Steroid-induced diabetic ketoacidosis

Alavi, Iltifat A.; Sharma, Bal Krishan; Pillay, Veerasamy K. G.

doi:10.1097/00000441-197107000-00003

Cited by 28 publications

(5 citation statements)

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“…The presentation of a mixed acid–base disorder in our subject is consistent with several patients manifesting DKA concurrently with other acid–base disorders established by examination of ∆AG and ∆HCO 3 − (Table 1) (1, 2, 3, 4, 5). In the presence of a pure or lone DKA, ∆AG is equal to ∆HCO 3 − .…”

Section: Discussionsupporting

confidence: 85%

“…Among patients with prior presence of diabetes, withdrawal or omission of insulin due to psychiatric, social or economic reasons is a common trigger (1, 2). DKA also occurs in subjects with both type 1 and 2 diabetes due to relative insulin deficiency at the onset of infections (3), myocardial infarction (1, 2), congestive heart failure (1, 2), lack of appropriate adjustment of insulin regimen in pregnancy (4), as well as after steroid therapy (5). …”

Section: Discussionmentioning

confidence: 99%

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Case of diabetic ketoacidosis as an initial presentation of Cushing’s syndrome

Acharya

Kabadi

2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryDiabetic ketoacidosis (DKA) is commonly encountered in clinical practice. The current case is a unique and rare presentation of DKA as the initial manifestation of Cushing’s disease secondary to ACTH-secreting pituitary adenoma. Appropriate management as elaborated in the article led to total remission of diabetes as well as the Cushing’s disease.Learning points:DKA is a serious and potentially life-threatening metabolic complication of diabetes mellitus.Some well-known precipitants of DKA include new-onset T1DM, insulin withdrawal and acute illness.In a patient presenting with DKA, the presence of a mixed acid–base disorder warrants further evaluation for precipitants of DKA.We present a rare case of DKA as an initial manifestation of Cushing’s disease secondary to ACTH-producing pituitary adenoma.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Case of diabetic ketoacidosis as an initial presentation of Cushing’s syndrome

Acharya

Kabadi

2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…Glucose intolerance or frank diabetes mellitus are known (although uncommon) consequences of longterm GC therapy (78). Hypothalamic-pituitary-adrenal suppression is a complication of long-term GC use, usually noted with higher doses of GCs used for longer periods (79)(80)(81)(82).…”

Section: Clinical Use Of Gcsmentioning

confidence: 99%

Glucocorticoids and rheumatoid arthritis: Back to the future?

Moreland

O'Dell

2002

Arthritis & Rheumatism

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“…In this patient, there is a possibility that the diabetic ketoacidosis may have followed an acute corticosteroid overdose at home, but steroidinduced diabetes was also reported while using therapeutic doses. [1][2][3] Banac et al 1 pointed out the effect of long-term therapy with steroid in children with Crohn disease. Alavi et al 2 described the onset of steroid-induced diabetic ketoacidosis in 5 patients receiving glucocorticoid for collagen vascular disease.…”

Section: Discussionmentioning

confidence: 99%

Glucocorticoid-induced Diabetic Ketoacidosis in Acute Rheumatic Fever

Çağdaş¹,

Paç

Çakal

2008

J Cardiovasc Pharmacol Ther

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Glucocorticoids are used as anti-inflammatory agents and are associated with many side effects including hyperglycemia, hypertension, pancreatitis, peptic ulcer, and so on. Hyperglycemia is a common side effect, but ketoacidosis is observed rarely. We present a girl who developed diabetic ketoacidosis after the administration of methylprednisolone during the treatment of acute rheumatic fever. She did not have diabetes and was not obese. She developed ketoacidosis after glucocorticoid therapy. Glucocorticoid-induced insulin resistance, lipolysis, and ketogenesis were likely to have precipitated ketoacidosis. During the treatment of ketoacidosis, the insulin need of the patient was gradually decreased by reducing glucocorticoid dose. In addition to the gradual reduction in glucocorticoid dose, salicylate therapy could be considered the treatment for insulin resistance. In this patient, screening for blood gases and urine was diagnostic in the diagnosis of ketoacidosis. The risk of ketoacidosis as well as hyperglycemia should be considered in the course of glucocorticoid therapy.

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Steroid-induced diabetic ketoacidosis

Cited by 28 publications

References 0 publications

Case of diabetic ketoacidosis as an initial presentation of Cushing’s syndrome

Case of diabetic ketoacidosis as an initial presentation of Cushing’s syndrome

Glucocorticoids and rheumatoid arthritis: Back to the future?

Glucocorticoid-induced Diabetic Ketoacidosis in Acute Rheumatic Fever

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