Acute Metabolic Complications of Diabetes in Emergency Department
Iranian Journal of Emergency Medicine,
Vol. 4 No. 2 (2017),
30 March 2017
,
Page 90-83
https://doi.org/10.22037/ijem.v4i2.16552
Abstract
Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are 2 acute metabolic crisis of uncontrolled diabetes mellitus. DKA usually occurs in patients with type 1 diabetes and HHS is seen mostly in those with type 2. In DKA, hyperglycemia, metabolic acidosis, and dehydration are the most prominent clinical symptoms and HHS is identified by hyperglycemia, severe dehydration without acidosis, and alterations in level of consciousness from sleepiness to confusion, seizure and coma. Treatment for both conditions is based on correction of dehydration and hyperglycemia, and establishing homeostasis of electrolytes. In the present review, we decided to present a comprehensive picture of the pathology and clinical manifestations, diagnosis and treatment of these 2 important conditions.- اختلالات متابولیسم گلوکز؛ کتواسیدوز دیابتی؛ کمای هایپراسملار هایپرگلیسمیک غیرکتونی؛ درمان اورژانس
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References
DeFronzo RA, Ferrannini E. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes care. 1991;14(3):173-94.
Maletkovic J, Drexler A. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Endocrinology and metabolism clinics of North America. 2013;42(4):677-95.
Chiasson J-L, Aris-Jilwan N, Bélanger R, Bertrand S, Beauregard H, Ékoé J-M, et al. Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Canadian Medical Association Journal. 2003;168(7):859-66.
Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes care. 2009;32(7):1335-43.
Wachtel T. The diabetic hyperosmolar state. Clinics in geriatric medicine. 1990;6(4):797-806.
Kitabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA. Hyperglycemic crises in adult patients with diabetes. Diabetes care. 2006;29(12):2739-48.
Umpierrez GE, Murphy MB, Kitabchi AE. Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome. Diabetes Spectrum. 2002;15(1):28-36.
Minokoshi Y, Kahn CR, Kahn BB. Tissue-specific ablation of the GLUT4 glucose transporter or the insulin receptor challenges assumptions about insulin action and glucose homeostasis. Journal of Biological Chemistry. 2003;278(36):33609-12.
Miles J, Haymond M, Nissen S, Gerich J. Effects of free fatty acid availability, glucagon excess, and insulin deficiency on ketone body production in postabsorptive man. Journal of Clinical Investigation. 1983;71(6):1554.
Deeter KH, Roberts JS, Bradford H, Richards T, Shaw D, Marro K, et al. Hypertension despite dehydration during severe pediatric diabetic ketoacidosis. Pediatric diabetes. 2011;12(4pt1):295-301.
Bowden SA, Duck MM, Hoffman RP. Young children (< 5 yr) and adolescents (> 12 yr) with type 1 diabetes mellitus have low rate of partial remission: diabetic ketoacidosis is an important risk factor. Pediatric diabetes. 2008;9(3pt1):197-201.
Razavi Nematollahi L, Kitabchi AE, Stentz FB, Wan JY, Larijani BA, Tehrani MM, et al. Proinflammatory cytokines in response to insulin-induced hypoglycemic stress in healthy subjects. Metabolism. 2009;58(4):443-8.
Stentz FB, Umpierrez GE, Cuervo R, Kitabchi AE. Proinflammatory cytokines, markers of cardiovascular risks, oxidative stress, and lipid peroxidation in patients with hyperglycemic crises. Diabetes. 2004;53(8):2079-86.
Büyükaşik Y, ş İleri N, Haznedaroğlu İC, Karaahmetoğlu S, Müftüoğlu O, Dündar S. Enhanced subclinical coagulation activation during diabetic ketoacidosis. Diabetes Care. 1998;21(5):868-70.
Nyenwe EA, Kitabchi AE. Evidence-based management of hyperglycemic emergencies in diabetes mellitus. Diabetes research and clinical practice. 2011;94(3):340-51.
Rosenbloom AL. Hyperglycemic hyperosmolar state: an emerging pediatric problem. The Journal of pediatrics. 2010;156(2):180-4.
