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Pediatric Diabetic Ketoacidosis

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Acute kidney injury and diabetic ketoacidosis in pediatric patients: risk factors.

Carlos Sánchez García, Mónica Briones Castellanos, Artemio Velasco Morales,

Acute kidney injury is a cause of morbidity in children with diabetes in developing countries, especially in patients with diabetic ketoacidosis. The objective of this study was to identify the risk factors for acute kidney injury in patients with diabetic ketoacidosis. This was a retrospective cohort study. A total of ... Read more >>

Arch Argent Pediatr (Archivos argentinos de pediatria)
[2020, 118(2):135-138]

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Bihemispheric Cerebral Oximetry Monitoring's Functionality in Suspected Cerebral Edema Diabetic Ketoacidosis With Therapeutic 3% Hyperosmolar Therapy in a Pediatric Emergency Department.

Thomas J Abramo, Sarah Szlam, Hailey Hargrave, Zena Leah Harris, Abby Williams, Mark Meredith, Madison Hedrick, Zhuopei Hu, Todd Nick, Cruz Velasco Gonzalez,

BACKGROUND:Suspected cerebral edema diabetic ketoacidosis (SCEDKA) is more common than perceived with symptoms including altered mentation, headache with vomiting, depressed Glasgow coma scale (GCS), abnormal motor or verbal responses, combativeness, and neurological depression. Suspected cerebral edema diabetic ketoacidosis has been associated with initial diabetic ketoacidosis (DKA) presentation and at start ... Read more >>

Pediatr Emerg Care (Pediatric emergency care)
[2020, :]

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Difference in the duration of pediatric diabetic ketoacidosis: Comparison of new-onset to known type 1 diabetes.

Leonardo Valero-Guzmán, Pablo Vásquez-Hoyos, Jhon Camacho-Cruz, Luis Carlos Maya-Hijuelos, Susan Martínez-Lozada, Ana María Rubiano-Acevedo, Marleny Lara-Bernal, Tomas Diaz-Angarita,

OBJECTIVE:To compare the duration (hours until HCO3-  ≥ 15 mmol/L) of diabetic ketoacidosis (DKA) episodes that are the first manifestation of new type 1 diabetes (NT1D) and those that are a complication in patients with previously diagnosed type 1 diabetes (PT1D). METHODS:A multicenter retrospective cohort study was designed. The duration of DKA ... Read more >>

Pediatr Diabetes (Pediatric diabetes)
[2020, :]

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Evaluation of thiol/disulfide homeostasis in pediatric patients with diabetic ketoacidosis.

Mutlu Uysal Yazıcı, Ganime Ayar, Semra Çetinkaya, Meliksah Keskin, Ebru Azapağası, Saim Neşelioğlu, Özcan Erel, Benan Bayrakçı,

AIM AND OBJECTIVE:This study aimed to investigate the value of Thiol/Disulfide homeostasis in pediatric diabetic ketoacidosis patients suffering from type 1 diabetes mellitus. MATERIALS AND METHODS:This study featured children who were diagnosed with diabetic ketoacidosis and who were consecutively admitted to pediatric intensive care within one year of their diagnosis. ... Read more >>

Comb. Chem. High Throughput Screen. (Combinatorial chemistry & high throughput screening)
[2020, :]

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Factors Associated With Cerebral Edema at Admission in Indian Children with Diabetic Ketoacidosis.

N Agarwal, C Dave, R Patel, R Shukla, R Kapoor, A Bajpai,

OBJECTIVE:To evaluate the time course and predictors of cerebral edema in diabetic ketoacidosis (DKA). METHODS:Review of hospital records of 107 episodes of DKA between January 2013 to March 2019. RESULTS:Cerebral edema was identified in 26 (24.3%; 22 at presentation and 4 during treatment). Cerebral edema at presentation was associated with ... Read more >>

Indian Pediatr (Indian pediatrics)
[2020, :]

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Assessment of a Day Hospital Management Program for Children With Type 1 Diabetes.

