scholarly journals Cannabis Use Is Associated With Increased Risk for Diabetic Ketoacidosis in Adults With Type 1 Diabetes: Findings From the T1D Exchange Clinic Registry

Diabetes Care ◽  
2019 ◽  
Vol 43 (1) ◽  
pp. 247-249 ◽  
Author(s):  
Gregory L. Kinney ◽  
Halis K. Akturk ◽  
Daniel D. Taylor ◽  
Nicole C. Foster ◽  
Viral N. Shah
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Cannabis Use ◽  
Increased Risk

836-P: Cannabis Use in Adults with Type 1 Diabetes (T1D) Is Associated with Poor Glycemic Control and Increased Risk for Diabetic Ketoacidosis (DKA)

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 836-P ◽  
Author(s):  
VIRAL N. SHAH ◽  
DANIEL D. TAYLOR ◽  
NICOLE C. FOSTER ◽  
ROY BECK ◽  
HALIS K. AKTURK ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetic Ketoacidosis ◽  
Cannabis Use ◽  
Poor Glycemic Control ◽  
Increased Risk

scholarly journals COVID-19 Infection with Refractory Diabetic Ketoacidosis- A case Report

2021 ◽  
Vol 7 (2) ◽  
pp. 54-56
Author(s):  
Reshmi Mishra ◽  
◽  
Jyoti Ranjan Behera ◽  
P. Ramkumar ◽  
Mukesh Kumar Jain ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Metabolic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Vital Organ ◽  
Increased Risk ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
New Onset

Diabetic ketoacidosis is an acute life-threatening complication of type 1 diabetes. Sometimes it is the first presentation in an undiagnosed child. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) and diabetes mellitus are very much interrelated as diabetes mellitus is associated with an increased risk of severe COVID19 at the same time, many cases of new-onset diabetes had been diagnosed. Hyperglycemia, metabolic acidosis, and ketonemia are classical presentations. It is essential to correct the acidosis and fluid correction and insulin therapy in these patients, leading to vital organ dysfunction. In refractory metabolic acidosis, renal replacement therapy may help

scholarly journals Differentiating Diabetic Ketoacidosis and Hyperglycemic Ketosis Due to Cannabis Hyperemesis Syndrome in Adults With Type 1 Diabetes

2021 ◽  
Author(s):  
Halis Kaan Akturk ◽  
Janet Snell-Bergeon ◽  
Gregory L Kinney ◽  
Anagha Champakanath ◽  
Andrew Monte ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Mixed Models ◽  
Operating Characteristic ◽  
Cannabis Use ◽  
Urine Test ◽  
Icd 10 ◽  
Design And Methods ◽  
Cannabis Hyperemesis Syndrome

<b>Objective</b> <p>To differentiate diabetic ketoacidosis (DKA) from hyperglycemic ketosis due to cannabis hyperemesis syndrome (HK-CHS) in adults with type 1 diabetes.</p> <p><b>Research Design and Methods</b></p> <p>Of 295 adults with type 1 diabetes who were seen with DKA related ICD-10 codes, 68 patients with 172 DKA events meeting the inclusion criteria were analyzed. Cannabis use was defined as positive urine test for cannabis. Linear mixed models were used to define HK-CHS (pH ≥7.4 with bicarbonate ≥ 15) and sensitivity and specificity were calculated using receiver operating characteristic (ROC).</p> <p><b>Results</b></p> <p>Cannabis users had significantly higher pH (7.42 ± 0.01 vs 7.09 ± 0.02) and bicarbonate (19.2 ± 0.61 vs 9.1 ± 0.71) (p<0.0001) compared to non-users. The area under the ROC for positive cannabis urine test predicting HK-CHS was 0.9892.</p> <p><b>Conclusions</b></p> <p>In patients who present with DKA and higher pH, especially pH ≥ 7.4, cannabis use should be considered in differential diagnosis.</p>

scholarly journals Differentiating Diabetic Ketoacidosis and Hyperglycemic Ketosis Due to Cannabis Hyperemesis Syndrome in Adults With Type 1 Diabetes

2021 ◽  
Author(s):  
Halis Kaan Akturk ◽  
Janet Snell-Bergeon ◽  
Gregory L Kinney ◽  
Anagha Champakanath ◽  
Andrew Monte ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Mixed Models ◽  
Operating Characteristic ◽  
Cannabis Use ◽  
Urine Test ◽  
Icd 10 ◽  
Design And Methods ◽  
Cannabis Hyperemesis Syndrome

