Diabetic Ketoacidosis

Cesur, Mustafa; Sayi, Irmak

doi:10.5772/53199

Cited by 2 publications

(4 citation statements)

References 176 publications

(272 reference statements)

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“…The mean ± SD age of the patients was 11.99 ± 4.63 years, their median diabetes duration was 3.5 [1][2][3][4][5][6] years, their mean ± SD age at diabetes diagnosis was 7.62 ± 3.67 years, while their mean HbA1c during the past 12 months was 7.66 ± 1.16%. Median c-peptide levels were 0.59 ng/ ml (range: 0.45-0.86).…”

Section: Resultsmentioning

confidence: 99%

“…A Soehnle Professional Scale was used for evaluation of anthropometric parameters, and body weight was measured at diagnosis and during each outpatient visit to the Diabetic Clinic. Body mass index (BMI) was calculated as weight (kg)/ height (m) 2 . Evaluation of GADA and ΙΑ2 anti-pancreatic antibodies was performed using a radioimmunoassay (RIA) method, with normal upper limit 0.9 U/ml and 0.75 U/ml, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…Diabetic ketoacidosis (DKA) as the first presentation of the disease occurs often and is well recognized as the main cause of death at diabetes diagnosis due to severe adverse events such as electrolytic disturbances, brain edema, and coma [1]. Additionally, DKA is accompanied by lower c-peptide levels due to decreased residual beta cell function [2]. During the course of diabetes, DKA is correlated with poor glycemic control and neurocognitive deficits, as well as elevated health care costs [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Familial autoimmunity in pediatric patients with type 1 diabetes (T1D) and its associations with the severity of clinical presentation at diabetes diagnosis and with coexisting autoimmunity

et al. 2022

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PurposeThe aim was to evaluate the impact of familial autoimmunity on the age and severity of type 1 diabetes (T1D) presentation and on the coexistence of other autoimmune diseases. Methods We retrospectively evaluated the medical records of 121 children/adolescents (male: 63) followed in our Diabetic Clinic from 2002 to 2016. Results Seventy-six patients (62.8%) had at least one relative with an autoimmune disease, Hashimoto's thyroiditis (49.5%) and T1D (22.3%) being the commonest. Children with familial autoimmunity were younger at T1D diagnosis (mean age ± SD) (6.766 ± 3.75). Median fasting c-peptide levels at presentation were not related to familial autoimmunity. Patients with familial autoimmunity more often exhibited GADA autoantibody positivity at diagnosis. The larger the number of the patient's relatives diagnosed with an autoimmune disease, the higher were the patient's GADA levels (Spearman's rho test = 0.19, p = 0.049). Children with a first-degree relative with autoimmunity had a coexisting autoimmune disorder at a significantly higher percentage (p = 0.016). Family history of autoimmunity was negatively associated with the presence of diabetic ketoacidosis (DKA) (p = 0.024). Patients with a relative with T1D less frequently exhibited DKA at diagnosis (12.8 vs. 87.2%, p = 0.003). The presence of DKA was associated with younger age (p = 0.05) and lower c-peptide levels (p = 0.033). Conclusions Familial autoimmunity was present in 62.8% of children with T1D, autoimmune thyroiditis and T1D being the two most frequent familial autoimmune diseases. Familial autoimmunity reduced the risk of DKA at diagnosis, but these patients were younger and had higher levels of pancreatic autoantibodies and a greater risk of developing additional autoimmune diseases.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Familial autoimmunity in pediatric patients with type 1 diabetes (T1D) and its associations with the severity of clinical presentation at diabetes diagnosis and with coexisting autoimmunity

et al. 2022

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“…Unlike in type 2 DM, acute metabolic diabetes keto-acidosis (DKA) characterized by lactic acidosis and ketonemia occurs in T1DM with a rate between 20 and 70% depending on the intensity of glucose control [53]. Subjects in DKA have increased blood levels of β-Thromboglobulin (β-TG), platelet factor-4 (PF-4), but their platelets are paradoxically less sensitive to aggregation agonists such as ADP and prostacyclin.…”

Section: Acute Metabolic Acidosismentioning

confidence: 99%

Controversies in Platelet Functions in Diabetes Mellitus Type 1

Ogweno¹,

Murungi²

2023

Type 1 Diabetes in 2023 - From Real Practice to Open Questions

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Individuals with diabetes mellitus (DM) are at high risk of thrombosis in which hyperactive platelets are implicated. The platelet hyperactivity has been linked to hyperglycemia. This hypothesis is supported by studies in type II diabetes mellitus showing increased sensitivity of platelets to stimulating agonists in the context of tissue resistance to high-circulating insulin. However, controversy still exists regarding the altered platelet functions in type 1 diabetes mellitus (T1DM) and the link to modifying factors such as blood glucose, hyperlipidemia, metabolic acidosis and insulin treatment. Moreover, increased insulin dosage or treatment appears to have antagonistic actions: diminished functions at low doses and enhanced activation at high doses, the switch being attributable to insulin-like growth factor. The physiological role of insulin in suppressing platelet activation is lost in T1DM, a scenario that favors increased platelet sensitivity to stimulating agonists. Furthermore, the response to antiplatelet agents and statins is sub-optimal in diabetics presenting clinical and research knowledge gap regarding the ideal antiplatelet treatment in DM in general and T1DM in particular. This chapter reviews the unique characteristics of platelet functions in T1DM highlighting the controversial areas linking unique behavior of platelets and the abnormal response to therapeutic interventions.

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Diabetic Ketoacidosis

Cited by 2 publications

References 176 publications

Familial autoimmunity in pediatric patients with type 1 diabetes (T1D) and its associations with the severity of clinical presentation at diabetes diagnosis and with coexisting autoimmunity

Familial autoimmunity in pediatric patients with type 1 diabetes (T1D) and its associations with the severity of clinical presentation at diabetes diagnosis and with coexisting autoimmunity

Controversies in Platelet Functions in Diabetes Mellitus Type 1

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