The concomitant occurrence of diabetic ketoacidosis and hyperosmolarity is reported in two children, as early symptoms of misdiagnosed type 1 diabetes mellitus. The precipitating factor for both severe metabolic abnormalities was the ingestion of a large amount of high-carbohydrate-containing fluids, a few days before admission. A similar situation has never been reported before in the literature. A successful therapeutic scheme is described.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1515/jpem.1999.12.5.691 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictors of 7-day mortality in critically ill patients with hyperglycemic crisis : A single center retrospective analysis.
Wien Klin Wochenschr
January 2025
Department of Medicine III and Karl Landsteiner Institute for Metabolic Diseases and Nephrology, Klinik Hietzing, Vienna, Austria.
Aim/hypothesis: The main aim of the study was to identify point of care available laboratory and clinical predictors of 7‑day mortality in critically ill patients with a hyperglycemic crisis.
Methods: A retrospective study of 990 patients with the first hospitalization due to hyperglycemia was performed. Patients were classified as having diabetic ketoacidosis (DKA) or being in a hyperosmolar hyperglycemic state (HHS) according to the recommendations of the American Diabetes Association (ADA).
Quantifying the Deficits of Body Water and Monovalent Cations in Hyperglycemic Emergencies.
J Clin Med
December 2024
Research Service, Department of Medicine, Raymond G. Murphy Veterans Affairs Medical Center, University of New Mexico School of Medicine, Albuquerque, NM 87108, USA.
Hyperglycemic emergencies cause significant losses of body water, sodium, and potassium. This report presents a method for computing the actual losses of water and monovalent cations in these emergencies. We developed formulas for computing the losses of water and monovalent cations as a function of the presenting serum sodium and glucose levels, the sum of the concentrations of sodium plus potassium in the lost fluids, and body water at the time of hyperglycemia presentation as measured by bioimpedance or in the initial euglycemic state as estimated by anthropometric formulas.
View Article and Find Full Text PDFDiazoxide-Associated Hyperglycemia: A Critical Case Precipitating Hyperosmolar Hyperglycemic State in a Child.
J Med Toxicol
January 2025
Division of Pediatric Emergency Medicine, Johns Hopkins Children's Center, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Introduction: Diazoxide is the first-line treatment for children with hyperinsulinemic hypoglycemia (HI). In these cases, diazoxide raises blood glucose levels by suppressing insulin release, preventing hypoglycemia, and potentially devastating end-organ sequelae. Hyperosmolar hyperglycemic state (HHS) is an exceedingly rare side effect of diazoxide.
View Article and Find Full Text PDFA nested case-control study of adverse outcomes in children with diabetic ketoacidosis.
J Clin Endocrinol Metab
December 2024
Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, Dallas TX.
Background: Adverse Outcomes (death or ICU stays longer than 48h) in children with diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar syndrome (HHS) can be predicted by a composite risk score based on severity of hyperglycemia and acidosis, and presence of type 2 diabetes. Because most high-risk patients nevertheless do not experience an Adverse Outcome, we tried to identify differences in management or other clinical characteristics that influenced outcomes.
Methods: In a previously defined group of 4565 admissions for DKA-HHS in 2010-2023, 109 had Adverse Outcomes.
Optimising risk stratification in diabetic ketoacidosis: a re-evaluation of acid-base status and hyperosmolarity using observational data.
Intern Emerg Med
December 2024
Department of Anaesthesia, Royal Darwin Hospital, Darwin, NT, 0810, Australia.
Accurate assessment of severity in diabetic ketoacidosis (DKA) can optimise early management and facilitate prioritisation for high acuity care. The primary aim was to evaluate the relationship between severity of acidosis (considering pH, bicarbonate, and anion gap) and hyperosmolarity with hospital mortality. Secondary outcomes included intensive care mortality, mechanical ventilation, vasopressor/inotrope use, and dialysis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!