<b>Objective</b> <p>To differentiate diabetic ketoacidosis (DKA) from hyperglycemic ketosis due to cannabis hyperemesis syndrome (HK-CHS) in adults with type 1 diabetes.</p> <p><b>Research Design and Methods</b></p> <p>Of 295 adults with type 1 diabetes who were seen with DKA related ICD-10 codes, 68 patients with 172 DKA events meeting the inclusion criteria were analyzed. Cannabis use was defined as positive urine test for cannabis. Linear mixed models were used to define HK-CHS (pH ≥7.4 with bicarbonate ≥ 15) and sensitivity and specificity were calculated using receiver operating characteristic (ROC).</p> <p><b>Results</b></p> <p>Cannabis users had significantly higher pH (7.42 ± 0.01 vs 7.09 ± 0.02) and bicarbonate (19.2 ± 0.61 vs 9.1 ± 0.71) (p<0.0001) compared to non-users. The area under the ROC for positive cannabis urine test predicting HK-CHS was 0.9892.</p> <p><b>Conclusions</b></p> <p>In patients who present with DKA and higher pH, especially pH ≥ 7.4, cannabis use should be considered in differential diagnosis.</p>

scholarly journals Association Between Cannabis Use and Risk for Diabetic Ketoacidosis in Adults With Type 1 Diabetes

2019 ◽  
Vol 179 (1) ◽  
pp. 115 ◽  
Author(s):  
Halis K. Akturk ◽  
Daniel D. Taylor ◽  
Ulas M. Camsari ◽  
Amanda Rewers ◽  
Gregory L. Kinney ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Cannabis Use

scholarly journals Unusual high blood glucose in ketoacidosis as first presentation of type 1 diabetes mellitus

2018 ◽  
Vol 2018 ◽  
Author(s):  
Sebastian Hörber ◽  
Sarah Hudak ◽  
Martin Kächele ◽  
Dietrich Overkamp ◽  
Andreas Fritsche ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Atypical Antipsychotics ◽  
List Type ◽  
High Blood Glucose ◽  
Increased Risk ◽  
New Onset

Summary Diabetic ketoacidosis is a life-threatening complication of diabetes mellitus. It usually occurs in patients with type 1 diabetes where it is typically associated with only moderately increased blood glucose. Here, we report the case of a 52-year-old female patient who was admitted to the emergency unit with severely altered mental status but stable vital signs. Laboratory results on admission revealed very high blood glucose (1687 mg/dL/93.6 mmol/L) and severe acidosis (pH <7) with proof of ketone bodies in serum and urine. Past history revealed a paranoid schizophrenia diagnosed 10 years ago and for which the patient was treated with risperidone for many years. Acute treatment with intravenous fluids, intravenous insulin infusion and sodium bicarbonate improved the symptoms. Further laboratory investigations confirmed diagnosis of autoimmune type 1 diabetes. After normalization of blood glucose levels, the patient could soon be discharged with a subcutaneous insulin therapy. Learning points: Diabetic ketoacidosis as first manifestation of type 1 diabetes can occur with markedly elevated blood glucose concentrations in elder patients. Atypical antipsychotics are associated with hyperglycemia and an increased risk of new-onset diabetes. First report of risperidone-associated diabetic ketoacidosis in new-onset type 1 diabetes. Patients treated with atypical antipsychotics require special care and regular laboratory examinations to detect hyperglycemia and diabetic ketoacidosis. In cases when the diagnosis is in doubt, blood gas analysis as well as determination of C-peptide and islet autoantibodies can help to establish the definite diabetes type.

scholarly journals A Comprehensive System for Identifying Patients With Type 1 Diabetes at Increased Risk for Diabetic Ketoacidosis at Texas Children's Hospital

2021 ◽  
pp. cd210072
Author(s):  
David D. Schwartz ◽  
Mili Vakharia ◽  
Serife Uysal ◽  
Kristen R. Hendrix ◽  
Kelly Fegan-Bohm ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Comprehensive System ◽  
Children's Hospital ◽  
Increased Risk ◽  
Children’S Hospital

scholarly journals Impact of Covid-19 on the Rate of Diabetic Ketoacidosis in Pediatric New-Onset Type 1 Diabetes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A659-A660
Author(s):  
Kaleb T Bogale ◽  
Valerie Urban ◽  
Eric Schaefer ◽  
Kanthi Bangalore Krishna
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Altered Mental Status ◽  
Newly Diagnosed ◽  
Central Pennsylvania ◽  
Increased Risk

