Diabetes Associated with Atypical Antipsychotic Treatment May Be Severe but Reversible: Case Report

2005 ◽  
Vol 35 (3) ◽  
pp. 307-311 ◽  
Author(s):  
C. R. M. Dibben ◽  
S. S. Kalavalapalli ◽  
H. E. J. Linnington ◽  
F. A. Hynes ◽  
S. F. Dinneen ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Atypical Antipsychotic ◽  
Insulin Treatment ◽  
Drug Withdrawal ◽  
Islet Cell Antibodies ◽  
Antipsychotic Treatment ◽  
Insulin Requirements ◽  
Antidiabetic Treatment ◽  
Very High

Objective: To draw attention to severe presentations of atypical neuroleptic related diabetes and to document that a marked degree of remission can take place after drug withdrawal. Method: We describe two patients who presented with diabetic ketoacidosis after treatment with quetiapine and risperidone, respectively. Results: Both patients were negative for islet cell antibodies. They both required treatment with insulin, one in very high dosage, but their insulin requirements fell progressively after the atypical antipsychotic was withdrawn. After several months, neither patient required antidiabetic treatment. Conclusions: Atypical antipsychotic-induced diabetes does not always take a “type 2” presentation in which weight gain and insulin resistance are implicated. Sometimes the presentation is with diabetic ketoacidosis, requiring insulin treatment, which can nevertheless be reversible.

Atypical mucormycosis masquerading as non-resolving cavitatory pneumonia: A frequently misdiagnosed entity

2021 ◽  
pp. 004947552199134
Author(s):  
Ruchika Saini ◽  
Arshi Syal ◽  
Saurabh Gaba ◽  
Monica Gupta ◽  
Yajur Arya
Keyword(s):  
Diabetic Ketoacidosis ◽  
Undiagnosed Diabetes ◽  
Predisposing Factor ◽  
High Blood Glucose ◽  
Excellent Outcome ◽  
Pulmonary Mucormycosis ◽  
Uncontrolled Diabetes ◽  
Low Threshold ◽  
Very High

We are reporting an unusual case of cavitatory pulmonary mucormycosis in a patient with uncontrolled type 2 diabetes mellitus who was treated successfully. This is a unique case of pulmonary mucormycosis masquerading as cavitatory pulmonary disease. A 45-year-old female presented with fever, chest pain, cough and breathlessness. She was also found to have very high blood glucose due to previously undiagnosed diabetes. Diabetic ketoacidosis is the most common predisposing factor for mucormycosis. Our patient had uncontrolled diabetes and presented with bilateral cavitatory pulmonary lesions even in the absence of diabetic ketoacidosis. Appropriate investigations were ordered, and alternate causes of lung cavitation were diligently excluded. She was treated with amphotericin-B for three weeks followed by oral posaconazole for eight weeks with excellent outcome. A low threshold for detection as well as a differential of mucormycosis must be kept in immunocompromised patients presenting with cavitatory lung disease.

scholarly journals Insulin Edema in Type 2 Diabetes Mellitus: A Case Report Study

2021 ◽  
Author(s):  
Maryam Dehghan ◽  
Zohreh Akhoundimeybodi
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Diabetic Ketoacidosis ◽  
Insulin Treatment ◽  
Rare Complication ◽  
Blood Glucose Control ◽  
Diabetic Patients ◽  
Oral Agents

Edema is a rare complication induced by insulin therapy, which is mostly developed after initiation or intensification of insulin treatment in diabetic patients. Edema can either be localized or generalized. Our patient was a 34-year-old woman with type 2 diabetes. She was under treatment with oral agents medication, but recently insulin therapy was initiated for her due to inability to control her hyperglycemia and development of diabetic ketoacidosis. The patient referred while suffering from bilateral lower extremity edema. During follow-up, her edema resolved spontaneously without any specific treatments. In this patient, the diagnosis of edema was based on ruling out other causes, along with more accurate blood glucose control during diabetic ketoacidosis process and spontaneous recovery. Based on our finding, it can be concluded that insulininduced edema is not a worrisome problem and in most cases, its symptoms resolve without treatment and through restricting the consumption of water and salt.  

