Abstract Objective: To evaluate the factors associated with knowledge of diabetic ketoacidosis among individuals with type 1 diabetes mellitus and to analyze how sociodemographic, clinical, and healthcare access variables influence understanding of the condition’s prevention and management. Methods: This cross-sectional study was conducted with 465 individuals with type 1 diabetes mellitus via an online questionnaire. The instrument included sociodemographic and clinical variables and a 13-item test assessing participant’s knowledge of diabetic ketoacidosis. Data analysis employed the Kruskal-Wallis test and the […]

ABSTRACT Objective Leukocytosis is often observed among children presenting with diabetic ketoacidosis (DKA). This study compares detailed parameters of leukocytosis in children presenting with DKA versus infection. Subjects and methods In this comparative cohort study, we collected data from two groups of children, one hospitalized with DKA and another with community-acquired pneumonia (CAP). The primary objective was to compare the neutrophil-to-lymphocyte ratio (NLR) between the groups. Total leukocyte count (TLC), absolute neutrophil count (ANC), platelet-to-lymphocyte ratio (PLR), and platelet-to-monocyte ratio […]

ABSTRACT Objective: To evaluate the precipitating factors of diabetic ketoacidosis (DKA) in patients with type 1 diabetes hospitalized through the emergency department of a tertiary hospital. Materials and methods: Individuals with type 1 diabetes hospitalized for DKA from January 2005 to March 2010 (first period [P1], n = 75) and from April 2010 to January 2017 (second period [P2], n = 97) were identified through a query of electronic medical records. Data were collected by reviewing medical records. Only the […]

OBJECTIVE: To evaluate the accuracy of potassium concentrations measured by blood gas analysis (PBG) compared with laboratory serum potassium (LSP), in the initial care of patients with diabetic ketoacidosis (DKA). SUBJECTS AND METHODS: Fifty three patients with diabetes mellitus were evaluated in a retrospective analysis. PBG was carried out using the Radiometer ABL 700 (Radiometer Copenhagen®), and results were compared with LSP ADVIA 1650 Chemistry system (Siemens®), the gold standard method. Both methods are based on potentiometry. RESULTS: Mean PBG […]

OBJECTIVES: Diabetic ketoacidosis is a recurrent problem in the emergency room that requires prompt and effective treatment. Usually, it may be associated with an increase in triglyceride levels, exposing the patient to the risk of pancreatitis. METHODS: We report the case of a 38-year-old female patient with diabetic ketoacidosis and severe hypertriglyceridemia (triglycerides: 11.758 mg/dL). RESULTS: The patient was admitted to the Intensive Care Unit. Hydration and intravenous insulin were performed with success. During hospitalization, the levels of triglycerides decreased […]

Guillain-Barré syndrome (GBS) is a disorder caused by exaggerated immune response to infectious process. Diabetes Melito (DM) is not recognized as one cause of this inflammatory polyradiculoneuropathy with just a few cases of this association been described in the literature so far. We report here the case of a 44 years-old female patient admitted with a history of polyuria, polydipsia, weight loss, asthenia, hyperglycemia (562 mg/dL) and ketoacidosis without any infectious focus. The patient progressed with poliradiculopathy, respiratory insufficiency and […]

Diabetic ketoacidosis (DKA) is the main hyperglycemic complication in type 1 Diabetes Mellitus (DM1). The basic principles in treatment have to be followed carefully. The patient with DKA has a very deep volume depletion. To restore the circulatory capacity is the first step. From this point on, the restoration of the lost fluids is slow, around 1% per hour, aiming at the correction of the metabolic disturbance already on and avoiding great fluctuations in osmolality, which increases the risk of […]

Diabetic ketoacidosis is an acute complication of Diabetes Mellitus characterized by hyperglycemia, metabolic acidosis, dehydration, and ketosis, in patients with profound insulin deficiency. It occurs predominantly in patients with type 1 diabetes and is frequently precipitated by infections, insulin withdrawal or undiagnosed type 1 diabetes. The authors review its pathophysiology, diagnostic criteria and treatment options in adults, as well as its complications.

Since the introduction of atypical antipsychotic medications, starting with clozapine in 1990, many studies have associated these drugs with the development of diabetes among other metabolic disorders, as well as with the onset of the disease as ketoacidosis. We report the case of a 28-year-old patient with schizophrenia who was admitted with diabetic acidosis 1 month after the beginning of clozapine therapy. No weight gain was reported and the patient maintains satisfactory glycemia levels with no treatment required after discontinuation […]

A subgroup of patients presents diabetic ketoacidosis at the onset of diabetes mellitus (DM) but later is classified as type 2 DM based on the clinical follow-up. These individuals, most commonly obese of African or Hispanic origin, have negative auto-antibodies associated with type 1 DM, but frequently HLA class II DRB1*03 and/or DRB1*04 are detected. This peculiar subtype of DM is commonly referred to as diabetes flatbush. Here we report the case of a Caucasian patient that exhibited the described […]