Abstract Introduction: Several demographic and clinical characteristics, including age, low socioeconomic status, and misdiagnosis at initial clinical presentation were previously associated with increased risk of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes (T1D) in the pediatric population. However, it is unclear whether the coronavirus (COVID-19) pandemic and subsequent lockdown influenced the rate of DKA in children newly diagnosed with T1D. We undertook this study to identify the impact of the COVID-19 pandemic on the rate of DKA in children newly diagnosed with T1D in a single tertiary care referral center in central Pennsylvania. Methods: We performed an extension of a retrospective analysis of all pediatric patients (age ≤18) newly diagnosed with T1D within a tertiary care referral center between 01/01/2017-09/14/2020. Demographics, insurance coverage, and all clinical documents 30 days before their T1D diagnosis were abstracted to assess for symptoms at diagnosis (polyuria, polydipsia, nocturia, weight loss, nausea, vomiting, altered mental status, infection, vision changes, and autism spectrum disorder), lab values (blood glucose, HbA1c, venous pH, and bicarbonate), and any healthcare encounters within 30 days of their diagnosis of T1D. We performed descriptive statistics and univariate analyses [evaluating children diagnosed with T1D during the pre-COVID-19 era (diagnosed between 1/1/2017-2/28/2020) and post-COVID-19 era (diagnosed between 03/01/2020-09/14/2020) associated with the incidence of DKA], followed by logistic regression analysis (incorporating key clinical factors previously associated with DKA and the pre- or post- COVID-19 era classification). Results: 412 pediatric patients with T1D [171 F:241 M; 370 pre-COVID-19 era:42 post-COVID-19 era] were included. The percentages of DKA diagnoses at admission were very similar between the pre-COVID-19 and post-COVID-19 groups (47% vs. 48%), as were the severity (13% vs. 14% mild DKA; 33% vs. 31% moderate or severe DKA). There were no temporal associations with the rate of DKA in respect to COVID-19, however, age (0-3 and 9-13 years), misdiagnosis during a preceding healthcare encounter, presenting to the emergency department directly, elevated HbA1c (&gt;10.0%/13.4mmol/L), and altered mental status were associated with increased risk of DKA on multivariable analysis. Conclusion: There were no fluctuations in the rate of DKA among pediatric patients newly diagnosed with T1D throughout the COVID-19 pandemic in central Pennsylvania. Interestingly, some geographic locations observed an increased frequency of DKA in children newly diagnosed with T1D, while others noted a decreased rate. Regardless, our findings suggest previously described predictors of DKA in the pediatric population persist, even in the setting of the COVID-19 pandemic.

scholarly journals Diabetic Ketoacidosis in a Patient with Type 1 Diabetes on Sodium-glucose Co-transporter-2 Inhibitors—a Case Report

2017 ◽  
Vol 13 (02) ◽  
pp. 72
Author(s):  
Gagan Priya ◽  
Vishal Bhambri ◽  
◽  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Sglt2 Inhibitors ◽  
Short Term ◽  
Lower Blood Glucose ◽  
The Past ◽  
Increased Risk ◽  
Lower Blood ◽  
Potential Benefits

We describe a case of a 26-year-old female with long-standing type 1 diabetes (T1D), on multiple subcutaneous insulin injections, who had been taking empagliflozin for the past year. She was detected to have severe diabetic ketoacidosis (DKA) with relatively lower blood glucose values during hospitalisation for dengue fever. The factors that precipitated the DKA are discussed, along with the unique challenges in the management of her metabolic status. While sodium-glucose co-transporter-2 (SGLT2) inhibitors have several potential benefits as adjunctive add-on therapy to insulin in T1D, the evidence is limited to short-term studies. However, their off-label use is increasing and there have been concerns related to increased risk of diabetic ketoacidosis. At present, SGLT2 inhibitors are not approved for use in T1D, and the risks should be discussed at length with the patient.

Sign in / Sign up

Export Citation Format

Share Document