A case of newly diagnosed autoimmune diabetes in pregnancy presenting after acute onset of diabetic ketoacidosis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Charissa DiNobile ◽  
Anna Fuchs ◽  
Kimberly Herrera
Keyword(s):  
Diabetic Ketoacidosis ◽  
Glucose Control ◽  
Autoimmune Diabetes ◽  
Islet Cell Antibodies ◽  
Acute Onset ◽  
Case Presentation ◽  
Insulin Requirements ◽  
Immune Mediated ◽  
Normal Glucose ◽  
In Pregnancy

Abstract Objectives We present a case of immune-mediated diabetes mellitus, diagnosed in pregnancy upon presentation with diabetic ketoacidosis, found to have normal glucose control postpartum. Case presentation A 28-year-old medically uncomplicated G1P0 presented in diabetic ketoacidosis at 28.2 weeks gestation. Workup for pancreatic autoantibodies revealed indeterminate anti-islet cell antibodies and positive anti-glutamic acid antibodies. She was stabilized with intravenous fluids and insulin, and transitioned to long and short acting subcutaneous insulin. Her insulin requirements decreased over the course of her pregnancy. Spontaneous vaginal delivery occurred at 37 weeks. Her postpartum glucose control was normal without re-initiation of insulin. Conclusions The diagnosis of diabetic ketoacidosis during pregnancy should prompt further investigation into an underlying diagnosis of immune mediated diabetes. These patients should be followed closely in the postpartum period.

The Effect of Insulin Treatment on the Balance between Tissue Plasminogen Activator and Plasminogen Activator Inhibitor-1 in Type 2 Diabetic Patients

1992 ◽  
Vol 68 (03) ◽  
pp. 253-256 ◽  
Author(s):  
Thomas Vukovich ◽  
Sylvia Proidl ◽  
Paul Knöbl ◽  
Harald Teufelsbauer ◽  
Christoph Schnack ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Insulin Treatment ◽  
Plasminogen Activator Inhibitor ◽  
Diabetic Patients ◽  
Plasminogen Activator Inhibitor 1 ◽  
Type 2 Diabetic Patients ◽  
Glycemic Regulation ◽  
Type 2 Diabetic ◽  
Pai 1

SummaryBeside hypercoagulation and hyperactivated platelets disturbances of the fibrinolytic system towards hypofibrinolysis have been reported to be associated with both glycemic and lipidemic derangement in diabetic patients. In the present prospective follow-up study the effect of 16 weeks insulin treatment and glycemic regulation on plasma levels of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1), the main regulators of fibrinolysis, was investigated in 19 type-2 diabetic patients with secondary failure to sulphonylureas. A similar glycemic regulation was obtained in a control group of 10 type 2 diabetic patients with sufficient metabolic response to strict dietary treatment and continuation of sulphonylurea treatment. Compared to 27 healthy subjects levels of tPA and PAI-1 were not significantly increased in type 2 diabetic patients before metabolic intervention. Although a hypofibrinolytic state due to an increase of PAI-1 levels was previously reported in obese hyperinsulinemic patients, no effect of insulin treatment on both tPA- and PAI-1 levels was observed in the present study including patients with only slightly increased body mass index (median 26.0 kg/m2). By correlation analysis PAI-1 levels were significantly related to serum cholesterol (R = 0.52) and glycemic control (glucose R = 0.41) in the whole group of diabetic patients at entry and in both subgroups after 16 weeks of treatment (insulin group: cholesterol R = 0.46, HbA1c R = 0.51; sulphonylurea group: cholesterol R = 0.59, HbA1c R = 0.58). In healthy subjects tPA and PAI-1 was correlated to serum insulin (R = 0.54, R = 0.56) and triglycerides (R = 0.46, R = 0.40). In conclusion, our results indicate that insulin treatment associated with metabolic improvement has no adverse effect to fibrinolysis in type 2 diabetic patients.

Severe diabetic ketoacidosis in type 2 diabetes mellitus

2013 ◽  
Author(s):  
Rene Rodriguez-Gutierrez ◽  
Emanuel I Gonzalez-Moreno ◽  
Carlos R Camara-Lemarroy ◽  
Dania L Quintanilla-Flores ◽  
Juan M Gonzalez-Chavez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Ketoacidosis

A rare presentation of type 2 diabetes: diabetic ketoacidosis, acute pancreatitis, and hypertriglyceridaemia

2014 ◽  
Author(s):  
Abdulghani Al-Saeed ◽  
Ahmad Alobedallah ◽  
Ayman Al-Hayek ◽  
Sohail Inam ◽  
Rim Braham ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Acute Pancreatitis ◽  
Diabetic Ketoacidosis ◽  
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