Sarah Lawson, Jacob M Redel, Allison Smego, Melanie Gulla, Pamela J Schoettker, Mary Jolly, Farida Mostajabi, Lindsey Hornung,

Importance:A shift in the setting of care delivery for children with a new diagnosis of type 1 diabetes led to a reorganization of treatment. Objective:To determine whether a new diagnosis of pediatric diabetes can be successfully managed in a day hospital model. Design, Setting, and Participants:This quality improvement study used ... Read more >>

JAMA Netw Open (JAMA network open)
[2020, 3(3):e200347]

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Plasma β-Hydroxybutyrate for the Diagnosis of Diabetic Ketoacidosis in the Emergency Department.

Elise Schlissel Tremblay, Kate Millington, Michael C Monuteaux, Richard G Bachur, Joseph I Wolfsdorf,

OBJECTIVE:Diabetic ketoacidosis (DKA) is a common emergency department presentation of both new-onset and established diabetes mellitus (DM). β-Hydroxybutyrate (BOHB) provides a direct measure of the pathophysiologic derangement in DKA as compared with the nonspecific measurements of blood pH and bicarbonate. Our objective was to characterize the relationship between BOHB and ... Read more >>

Pediatr Emerg Care (Pediatric emergency care)
[2020, :]

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The factors relevant to partial remission in children with type 1 diabetes mellitus after measles vaccination: A retrospective study.

Gonca Bektaş, Hasan Önal, Erdal Adal,

We aimed to identify the determinants of partial remission in patients with type 1 diabetes mellitus (DM), and whether there is an influence of vaccination against measles on partial remission. This was a retrospective study consisting of consecutive patients diagnosed with type 1 DM followed-up from 1 September 2010, through ... Read more >>

J. Med. Virol. (Journal of medical virology)
[2020, :]

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Monitoring of Pediatric Type 1 Diabetes.

Brynn E. Marks, Joseph I. Wolfsdorf,

Regular self-monitoring of blood glucose levels, and ketones when indicated, is an essential component of type 1 diabetes (T1D) management. Although fingerstick blood glucose monitoring has been the standard of care for decades, ongoing rapid technological developments have resulted in increasingly widespread use of continuous glucose monitoring (CGM). This article ... Read more >>

Front Endocrinol (Lausanne) (Frontiers in endocrinology)
[2020, 11:]

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Ketoacidosis in type 1 diabetics: we should return to pediatric guidelines.

Sébastien Redant, David De Bels, Jacques Massaut, Jacques Devriendt, Xavier Beretta-Piccoli, Rachid Attou, Patrick M Honore,

Ann Intensive Care (Annals of intensive care)
[2020, 10(1):19]

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The Influence of Chloride for the Interpretation of Plasma Bicarbonate During the Treatment of Diabetic Ketoacidosis.

Juan Pablo Ferreira, Magali Hamui, Milagros Torrents, Romina Carrano, Mabel Ferraro, Ismael Toledo,

INTRODUCTION:Hyperchloremic metabolic acidosis can occur in diabetic ketoacidosis (DKA) and may affect the acid-base interpretation during treatment. OBJECTIVES:This study aims to describe the prevalence of hyperchloremia during the treatment of DKA and its effect on the interpretation of bicarbonate value. METHODS:A cross-sectional study, including all cases of DKA in patients ... Read more >>

Pediatr Emerg Care (Pediatric emergency care)
[2020, 36(3):e143-e145]

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Air occlusion in insulin pumps of children and adolescents with type 1 diabetes.

Michelle M Knoll, Turaj Vazifedan, Eric Gyuricsko,

Background Insulin pumps are a frequently used technology among youth with type 1 diabetes. Air bubbles within insulin pump tubing are common, preventing insulin delivery and increasing the risk of large glycemic excursions and diabetic ketoacidosis (DKA). We sought to determine the prevalence of air bubbles in insulin pump tubing ... Read more >>

J. Pediatr. Endocrinol. Metab. (Journal of pediatric endocrinology & metabolism : JPEM)
[2020, 33(2):179-184]

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Acute diabetes complications across transition from pediatric to adult care in Ontario and Newfoundland and Labrador: a population-based cohort study.

