Expectations and Outcomes From Glucagon-Like Peptide-1 Receptor Agonists As Adjunct Treatment for Type 1 Diabetes - Case Presentations.

Background: Type 1 diabetes (T1D) is characterized by the autoimmune destruction of pancreatic beta cells, leading to lifelong insulin dependence. Despite advancements in insulin therapies and glucose monitoring, maintaining optimal blood glucose control remains challenging with common issues like weight gain and glucose variability. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs), approved for type 2 diabetes and obesity, are being explored off-label for T1D.

Metabolomic signature of pediatric diabetic ketoacidosis: key metabolites, pathways, and panels linked to clinical variables.

Background: Diabetic ketoacidosis (DKA) is a serious complication of type 1 diabetes (T1D), arising from relative insulin deficiency and leading to hyperglycemia, ketonemia, and metabolic acidosis. Early detection and treatment are essential to prevent severe outcomes. This pediatric case-control study utilized plasma metabolomics to explore metabolic alterations associated with DKA and to identify predictive metabolite patterns.

Retrospective derivation of a causal pathway for diabetic ketoacidosis in adult patients with type 2 diabetes mellitus.

Background: Type 2 ketone-prone diabetes mellitus (T2KPDM) is thought to occur in men of African descent, with obesity who experienced prolonged hyperglycemia; the role of medication non-adherence as a contributing cause remains unstudied.

Research Design And Methods: This was a retrospective study of unique adults (>18 years) who sought emergency care one of four hospitals in the greater Detroit area. Patients were identified on the basis of a laboratory order for a ß-hydroxybutyrate concentration.

Iliopsoas Abscess Mimicking a Lower Motor Neuron Lesion: A Diagnostic Challenge.

Iliopsoas abscess is a rare infection that presents with a triad of fever, back pain, and hip pain. However, due to the anatomical proximity of the psoas muscle to various structures, an abscess in this region can manifest with nonspecific symptoms, leading to potential misdiagnosis and delayed diagnosis, which can be fatal. We report a case of a 54-year-old female who presented to the emergency department with right-sided flank pain and symptoms resembling lower motor neuron disorder.

Hybrid closed-loop insulin therapy and risk of severe hypoglycaemia and diabetic ketoacidosis in young people (aged 2-20 years) with type 1 diabetes: a population-based study.

Background: The effect of closed-loop insulin delivery on the risk of acute diabetes complications in people with type 1 diabetes is unclear. We investigated whether the rates of severe hypoglycaemia and diabetic ketoacidosis are lower with hybrid closed-loop insulin therapy compared with sensor-augmented (open-loop) pump therapy in a large cohort of young people.

Methods: In this population-based cohort study, we evaluated young people with type 1 diabetes from 250 diabetes centres in Germany, Austria, Switzerland, and Luxembourg participating in the Diabetes Prospective Follow-up (DPV) initiative.

Management of diabetic keto-acidosis in adult patients admitted to intensive care unit: an ESICM-endorsed international survey.

Background: Guidelines for diabetic ketoacidosis (DKA) management are limited, resulting in varied practices. This study assessed Intensive Care Unit (ICU) admission criteria, fluid resuscitation, insulin therapy, and metabolic management in adult patients with DKA.

Methods: An international survey of ICU clinicians consisted of 39 items that focused on management of DKA and was endorsed by the European Society of the Intensive Care Medicine.

Diazoxide-Associated Hyperglycemia: A Critical Case Precipitating Hyperosmolar Hyperglycemic State in a Child.

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.

Cost-Effectiveness of FreeStyle Libre for Glucose Self-Management Among People with Diabetes Mellitus: A Canadian Private Payer Perspective.

Introduction: For people living with diabetes, effective glucose monitoring is a key component in diabetes care, helping to reduce disease burden, complications, and healthcare utilization. Sensor-based glucose monitoring systems, which can provide more comprehensive information about glucose levels than capillary-based self-monitoring of blood glucose (SMBG), are becoming established among people living with diabetes. The objective of this study was to assess the cost-effectiveness of glucose monitoring with FreeStyle Libre systems, compared with SMBG, from the perspective of a Canadian private payer.

