Review
Medicine, General & Internal
Leonid Barski, Evgeny Golbets, Alan Jotkowitz, Dan Schwarzfuchs
Summary: Diabetic ketoacidosis is a life-threatening emergency in diabetes patients, and its management is still controversial. Different society guidelines have inconsistencies and certain treatment aspects are not precise enough. Special patient factors and comorbidities should receive more attention, but guidelines often lack recommendations for specific conditions.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2023)
Article
Endocrinology & Metabolism
Eric S. S. Kilpatrick, Alexandra E. E. Butler, Linda Ostlundh, Stephen L. L. Atkin, David B. B. Sacks
Summary: The measurement of blood ketones has become an important tool in diagnosing and managing diabetic ketoacidosis. However, there is still disparity among guidelines on when and how to use this test, and several issues, such as inconsistent measurement methods and lack of evidence for cutoff values, remain to be addressed.
Article
Multidisciplinary Sciences
William H. Hoffman, Stephen A. Whelan, Norman Lee
Summary: Diabetic ketoacidosis (DKA) is a serious complication of Type 1 diabetes (T1D) caused by insulin deficiency and insulin resistance. The metabolic and immunologic dysregulation in DKA leads to oxidative stress, inflammation, and the development of brain edema (BE). Changes in the tryptophan (TRP)/kynurenine pathway (KP) metabolites may play a role in the pathogenesis of DKA/BE.
Article
Endocrinology & Metabolism
Farook Jahoor, Jean W. Hsu, Paras B. Mehta, Kelly R. Keene, Ruchi Gaba, Surya Narayan Mulukutla, Eunice Caducoy, W. Frank Peacock, Sanjeet G. Patel, Rasmus Bennet, Ake Lernmark, Ashok Balasubramanyam
Summary: Patients with A-beta+ ketosis-prone diabetes (KPD) during diabetic ketoacidosis (DKA) show metabolic similarities to type 1 diabetes (T1D) patients, including impaired branched-chain amino acid (BCAA) catabolism and accelerated fatty acid flux to ketones. The natural history of A-beta+ KPD is characterized by chronic but varying dysregulation of BCAA metabolism.
Article
Endocrinology & Metabolism
Nicole K. Gibbings, Paul A. Kurdyak, Patricia A. Colton, Baiju R. Shah
Summary: Adolescents and young adults with type 1 diabetes and eating disorders have more than triple the risk of DKA and nearly sixfold increased risk of death compared with their peers without eating disorders.
Article
Multidisciplinary Sciences
Gizework Alemnew Mekonnen, Kassahun Alemu Gelaye, Eyob Alemayehu Gebreyohannes, Tadesse Melaku Abegaz
Summary: This study aimed to determine the treatment outcomes of patients with diabetic ketoacidosis (DKA) in Debre Tabor General Hospital, Ethiopia. The study found that new onset type 1 diabetes was the main precipitating factor for DKA, and the average hospital stay was approximately five days. About five percent of DKA patients died in the hospital. Infection, serum glucose fluctuations, and the severity of DKA were factors that influenced the length of hospital stay.
Review
Medicine, General & Internal
Eirini Kostopoulou, Xenophon Sinopidis, Sotirios Fouzas, Despoina Gkentzi, Theodore Dassios, Stylianos Roupakias, Gabriel Dimitriou
Summary: Diabetic ketoacidosis (DKA) is an acute complication of type 1 diabetes mellitus (T1DM) and occasionally type 2 diabetes mellitus (T2DM), characterized by hyperglycemia, ketonemia and/or ketonuria, and acidemia. Clinical symptoms include dehydration, tachypnea, gastrointestinal symptoms, and reduced level of consciousness, often preceded by polyuria, polydipsia, and weight loss. This review aims to summarize potential pitfalls in the diagnosis and management of DKA.
Article
Endocrinology & Metabolism
Tatsuya Iino, Masayuki Akatsuka, Shuji Yamamoto
Summary: In severe cases of recurrent DKA, the presence of TS should be considered, and early treatment should be initiated before the patient's condition worsens.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Elizabeth S. Keiner, James C. Slaughter, Karishma A. Datye, Alan D. Cherrington, Daniel J. Moore, Justin M. Gregory
Summary: COVID-19 infection in pediatric patients with type 1 diabetes is associated with lower tissue glucose disposal during standardized therapy for diabetic ketoacidosis (DKA), suggesting a metabolic derangement caused by COVID-19.
Article
Endocrinology & Metabolism
Lily C. Chao, Alaina P. Vidmar, Senta Georgia
Summary: In 2020, youth with new-onset type 2 diabetes saw a marked increase in the incidence of DKA at presentation compared to previous years. Future studies should investigate the impact of SARS-CoV2 exposure on type 2 diabetes presentation across all age groups to enhance patient care.
Article
Chemistry, Multidisciplinary
Xue Wang, Jin Li, Wei Zhang, Ping Li, Wen Zhang, Hui Wang, Bo Tang
Summary: A new type of composite metal-organic framework sensor was designed and prepared in this study, which utilizes in situ fluorescence imaging of phosphate and pH to effectively evaluate diabetic complication-ketoacidosis, offering a new approach for early clinical diagnosis.
CHEMICAL COMMUNICATIONS
(2022)
Article
Pediatrics
Clemens Kamrath, Joachim Rosenbauer, Alexander J. Eckert, Angeliki Pappa, Felix Reschke, Tilman R. Rohrer, Kirsten Moenkemoeller, Michael Wurm, Kathrin Hake, Klemens Raile, Reinhard W. Holl
Summary: This study aimed to quantify the relative risk of diabetic ketoacidosis in children with newly diagnosed type 1 diabetes in 2020 and examine its association with regional COVID-19 incidence. The findings indicate a significant increase in ketoacidosis frequency compared to expected rates during certain months in 2020, with a positive association between regional COVID-19 incidence and ketoacidosis risk in the first half of the year. However, this association was not observed in the second half of 2020.
Article
Endocrinology & Metabolism
Ketan K. Dhatariya
Summary: This article summarises the Joint British Diabetes Societies for Inpatient Care guidelines on the management of ketoacidosis, including recommendations for different age groups and consideration of new evidence on hypoglycaemia and hypokalaemia. It also addresses the increased risk of euglycaemic ketoacidosis associated with the use of sodium glucose co-transporter 2 inhibitors and provides guidance for managing ketoacidosis in patients with end-stage renal failure or on dialysis.
Article
Medicine, General & Internal
Priya Rao, Sheng-Fang Jiang, Patricia Kipnis, Divyesh M. Patel, Svetlana Katsnelson, Samineh Madani, Vincent X. Liu
Summary: This study suggests that an SQ insulin protocol for treating diabetic ketoacidosis is associated with significant decreases in intensive care unit need and readmission, without evidence of increases in adverse events.
Article
Veterinary Sciences
Chris Scudder, Emma Roberts
Summary: This article discusses the etiology, clinical presentation, and treatment options for patients with diabetic ketoacidosis (DKA) in cats and dogs. DKA patients often have electrolyte and fluid balance abnormalities that require immediate treatment. With sufficient owner finances, tailored approaches can be successful in treating DKA patients.
