Hyperglycemic Crises in Adult Patients With Diabetes

Kitabchi, Abbas E.; Umpiérrez, Guillermo E.; Miles, John M.; Fisher, Joseph N.

doi:10.2337/dc09-9032

Cited by 1,705 publications

(2,116 citation statements)

References 80 publications

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“…The decrease in average body weight of rats in group A and B may be associated with weight loss at times experienced in diabetic patients 9 . However, fasting blood glucose level of rats in group A was under control probably because of Moringa oleifera administration.…”

Section: Discussionmentioning

confidence: 99%

Effect of Moringa oleifera leaf extract on serum lipids and glycaemic control in alloxan induced diabetic albino rats

Oparinde¹,

Atiba²,

Ajose³

et al. 2014

Int J of Biomed & Adv Res

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Section: Discussionmentioning

confidence: 99%

Effect of Moringa oleifera leaf extract on serum lipids and glycaemic control in alloxan induced diabetic albino rats

Oparinde¹,

Atiba²,

Ajose³

et al. 2014

Int J of Biomed & Adv Res

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“…In this case, we postulate the relationship between ketosis and SGLT2-I, since both infection and alcohol intake were ruled out 18 , there was no other intervention that could mask hyperglycemia and no other known factors that could favor ketosis were found.…”

Section: Discussionmentioning

confidence: 99%

“…DKA is a complication of T1D, defined by the triad: hyperglycemia (> 250 mg/dl), metabolic acidosis and ketones 18 . DKA without severe hyperglycemia is unexpected and has a very low incidence that might be due to the lack of recognition and under-registration.…”

Section: Introductionmentioning

confidence: 99%

Cetosis normoglicémica en adolescente con diabetes tipo 1 recibiendo insulina y dapaglifozina: Reporte de un caso

Ramírez

Román

2017

Rev. chil. pediatr.

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Introduction: Dapagliflozin, an insulin-independent sodium-glucose cotransporter 2 inhibitor (SGLT2-I) induces glycosuria and reduces hyperglycemia in adults with type 2 diabetes. Objective: To present an "euglycemic" diabetic ketosis in an adolescent with type 1 diabetes (T1D) receiving dapagliflozin, to alert about the risk of a drug not approved in children nor in T1D. Case report: A 17 years old adolescent with T1D during 9 years, was started on dapagliflozin 10 mg/day to reduce insulin dose and weight. During 11 months on treatment, capillary ketones were undetectable and she exhibited a reduction in body mass index 23.9 to 21.1 kg/m 2 , basal insulin 40 to 17 U, glycated hemoglobin 8.3 to 7.5%, capillary glucose 175 to 161 mg/dl and glucose variability (standard deviation) 85 to 77. Suddenly nausea and vomits appeared. The patient was on an insulin pump and well calibrated continuous glucose monitoring, showing stable glucose levels under 200 mg/dl, and an insulin bolus was delivered. Vomiting without hyperglycemia persisted; three hours later, she was severely dehydrated and fainting, with ketones 4.6 nmol/l and glucose 224 mg/dl. She received IV saline fluids, ondansetron, carbohydrates and several insulin boluses. Hydration and general condition improved soon, however despite several insulin doses, ketosis continued for 24 hours. It is remarkable that the pump was working well and the cannula was not changed. After the ketosis was resolved, she continued using the same cannula with good metabolic control. Conclusion: Euglycemic ketosis is a life-threatening condition that must be suspected.

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“…6 They were, however, also amongst the first to describe a classification of severity for DKA, something that the American Diabetes Association continues to advocate. 7 Low dose insulin and aggressive fluid replacement Whilst there had been sporadic reports of low dose insulin being used to successfully treat DKA, it was not until Sönksen et al in 1972, 8 9 The weight based FRIII has also now been used successfully for several decades. 7,11 The concept of an FRIII is well established in paediatric diabetes, 12 and the question often arises 'when does a child become an adult?'.…”

Section: High Dose Insulinmentioning

confidence: 99%

The evolution of DKA management

Dhatariya

2015

Br J Diabetes

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The Joint British Diabetes Societies (JBDS) looked in detail at the evidence based management for diabetic ketoacidosis (DKA) and generated a set of guidelines to support the management of this complex condition. Because of the nature of research into DKA there are some areas which have less of an evidence base, so expert commentary and experience support several of the recommendations. This article describes the historical basis of the development of the management of this condition, how we came to arrive at the present situation and why the ongoing national DKA audit is so important in elucidating what is currently happening across the UK in clinical practice. Br J Diabetes Vasc Dis 2015;15:31-33

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Hyperglycemic Crises in Adult Patients With Diabetes

Cited by 1,705 publications

References 80 publications

Effect of Moringa oleifera leaf extract on serum lipids and glycaemic control in alloxan induced diabetic albino rats

Effect of Moringa oleifera leaf extract on serum lipids and glycaemic control in alloxan induced diabetic albino rats

Cetosis normoglicémica en adolescente con diabetes tipo 1 recibiendo insulina y dapaglifozina: Reporte de un caso

The evolution of DKA management

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