Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3122
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Euglyceamic diabetic ketoacidosis (EuDKA) is an uncommon but serious diabetes mellitus complication associated with risk factors such as fasting, surgery, pregnancy and, more recently, the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i). This case is of a woman with type 2 diabetes and hypertension in her 50s who underwent an incarcerated umbilical hernia repair and abdominoplasty. Two days after discharge, she was readmitted with nausea, vomiting, loss of appetite, low-grade fever and breathing difficulty. Preoperatively, her diabetes management included an SGLT2i. She was diagnosed with EuDKA with high anion gap metabolic acidosis, a medical emergency similar to diabetic ketoacidosis. The normal blood glucose levels in EuDKA can mask the condition, which poses a conundrum for physicians in the emergency department/intensive care units as it may delay diagnosis and treatment, worsening the outcomes. To mitigate this risk, SGLT2i should be stopped 3-4 days before planned surgery with appropriate adjustments to the insulin regimen.
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Source |
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http://dx.doi.org/10.1136/bcr-2024-260473 | DOI Listing |
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