Aim: to determine the role of serum lactate and diabetic ketoacidosis (DKA) severity as predictors for five-days mortality in DKA patients.
Methods: a prospective cohort study was conducted in DKA patients admitted to emergency department (ED) at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, during 2007-2008 periods. Predictors for 5 days mortality in DKA patients in this study including serum lactate and DKA severity (plasma glucose, arterial blood pH, serum bicarbonate, osmolality, anion gap, and alteration in sensorium) at admission. Cox's Proportional Hazard Regression Analysis was used to determine independent predictors for 5-days mortality among study population.
Results: sixty patients with diabetic ketoacidosis were enrolled in the study; in which 24 (40%) patients were died within 5 days after admission. In the multivariate analysis, the lactate level 4 mmol/L (HR, 3.09; 95% CI, 1.36-7.05) and altered in sensorium stuporous/comatose (HR, 3.38; 95% CI, 1.45-7.87) were identified as independent predictors for 5-days mortality in DKA adult patients.
Conclusion: lactate level 4 mmol/L and altered in sensorium stuporous/comatose can be used to predict 5-days mortality in adult patients with DKA.
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J Pediatr Nurs
January 2025
Faculty of Nursing, Yarmouk University, Irbid, Jordan. Electronic address:
Background: Type 1 diabetes is the most common endocrine health condition among youth. Healthcare professionals must consider evidence-based guidelines in managing children and adolescents with diabetic ketoacidosis (DKA). The current study aims to assess the outcomes of implementing clinical guidelines by the American Diabetes Association to manage DKA among pediatrics in an emergency department in Palestine.
View Article and Find Full Text PDFBackground: There have been 2 primary methods of intravenous fluid administration for diabetic ketoacidosis (DKA) treatment described in the literature: the serial bag method and the 2-bag method.
Objectives: This study will assess the clinical outcomes and workflow efficiency after a transition in practice from the serial fluid method to the 2-bag method for pediatric DKA.
Methods: This was a retrospective chart review of pediatric DKA patients 18 years or younger, 1 year before and after the transition was conducted.
Endocrine
January 2025
Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006, Spain.
Purpose: This study aims to evaluate the association between psychiatric disorders and diabetic ketoacidosis (DKA) in patients with type 1 diabetes (T1D) treated at a tertiary care hospital.
Methods: A propensity score-matched case-control study was conducted, comprising a total sample of 194 participants (97 DKA cases and 97 controls without DKA). Comprehensive data were collected on clinical, anthropometric, and socioeconomic characteristics, and psychiatric disorders were classified according to international standards.
Biosensors (Basel)
January 2025
NanoTech Laboratory, School of Engineering, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia.
Timely ketone detection in patients with type 1 diabetes mellitus (T1DM) is critical for the effective management of diabetic ketoacidosis (DKA). This systematic review evaluates the current literature on breath-based analysis for ketone detection in T1DM, highlighting nanotechnology as a potential for a non-invasive alternative to blood-based ketone measurements. A comprehensive search across 5 databases identified 11 studies meeting inclusion criteria, showcasing various breath analysis techniques, such as semiconducting gas sensors, colorimetry, and nanoparticle-based chemo-resistive sensors.
View Article and Find Full Text PDFFront Endocrinol (Lausanne)
January 2025
Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Background: The global prevalence of diabetes has been rising rapidly in recent years, leading to an increase in patients experiencing hyperglycemic crises like diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). Patients with impaired renal function experience a delay in insulin clearance, complicating the adjustment of insulin dosing and elevating hypoglycemia risk. Accordingly, this study aims to evaluate the impact of renal function on the safety and efficacy of insulin use in patients with isolated DKA or combined DKA/HHS.
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