SCHADE DS, EATON RP. Dose response to insulin in man: differential effects on glucose and ketone body regulation. The Journal of Clinical Endocrinology & Metabolism. 1977;44(6):1038-53.
Chupin M, Charbonnel B, Chupin F. C-peptide blood levels in keto-acidosis and in hyperosmolar non-ketotic diabetic coma. Acta diabetologia latina. 1981;18(2):123-8.
Wachtel TJ, Silliman RA, Lamberton P. Predisposing factors for the diabetic hyperosmolar state. Archives of internal medicine. 1987;147(3):499-501.
Jerums G, Premaratne E, Panagiotopoulos S, MacIsaac R. The clinical significance of hyperfiltration in diabetes. Diabetologia. 2010;53(10):2093-104.
Sheikh-Ali M, Karon BS, Basu A, Kudva YC, Muller LA, Xu J, et al. Can serum beta-hydroxybutyrate be used to diagnose diabetic ketoacidosis? Diabetes Care. 2008;31(4):643-7.
Pollock F, Funk DC. Acute diabetes management: Adult patients with hyperglycemic crises and hypoglycemia. AACN advanced critical care. 2013;24(3):314-24.
Lorber D. Nonketotic hypertonicity in diabetes mellitus. The Medical clinics of North America. 1995;79(1):39-52.
Gaglia JL, Wyckoff J, Abrahamson MJ. Acute hyperglycemic crisis in the elderly. Medical Clinics of North America. 2004;88(4):1063-84.
Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ, Kreisberg RA, Malone JI, et al. Management of hyperglycemic crises in patients with diabetes. Diabetes care. 2001;24(1):131-53.
Wolfsdorf JI, Allgrove J, Craig ME, Edge J, Glaser N, Jain V, et al. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatric diabetes. 2014;15(S20):154-79.
Kaufman FR, Halvorson M. The treatment and prevention of diabetic ketoacidosis in children and adolescents with type I diabetes mellitus. Pediatric annals. 1999;28(9):576-82.
Cope JU, Morrison AE, Samuels-Reid J. Adolescent use of insulin and patient-controlled analgesia pump technology: a 10-year Food and Drug Administration retrospective study of adverse events. Pediatrics. 2008;121(5):e1133-e8.
Hanas R, Lindgren F, Lindblad B. A 2‐yr national population study of pediatric ketoacidosis in Sweden: predisposing conditions and insulin pump use. Pediatric diabetes. 2009;10(1):33-7.
Barski L, Nevzorov R, Rabaev E, Jotkowitz A, Harman-Boehm I, Zektser M, et al. Diabetic ketoacidosis: clinical characteristics, precipitating factors and outcomes of care. The Israel Medical Association journal: IMAJ. 2012;14(5):299-303.
Gómez DR, Rivera MR, Ramos RR, Reza AA, Gómez-Pérez FJ, Rull J. Diabetic ketoacidosis in adults: clinical and laboratory features. Archives of medical research. 1995;27(2):177-81.
Arora S, Cheng D, Wyler B, Menchine M. Prevalence of hypokalemia in ED patients with diabetic ketoacidosis. The American journal of emergency medicine. 2012;30(3):481-4.
Arora S, Henderson S, Long T, Menchine M. Diagnostic accuracy of point-of-care testing for diabetic ketoacidosis at emergency-department triage:{beta}-hydroxybutyrate versus the urine dipstick. Diabetes care. 2011;34(4):852-4.
Wilson JF. In clinic. Diabetic ketoacidosis. Annals of internal medicine. 2010;152(1):ITC1-, ITC-2, ITC1-3,ITC1-4, ITC1-5, ITC1-6, ITC1-7, ITC1-8, ITC1-9, ITC1-10, ITC1-1, ITC1-2, ITC1-3, ITC1-4, ITC1-5, table of contents; quiz ITC1-6.
Savage M, Dhatariya K, Kilvert A, Rayman G, Rees J, Courtney C, et al. Joint British Diabetes Societies guideline for the management of diabetic ketoacidosis. Diabetic medicine: a journal of the British Diabetic Association. 2011;28(5):508-15.