Rayzel Shulman, Longdi Fu, John C Knight, Astrid Guttmann, Roger Chafe,

BACKGROUND:Transition to adult diabetes care is a high-risk period for acute complications, yet the optimal transition care model is unknown. To gain insight into the impact on health outcomes of system-level transition processes that reflect resourcing differences, we examined acute complications in youth with diabetes across transition in 2 Canadian ... Read more >>

CMAJ Open (CMAJ open)
[2020, 8(1):E69-E74]

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TREATMENT OF DIABETIC KETOACIDOSIS AND THE WEEKEND EFFECT AT AN URBAN TERTIARY-CARE CENTER.

Alon Yehuda Mazori, Dana Larsen, Maham Qureshi, Vafa Tabatabaie,

Objective: Weekend admission has been associated with higher morbidity and mortality, but the relationship between diabetic ketoacidosis (DKA) outcomes and this weekend effect is unclear. To better characterize it, we examined the outcomes of patients admitted with DKA to an urban tertiary-care center. Methods: This retrospective study included pediatric and ... Read more >>

Endocr Pract (Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists)
[2020, :]

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Reduction in Diabetic Ketoacidosis and Severe Hypoglycemia in Pediatric Type 1 Diabetes During the First Year of Continuous Glucose Monitoring: A Multicenter Analysis of 3,553 Subjects From the DPV Registry.

Martin Tauschmann, Julia M Hermann, Clemens Freiberg, Matthias Papsch, Angelika Thon, Bettina Heidtmann, Kerstin Placzeck, Dirk Agena, Thomas M Kapellen, Bernd Schenk, Johannes Wolf, Thomas Danne, Birgit Rami-Merhar, Reinhard W Holl, ,

Diabetes Care (Diabetes care)
[2020, 43(3):e40-e42]

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A Quality Improvement Initiative to Reduce Hospitalizations for Low-risk Diabetic Ketoacidosis.

Kelly R Bergmann, M Jennifer Abuzzahab, Joe Arms, Gretchen Cutler, Heidi Vander Velden, Ted Simper, Eric Christensen, Dave Watson, Anupam Kharbanda,

BACKGROUND AND OBJECTIVES:Children with established type 1 diabetes (T1D) who present to the emergency department (ED) with mild diabetic ketoacidosis (DKA) are often hospitalized, although outpatient management may be appropriate. Our aim was to reduce hospitalization rates for children with established T1D presenting to our ED with mild DKA who ... Read more >>

Pediatrics (Pediatrics)
[2020, 145(3):]

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Children and adolescents with type 1 and type 2 diabetes mellitus in the Pediatric Diabetes Consortium Registries: comparing clinical characteristics and glycaemic control.

M A Van Name, P Cheng, R L Gal, C Kollman, J Lynch, B Nelson, W V Tamborlane, ,

AIM:To compare the characteristics of children and adolescents with type 1 vs. type 2 diabetes in the Pediatric Diabetes Consortium (PDC) registries. METHODS:Participants were 10 to < 21 years of age at diagnosis; there were 484 with type 1 diabetes and 1236 with type 2 diabetes. RESULTS:Children and adolescents with type ... Read more >>

Diabet. Med. (Diabetic medicine : a journal of the British Diabetic Association)
[2020, :]

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FAMILY HISTORY OF DIABETES IS ASSOCIATED WITH INCREASED RISK OF RECURRENT DIABETIC KETOACIDOSIS IN PEDIATRIC PATIENTS.

Janaki D Vakharia, Sungeeta Agrawal, Janine Molino, Lisa Swartz Topor,

Objective: To determine the relationship between family history of diabetes mellitus (DM) and diabetic ketoacidosis (DKA) recurrence in youth with established type 1 diabetes mellitus (T1DM). Methods: We performed a retrospective chart review of patients with DKA admitted to a pediatric hospital between January, 2009, and December, 2014. We compared ... Read more >>

Endocr Pract (Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists)
[2020, 26(3):305-311]

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Two cases of ketosis-prone diabetes mellitus in Korean adolescents.

Won Bin Hwang, Ji Hyun Kim, Sung Min Cho,

In recent years, reports of diabetes mellitus (DM) cases that do not fit the traditional classification system have increased in prevalence. While insulin deficiency appears as type 1 DM (T1DM), the new type also has the clinical features of type 2 DM (T2DM); as such, this new type of DM ... Read more >>

Ann Pediatr Endocrinol Metab (Annals of pediatric endocrinology & metabolism)
[2019, 24(4):257-261]

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Association of diabetic ketoacidosis and HbA1c at onset with year-three HbA1c in children and adolescents with type 1 diabetes: Data from the International SWEET Registry.

