Diabetic Ketoacidosis Complicating Gestational Diabetes Mellitus

Villavicencio, Camila; Franco-Akel, Alberto; Belokovskaya, Regina

doi:10.1016/j.aace.2022.07.002

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Still, they may include impaired blood flow to the brain, decreased glucose usage, hyperosmolarity, high blood glucose levels, acidosis, or a direct influence of ketone bodies, which are proposed hypotheses. (13,14). Mechanical ventilation is an essential indicator of severe DKA in our research.…”

Section: Discussionmentioning

confidence: 80%

Clinical Features of Diabetic Keto Acidosis Individuals in the Intensive Care Unit

BUKHARI,

PERVAIZ,

JAVED

et al. 2023

Pak J Intens Care Med

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Background: Diabetic ketoacidosis (DKA) is the most common acute hyperglycemic condition related to diabetes. Recent investigations suggest that DKA affects approximately 8 out of every 1,000 diabetics annually. Objective: This study aims to determine the clinical features of individuals with severe DKA admitted to ICU. Study Design: A retrospective analysis. Setting: The study was conducted at Bahria International Hospital Lahore and Services Institute of Medical Sciences Lahore, Pakistan. Duration of Study: The study period was from Oct 01, 2022, to March 30, 2023. Methods: Data from patients' health records were retrospectively analysed, including demographics, clinical manifestations (fever, nausea, vomiting, abdominal pain, breathlessness, altered sensorium, low blood pressure), and triggering factors (insulin discontinuation, septicemia). Hospital stay duration, mortality rate, and usage of mechanical ventilation were also documented. Results: A total of 30 patients were enrolled in the study, of whom 26 (86.6%) were males. The most prevalent complaint was abdominal discomfort, observed in 86.6% of the study population. Vomiting was present in 93.3% of the individuals. Only 8 (26.6%) patients were newly diagnosed with diabetes, while the remainder were known type 1 diabetics on insulin treatment. The mean HbA1c was 10.2%, ranging from 8.7% to 12.6%. Serum blood glucose, bicarbonate levels, and anion gap were independently associated with clinical indicators of severe DKA. A correlation was found between DKA indicators and the requirement for mechanical ventilation. Conclusion: The majority of individuals with severe DKA admitted to our ICU experienced gastrointestinal symptoms, with noncompliance to insulin treatment being the primary cause of DKA.

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Section: Discussionmentioning

confidence: 80%

Clinical Features of Diabetic Keto Acidosis Individuals in the Intensive Care Unit

BUKHARI,

PERVAIZ,

JAVED

et al. 2023

Pak J Intens Care Med

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“…4 On Diabetes, Lipid, and Metabolism, authors highlighted the importance of evaluating pregnant women with gestational diabetes, as it may rarely present with diabetes ketoacidosis leading to poor fetal and maternal outcomes. 5 Further, an interesting 3case-series reported on the potential complication of prolonged hypoglycemia in infants of mothers with Maturity Onset Diabetes of Youth (MODY) due to pathogenic variant in HNF1A, suggesting that potential link of HNF1A variants causing MODY may also lead to neonatal hypoglycemia. 6 This issue also includes an interesting visual vignette of severe abdominal lipohypertrophy due to poor insulin management.…”

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confidence: 99%