Smiley D, Chandra P, Umpierrez GE. Update on diagnosis, pathogenesis and management of ketosis-prone Type 2 diabetes mellitus. Diabetes Management. 2011;1(6):589-600.
Kreshak A, Chen E. Arterial blood gas analysis: are its values needed for the management of diabetic ketoacidosis? Annals of emergency medicine. 2005;45(5):550-1.
Orlowski JP, Cramer CL, Fiallos MR. Diabetic ketoacidosis in the pediatric ICU. Pediatric Clinics of North America. 2008;55(3):577-87.
Wolfsdorf J, Glaser N, Sperling MA. Diabetic Ketoacidosis in Infants, Children, and Adolescents A consensus statement from the American Diabetes Association. Diabetes care. 2006;29(5):1150-9.
Brown T. Cerebral oedema in childhood diabetic ketoacidosis: Is treatment a factor? Emergency medicine journal. 2004;21(2):141-4.
Glaser NS, Ghetti S, Casper TC, Dean JM, Kuppermann N. Pediatric diabetic ketoacidosis, fluid therapy, and cerebral injury: the design of a factorial randomized controlled trial. Pediatric diabetes. 2013;14(6):435-46.
Waldhäusl W, Kleinberger G, Korn A, Dudczak R, Bratusch-Marrain P, Nowotny P. Severe hyperglycemia: effects of rehydration on endocrine derangements and blood glucose concentration. Diabetes. 1979;28(6):577-84.
Owen OE, Licht JH, Sapir DG. Renal function and effects of partial rehydration during diabetic ketoacidosis. Diabetes. 1981;30(6):510-8.
Luzi L, Barrett EJ, Groop LC, Ferrannini E, DeFronzo RA. Metabolic effects of low-dose insulin therapy on glucose metabolism in diabetic ketoacidosis. Diabetes. 1988;37(11):1470-7.
Kaiserman K, Rodriguez H, Stephenson A, Wolka L, Fahrbach JL. Continuous subcutaneous infusion of insulin lispro in children and adolescents with type 1 diabetes mellitus. Endocrine Practice. 2012;18(3):418-24.
Umpierrez GE, Latif K, Stoever J, Cuervo R, Park L, X Freire A, et al. Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. The American journal of medicine. 2004;117(5):291-6.
Goyal N, Miller JB, Sankey SS, Mossallam U. Utility of initial bolus insulin in the treatment of diabetic ketoacidosis. The Journal of emergency medicine. 2010;38(4):422-7.
Kitabchi AE, Nyenwe EA. Hyperglycemic crises in diabetes mellitus: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Endocrinology and metabolism clinics of North America. 2006;35(4):725-51.
Tridgell DM, Tridgell AH, Hirsch IB. Inpatient management of adults and children with type 1 diabetes. Endocrinology and metabolism clinics of North America. 2010;39(3):595-608.
Beigelman P. Potassium in severe diabetic ketoacidosis. The American journal of medicine. 1973;54(4):419-20.
Green SM, Rothrock SG, Ho JD, Gallant RD, Borger R, Thomas TL, et al. Failure of adjunctive bicarbonate to improve outcome in severe pediatric diabetic ketoacidosis. Annals of emergency medicine. 1998;31(1):41-8.
Kitabchi AE, Umpierrez GE, Fisher JN, Murphy MB, Stentz FB. Thirty years of personal experience in hyperglycemic crises: diabetic ketoacidosis and hyperglycemic hyperosmolar state. The Journal of Clinical Endocrinology & Metabolism. 2008;93(5):1541-52.
Nyenwe E, Loganathan R, Blum S, Ezuteh D, Erani D, Palace M, et al. Admissions for diabetic ketoacidosis in ethnic minority groups in a city hospital. Metabolism: clinical and experimental. 2007;56(2):172-8.
Leslie R, Williams R, Pozzilli P. Clinical review: Type 1 diabetes and latent autoimmune diabetes in adults: one end of the rainbow. The Journal of clinical endocrinology and metabolism. 2006;91(5):1654-9.
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