Exploring Hypoglycemic Ketoacidosis in Nondiabetic Patients on Tirzepatide: Is Starvation the Culprit?

BACKGROUND Tirzepatide is a long-acting glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist administered via subcutaneous injection for weight reduction and treating type 2 diabetes. CASE REPORT We report case series of hypoglycemic ketoacidosis after the use of tirzepatide to treat nondiabetic patients with obesity from Kuwait. The first case was a 29-year-old woman with a body mass index (BMI) of 32 kg/m² who developed abdominal pain and vomiting after increasing the dose to 5 mg subcutaneously in week 5 of treatment.

Exogenous Ketones in Cardiovascular Disease and Diabetes: From Bench to Bedside.

Ketone bodies are molecules produced from fatty acids in the liver that act as energy carriers to peripheral tissues when glucose levels are low. Carbohydrate- and calorie-restricted diets, known to increase the levels of circulating ketone bodies, have attracted significant attention in recent years due to their potential health benefits in several diseases. Specifically, increasing ketones through dietary modulation has been reported to be beneficial for cardiovascular health and to improve glucose homeostasis and insulin resistance.

Telemedicine for Managing Type 1 Diabetes in Children and Adolescents Before and After the COVID-19 Pandemic.

The COVID-19 pandemic has catalyzed the rapid expansion of telemedicine for managing chronic conditions such as type 1 diabetes (T1D) in children and adolescents. This narrative review aims to explore the role of telemedicine in pediatric T1D management by comparing its use before and after the pandemic. We conducted a comprehensive literature review covering studies published between 2000 and 2024, focusing on telemedicine applications in pediatric T1D care.

Hepatic parenchymal hypoattenuation in dogs with diabetes mellitus on computed tomography consistent with hepatic steatosis.

Hypoattenuation of the liver, consistent with hepatic steatosis or lipidosis, has been reported in veterinary patients. In people, measuring CT hepatic attenuation is diagnostic for hepatic steatosis, and hypoattenuation of the liver is defined as absolute if less than 40 HU or relative if the liver is 10 HU less than the spleen. The purpose of this study is to describe hepatic parenchymal attenuation in dogs with diabetes mellitus with or without diabetic ketosis (DK) or diabetic ketoacidosis (DKA), using the above categorization for absolute and relative hypoattenuation, as with humans.

Factors associated with intensive care unit admission due to diabetic ketoacidosis in adults: a validated predictive model.

Objective: The objective of this study was to develop a predictive model capable of determining the need for intensive care unit (ICU) admission of patients with diabetic ketoacidosis (DKA) during their assessment in the Emergency Department.

Methods: This is an observational study of consecutive cases including all adult patients diagnosed with DKA at a tertiary hospital between 2010 and 2024. Variables from medical history, physical examination, and laboratory tests at admission were collected and studied for their association with ICU admission.

COVID-19 infection and inactivated vaccination: Impacts on clinical and immunological profiles in Chinese children with type 1 diabetes.

Background: The coronavirus disease 2019 (COVID-19) pandemic has been linked to an increased incidence of diabetes and diabetic ketoacidosis (DKA). However, the relationship between COVID-19 infection and progression to type 1 diabetes (T1D) in children has not been well defined.

Aim: To evaluate the influence of COVID-19 infection and inactivated vaccine administration on the progression of T1D among Chinese children.

The effect of COVID-19 pandemic on new-onset adult diabetes and its one-year follow-up.

Aims: Bidirectional detrimental relationships between COVID-19 infection and diabetes have been described globally. However, new-onset diabetes in adults and its follow-up during the pandemic have not been sufficiently investigated. In this study, new-onset autoimmune and type 2 diabetes cases during the pandemic were compared to those before the pandemic, and the clinical course of new-onset diabetes during the pandemic was examined.

A nested case-control study of adverse outcomes in children with diabetic ketoacidosis.

