This study aims to assess the efficacy and safety of a two-bag method compared with a one-bag method for the treatment of diabetic ketoacidosis (DKA). We hypothesize that a two-bag method will decrease the incidence of hypoglycemia, when compared with a one-bag method. A retrospective chart review was conducted on patients treated for DKA at a Trinity Health institution between 2020 and 2022. A total of 1084 adult patients were included. Patients treated with the one-bag protocol were included in the pre-group, while those treated with the two-bag protocol were included in the post-group. The primary outcome was incidence of hypoglycemia (blood glucose <70 mg/dL). Secondary outcomes included time to anion gap closure, insulin infusion duration, time to HCO3 correction, and incidence of hypokalemia. Patients were excluded if they were pregnant or diagnosed with Hyperosmolar Hyperglycemic State (HHS), euglycemic DKA, or ketosis from other causes. The incidence of hypoglycemia was 38% in the pre-group and 15.83% in the post-group ( < .001). Patients in the pre-group were on an insulin infusion longer than the post-group (28.37 hours vs 22.17 hours, < .001). Patients in the pre-group had a slower time to anion gap closure (8.99 hours vs 8.52 hours, = .021) and had a slower time to HCO3 correction (10.88 hours vs 10.69 hours, = .004). Between-group incidence of hypokalemia was similar (66.39% vs 60%, = .079). The two-bag method for the treatment of DKA resulted in improved safety and efficacy outcomes, compared with the one-bag method.
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http://dx.doi.org/10.1177/08971900241262383 | DOI Listing |
Sci Rep
January 2025
Department of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China.
This study aimed to investigate whether lymphocyte-C-reactive protein ratio (LCR) upon admission can predict disease progression and intensive care unit (ICU) admission in adult patients with diabetic ketoacidosis (DKA). A single-center retrospective study was conducted, including adult DKA patients admitted to the First Affiliated Hospital of Harbin Medical University between March 2018 and March 2023. Multiple demographic and clinical data were collected from the medical records upon admission and during hospitalization.
View Article and Find Full Text PDFPLoS One
January 2025
School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia.
Background: Multiple studies across Ethiopia have investigated the occurrence of DKA, showing significant variations and conflicting findings. This systematic review and meta-analysis seek to consolidate the overall prevalence of diabetic ketoacidosis and its associated factors in the Ethiopian context.
Methods: The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines.
Front Pediatr
January 2025
Department of Urology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China.
Objective: This study aimed to systematically evaluate the safety of cyclosporine (CsA) and tacrolimus (TAC) in pediatric nephrotic syndrome (NS) patients using real-world data from the FDA Adverse Event Reporting System (FAERS).
Methods: We analyzed adverse event (AE) reports from the FAERS database between Q4 2003 and Q2 2024, focusing on AEs associated with CsA and TAC in NS patients aged 18 years and younger. We employed three signal detection methods-Proportional Reporting Ratio (PRR), Relative Reporting Ratio (RRR), and Reporting Odds Ratio (ROR)-to assess the risk of drug-related AEs.
JCEM Case Rep
February 2025
Department of Ophthalmology, University of Chicago Medicine, Chicago, IL 60637, USA.
Cataracts secondary to type 1 or type 2 diabetes are not uncommon in adults; however, they are a rare finding in pediatric patients with type 1 diabetes. A 15-year-old girl presented with progressively worsened bilateral vision for 6 months. Her vision rapidly deteriorated over the previous month, prompting further evaluation that found bilateral cataracts with haziness in all layers and swollen lenses.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Patients with Diabetic ketoacidosis (DKA) have increased critical illness and mortality during coronavirus diseases 2019 (COVID-19). The aim of our study was to develop a predictive model for the occurrence of critical illness and mortality in COVID-19 patients with DKA utilizing machine learning. Blood samples and clinical data from 242 COVID-19 patients with DKA collected from December 2022 to January 2023 at Second Xiangya Hospital.
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