Barbara Piccini, Anke Schwandt, Craig Jefferies, Olga Kordonouri, Catarina Limbert, Ilknur Arslanoglu, Roque Cardona-Hernandez, Regis Coutant, Jae Hyun Kim, Romualdas T Preiksa, Auste Pundziute Lyckå, Birgit Rami-Merhar, Erick Richmond, Radka Savova, Sladjana Todorovic, Henk J Veeze, Sonia Toni, ,

OBJECTIVE:To establish whether diabetic ketoacidosis (DKA) or HbA1c at onset is associated with year-three HbA1c in children with type 1 diabetes (T1D). METHODS:Children with T1D from the SWEET registry, diagnosed <18 years, with documented clinical presentation, HbA1c at onset and follow-up were included. Participants were categorized according to T1D onset: (a) ... Read more >>

Pediatr Diabetes (Pediatric diabetes)
[2020, 21(2):339-348]

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Can we effectively predict the occurrence of cerebral edema in children with ketoacidosis in the course of type 1 diabetes? - case report and literature review.

Krzysztof Jeziorny, Arleta Waszczykowska, Dobromiła Barańska, Agnieszka Szadkowska, Wojciech Młynarski, Agnieszka Zmysłowska,

Background Cerebral edema (CE) is one of the most serious complications of diabetic ketoacidosis (DKA) and can result in central nervous system (CNS) disorders and even lead to death of the patient. Case presentation We present the case of a 11-year-old boy with severe DKA in the course of newly ... Read more >>

J. Pediatr. Endocrinol. Metab. (Journal of pediatric endocrinology & metabolism : JPEM)
[2020, 33(2):319-322]

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The Effects of Prehospital Care on Outcome in Pediatric Diabetic Ketoacidosis

Caner Turan, Ali Yurtseven, Elif Gokce Basa, Damla Goksen, Eylem Ulas Saz,

Objective:Despite the guidelines, significant variations can be encountered on initial therapy for pediatric diabetic ketoacidosis (DKA) in the prehospital setting. These variations mostly on fluid administration, insulin dosing, route of administration, and other aspects of the initial resuscitation and stabilization. We aimed to identify the effect of transport care ... Read more >>

J Clin Res Pediatr Endocrinol (Journal of clinical research in pediatric endocrinology)
[2019, :]

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0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial.

Vijai Williams, Muralidharan Jayashree, Karthi Nallasamy, Devi Dayal, Amit Rawat,

BACKGROUND:Acute kidney injury (AKI) is an important complication encountered during the course of diabetic ketoacidosis (DKA). Plasma-Lyte with lower chloride concentration than saline has been shown to be associated with reduced incidence of AKI in adults with septic shock. No study has compared this in DKA. METHODS:This double-blind, parallel-arm, investigator-initiated, ... Read more >>

Crit Care (Critical care (London, England))
[2020, 24(1):1]

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Perforation Peritonitis Secondary to Intestinal Mucormycosis in a Boy with Type I Diabetes Mellitus.

Abdul Haque M Quraishi, Aishwarya Peshattiwar, Girish Umare, Avishek Bannerji,

Intestinal mucormycosis is a rare fungal infection reported more commonly in immunocompromised patients, premature infants, diabetics, transplant recipients, prolonged use of corticosteroids, or in conditions associated with an increased availability of serum iron such as acidosis or deferoxamine administration and carries a high mortality rate. We report the case of ... Read more >>

J Indian Assoc Pediatr Surg (Journal of Indian Association of Pediatric Surgeons)
[2020, 25(2):118-120]

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Recent Advances in Neonatal Diabetes.

Amanda Dahl, Seema Kumar,

Neonatal diabetes mellitus (DM) is defined by the onset of persistent hyperglycemia within the first six months of life but may present up to 12 months of life. A gene mutation affecting pancreatic beta cells or synthesis/secretion of insulin is present in more than 80% of the children with neonatal ... Read more >>

Diabetes Metab Syndr Obes (Diabetes, metabolic syndrome and obesity : targets and therapy)
[2020, 13:355-364]

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