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.

Fatal Tracheal and Bronchial Destruction Due to Pulmonary Mucormycosis in a 20-Year-Old with Diabetic Ketoacidosis.

Pulmonary mucormycosis is a rare and aggressive invasive fungal infection that predominantly affects immunocompromised individuals, such as those with diabetes mellitus or those undergoing immunosuppressive therapy. This case describes a severe instance of pulmonary mucormycosis resulting in progressive tracheal wall destruction in a young, previously healthy male. A 20-year-old male with a denied history of diabetes mellitus was admitted to a local hospital with abdominal pain for 9 days and diagnosed with acute pancreatitis and diabetic ketoacidosis (DKA).

Regional deprivation and diabetic ketoacidosis at type 1 diabetes diagnosis in children and adolescents: International comparison among 6 countries.

Introduction: The incidence of diabetic ketoacidosis (DKA) at the time of diagnosis of type 1 diabetes in youth varies between countries and is influenced by socioeconomic factors. We investigated the relationship between regional deprivation indices and DKA at diagnosis of type 1 diabetes in six countries.

Methods: We analyzed children 0.

Retrospective Comparison of Early Versus Late Initiation of Long-Acting Insulin in Critically Ill Pediatric Patients in Diabetic Ketoacidosis.

Objective: Determine whether early administration (EA) of long-acting insulin in pediatric diabetic -ketoacidosis (DKA) reduces time to acidosis resolution while maintaining safety when compared with late administration (LA).

Methods: This retrospective review compared EA (within 4 hours) to LA (4 to 24 hours) of long-acting insulin in DKA management in the pediatric intensive care unit between 2015 and 2022. Admissions were excluded for patients ≥18 years of age, without type 1 diabetes, with insufficient laboratory data, or who did not receive insulin glargine within 24 hours of starting treatment.

Comparison of ketoacidosis in type 1 and 2 diabetic patients with and without concurrent COVID-19 and determining the factors affecting their treatment and survival: a retrospective cohort study.

Objectives: To assess the incidence of diabetic ketoacidosis in coronavirus disease-2019 patients and their survival rate, and to compare their outcomes with diabetic ketoacidosis patients without coronavirus disease-2019.

Methods: The retrospective cohort study was conducted at Aga Khan University Hospital, Karachi, and comprised data March 1, 2020, to March 31, 2021, related to patients. who had diabetic ketoacidosis with coronavirus disease- 2019 in group A, and those who had diabetic ketoacidosis without coronavirus disease-2019 in group B.

Versatile roles for neutrophil proteinase 3 in hematopoiesis and inflammation.

Neutrophil proteinase 3 (PR3), cathepsin G, elastase, and neutrophil serine protease 4 constitute the neutrophil serine protease family. These four members share varying sequence homology and functional similarities with each other. However, PR3 stands out as a unique autoantigen, serving as a primary autoantigen in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis.

Comparison of pediatric diabetic ketoacidosis in newly diagnosed versus known patients with type 1 diabetes mellitus: A single-center study.

Objectives: To compare the demographic, clinical, and biochemical characteristics of newly diagnosed versus known patients with type 1 diabetes mellitus (T1DM) presenting with diabetic ketoacidosis (DKA) in a tertiary care center in the Western region of Saudi Arabia.

Methods: We retrospectively reviewed 147 children and adolescents diagnosed with T1DM who presented with DKAs between January 2019 and December 2023. Data on age, gender, nationality, economic status, episode severity, presenting symptoms, and biochemical markers were collected and analyzed.

New-Onset Type 1 and Type 2 Diabetes Among Korean Youths During the COVID-19 Pandemic.

Importance: Whether COVID-19 contributes to youth-onset diabetes is controversial, and research in Asia is lacking.

Objective: To explore the incidence and severity of diabetes among youths during the COVID-19 pandemic in South Korea.

Design, Setting, And Participants: This cohort study used claims data for January 1, 2017, through February 28, 2022, from the National Health Insurance Service database in South Korea.