HbA1c was 12.7%. The present case highlights the role of fructose overconsumption as a contributory factor for severe hypertriglyceridemia in a patient with newly diagnosed diabetes. We discuss metabolic effects of uncontrolled fructose ingestion, as well as the interplay of primary and secondary factors, in the pathogenesis of hypertriglyceridemia accompanied by diabetes. Learning points Excessive dietary fructose intake can exacerbate hypertriglyceridemia in patients with underlying type 2 diabetes mellitus (T2DM) and absence of diabetic ketoacidosis or hyperosmolar hyperglycemic state. When consumed in large amounts, fructose is considered a highly lipogenic nutrient linked with postprandial hypertriglyceridemia and de novo hepatic lipogenesis (DNL). Severe lipemia (triglyceride plasma level > 9000 mg/dL) could be asymptomatic and not necessarily complicated by acute pancreatitis, although lipase levels should be closely monitored. Plasmapheresis is an effective adjunct treatment option for rapid lowering of high serum lipids, which is paramount to prevent acute complications of severe hypertriglyceridemia.

scholarly journals A Pediatric Diabetic Ketoacidosis Patient with Multisystem Complications and a Prolonged Course

2019 ◽  
Vol 12 (3) ◽  
pp. 89-90
Author(s):  
John Henry Carson ◽  
Lindall E. Smith ◽  
Poornima Pandiyan ◽  
Priyank J Yagnik
Keyword(s):  
Diabetes Mellitus ◽  
Acute Pancreatitis ◽  
Diabetic Ketoacidosis ◽  
Cerebral Edema ◽  
Unique Case ◽  
Vein Thrombosis ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Deep Vein

The prevalence of diabetic ketoacidosis (DKA) in children with type 1 diabetes mellitus (T1DM) is 30% at the time of diagnosis.1 Cerebral edema is a rare, but life-threatening complication of DKA, occurring in only 0.3 - 1% of cases.2 Deep vein thrombosis and acute pancreatitis are other rare complications of DKA. Supraventricular tachycardia (SVT) as a complication of pediatric DKA has been reported.3 A unique case of a pediatric patient who had multiple rare complications of DKA including cerebral edema, venous thrombosis, and hypertriglyceridemia associated acute pancreatitis is presented.The SVT episode encountered during the admission was due to complications arising from a procedure and not due to DKA itself.

scholarly journals Knowledge about Complications of Diabetes in Diabetic Patients Attending in General Health Checkup, Tribhuvan University Teaching Hospital Nepal

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Teaching Hospital ◽  
Diabetic Complications ◽  
General Health ◽  
Health Check ◽  
University Teaching ◽  
Diabetic Patients ◽  
Complications Of Diabetes ◽  
Duration Of Diabetes

Introduction: The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. The study aimed to assess the knowledge about the complications of diabetes in diabetic patients. Methods: A cross-sectional observational study was conducted among 100 diabetic patients who attended general health check-up clinic of Tribhuvan University Teaching Hospital. Results: Majority of the female patients (78.8%) had the knowledge of diabetes mellitus. Among them, over half had knowledge that diabetes can cause the problem of cardiovascular, kidney failure and retinopathy .Similarly, four-fifths (80%) of the patients above 40 years of age and majority (92.3%) of the patients with more than 5 years duration of diabetes had knowledge about diabetic complications. Conclusion: Female diabetic patients had slightly more knowledge of complication of diabetes in comparison to their male counterparts. The knowledge of diabetic complication was generally high among the patients above 40 years of age and the patients with more than 5 years duration of diabetes. Even then, sex and age was not associated with the knowledge of the need for annual eye checkup and specific diabetic complications such as, kidney and cardiovascular problem, hypoglycemia, neuropathy, foot problem, retinopathy, diabetic ketoacidosis and stroke. However, duration of patient’s diabetics was associated with their knowledge regarding cardiovascular problem, eye check-up annual and retinopathy but was not associated with kidney problem, hypoglycemia, neuropathy, foot problem, diabetic ketoacidosis and stroke. In order to make patient along with their family knowledgeable about the diabetes and its complications, there is need to incorporate diabetes counseling and education activities in General Health Check Up Clinic.

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