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Diazoxide-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 PDFReal-life evaluation of consensus recommendations for transition to subcutaneous insulin in hyperosmolar hyperglycemic crises.
J Diabetes Complications
December 2024
Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine, University of Oviedo, Spain; Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
Article Synopsis
- A recent report focused on hyperglycemic crises provides guidelines for determining subcutaneous insulin dosage when switching from intravenous insulin.
- The study involved 95 patients who were treated for hyperosmolar hyperglycemic crisis.
- Results showed no significant differences in blood sugar control after the transition between patients who followed the guidelines and those who didn't.
The role of ACPs in recognising and treating diabetic ketoacidosis and hyperosmolar hyperglycaemic state.
Br J Nurs
October 2024
Advanced Clinical Practitioner, Northampton General Hospital NHS Trust.
Article Synopsis
- - Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) are urgent diabetic emergencies that need quick detection and treatment.
- - Advanced clinical practitioners (ACPs) are vital for diagnosing, initiating treatment, and coordinating care, although some may lack confidence dealing with these complications.
- - The review covers the causes, risk factors, and management strategies for DKA and HHS, emphasizing the need to reduce risks and prevent future occurrences for better patient outcomes.
Trends in diabetic ketoacidosis- and hyperosmolar hyperglycemic state-related mortality during the COVID-19 pandemic in the United States: A population-based study.
J Diabetes
August 2024
Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Article Synopsis
- A significant rise in diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) mortality was observed during the COVID-19 pandemic, prompting an examination of death trends from 2006 to 2021.
- Analysis revealed DKA-related deaths increased notably during the pandemic years, with over half of these excess deaths linked to COVID-19, while HHS also saw a sharp rise in excess deaths despite a decline prior to the pandemic.
- The study highlighted concerning disparities, with higher mortality rates among pediatric patients and females, indicating an urgent need for targeted health strategies to address the risks faced by these populations in future public health emergencies.
Combined hyperglycemic crises in adult patients already exist in Latin America.
Biomedica
May 2024
Departamento de Medicina Interna, Fundación Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia.
Article Synopsis
- Diabetes is a common disease globally, with rising rates of acute complications like hyperglycemic crises, characterized by features of diabetic ketoacidosis and hyperosmolar state.
- A study conducted at Fundación Valle del Lili from 2015 to 2020 analyzed 317 cases of hyperglycemic crises, revealing that most patients had a combined state of both ketoacidosis and hyperosmolarity, often triggered by infections.
- The findings showed a mortality rate similar for both conditions, with invasive mechanical ventilation significantly associated with increased death rates among these patients.
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