Sepsis-Induced Diabetic Ketoacidosis (DKA) in Latent Autoimmune Diabetes in Adult (LADA)

Backgrounds. Latent autoimmune diabetes in adults (LADA) is a slowly progressive form of autoimmune diabetes mellitus characterized by older age at diagnosis, presence of pancreatic autoantibodies, and lack of absolute insulin requirement at diagnosis. Patients with LADA had better β-cell function than patients with classic Type 1 DM (T1DM). Overtime, LADA tends to experience rapid and progressive loss of beta cell function that requires intensive insulin therapy. This case report aims to describe a case of Diabetic Ketoacidosis (DKA) in a patient with latent autoimmune diabetes in adult (LADA) induced by sepsis (urinary tract infection/UTI). Case Presentations. A woman, 28 years-old, came to the Emergency Department (ED) RSMH Palembang with chief complaints of decreased consciousness and shortness of breath. Patient had a history of frequent urination, pain when urinating, and fever. Urinalysis examination were glycosuria, proteinuria, hematuria. Hb-A1c level was 10.7%, C-Peptide 0.11 ng/dL, Anti GAD65 qualitative positive, and Islet cell antibody (ICA) negative. Patient was diagnosed with diabetic ketoacidosis (DKA), LADA, and sepsis due to urinary tract infection (UTI). Patients were managed with DKA and sepsis management algorithm. Conclusion. Diabetic ketoacidosis (DKA) in LADA caused by sepsis is an emergency in the metabolic endocrine and diabetes fields. Prompt and appropriate management can improve outcome prognosis in this case.

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Safety of SGLT2 Inhibitors in Patients with Diabetes Mellitus

Current Drug Safety ◽

10.2174/1574886314666190206164647 ◽

2019 ◽

Vol 14 (2) ◽

pp. 87-93 ◽

Cited By ~ 7

Author(s):

Mahakpreet Singh ◽

Ruchika Sharma ◽

Anoop Kumar

Keyword(s):

Diabetes Mellitus ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Diabetic Ketoacidosis ◽

Adverse Drug Reactions ◽

Sglt2 Inhibitor ◽

Sglt2 Inhibitors ◽

Drug Reactions ◽

Authorization Holder

Background:Recently, Food and Drug Administration (FDA) has approved sodium/ glucose co-transporter 2 (SGLT2) inhibitors for the treatment of diabetes mellitus. However, regarding adverse drug reactions (ADRs) of SGLT2 inhibitors in large group of population, very less information is available. Thus, we have tried to find out the risk profile of SGLT2 inhibitors. Materials and Methods: A total of 1,042 studies have been published from Nov. 2012-Nov. 2017 regarding SGLT2 inhibitors. After inclusion and exclusion criteria, 27 studies have been selected for the analysis of risk. Results and Discussion:The emerging evidence indicates various adverse drug reactions such as foot and toe amputation, cancer, diabetic ketoacidosis, bone fracture risk and urinary as well as mycotic genital infection. The causality assessment has shown a correlation between SGLT2 inhibitors and diabetic ketoacidosis and urinary tract infection. Conclusion:In conclusion, Marketing Authorization Holder (MAH) and Regulatory Authorities (RA) should monitor various adverse drug reactions such as diabetic ketoacidosis and urinary tract infection with the use of SGLT2 inhibitor.

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Diabetic Ketoacidosis Triggered by an Emphysematous Urinary Tract Infection: A Case Report and Mini-Review of Literature

Journal of Family Medicine ◽

10.26420/jfammed.2021.1259 ◽

2021 ◽

Vol 8 (5) ◽

Author(s):

Buenrostro-Valenzuela JC ◽

◽

Amezquita-Perez J ◽

Schlie-Villa W ◽

Romero-Bermudez J ◽

...

Keyword(s):

Urinary Tract Infection ◽

Case Report ◽

Urinary Tract ◽

Tract Infection ◽

Infectious Diseases ◽

Diabetic Ketoacidosis ◽

Urinary Tract Infections ◽

Treatment Options ◽

Review Of Literature ◽

Tract Infections

Generally, the most common triggers for Diabetic Ketoacidosis (DKA) are infectious diseases, such as Urinary Tract Infections (UTIs) or pneumonia. However, emphysematous infections are significant diseases rarely associated with DKA. Here, we present two cases of emphysematous urinary tract infection associated to diabetic ketoacidosis, highlighting the importance of a timely intervention and treatment. We review the need for appropriate laboratory and image testing in the context of infected patients who do not reach inflammatory/ glycemic goals to diagnosticate complicated infectious processes. This case report and mini-review also explore pathophysiology, the association of DKA and urinary emphysematous infections and treatment options.

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To study the frequency, etiology and predisposing factors of urinary tract infection in children with nephrotic syndrome in Eastern Odisha Region: a hospital based study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20164594 ◽

2016 ◽

Vol 4 (1) ◽

pp. 140 ◽

Cited By ~ 1

Author(s):

Dillip Kumar Dash ◽

Swarup Kumar Bisoi ◽

Mamata Devi Mohanty ◽

Mrutunjaya Dash ◽

Naresh Chandra Acarya

Keyword(s):

Urinary Tract Infection ◽

Nephrotic Syndrome ◽

Urinary Tract ◽

Tract Infection ◽

Cell Function ◽

Predisposing Factors ◽

Klebsiella Species ◽

Sensitivity Pattern ◽

Tract Infections

Background: The increased prevalence of infection in nephrotic syndrome is due to immunoglobulin loss, defective T cell function, and presence of ascites, relative malnutrition, and immunosuppressive therapy and associated with other factors. The objective of this study was to study the incidence, aetiology and the antibiotic sensitivity pattern of urinary tract infections (UTI) in children at presentation of nephrotic syndrome (NS).Methods: A retrospective hospital-based study carried out in IMS and SUM Hospital, Bhubaneswar, India. Seventy six children aged between two to twelve years with a diagnosis of NS at the time of were studied from April 2014 to March 2016.Results: The mean age of males was 5.9±0.5years and females are 6.2±0.8years. Pyuria was noted in 44 (57.89%) of the patients. Boys were more commonly affected with urinary tract infection than girls with a ratio of 1.9:1. UTI is the most common encountered infection and was predominantly caused by E. Coli in 18 (39%), Klebsiella species 7 (15.21%) and culture negative in 8 (17.28%) cases. There was high in vitro resistance of these organisms to cefixime and ampicillin but sensitive to cefotaxime, amikacin, ceftriazone , piperacillin- tazobactum and vancomycin.Conclusions: It is recommended that UTI should be sought for in patients with nephrotic syndrome and treatment should be prompt and appropriate taking into account of etiology and predisposing factors. UTI is one of the most common infections accompanying NS due to many factors. A high index of suspicion and early institution of appropriate antibiotics will help in reducing morbidity and mortality.

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