1/5. urine glucose testing: reliable backup for whole blood glucose monitoring.urine glucose testing has been deemed by some to be nonessential in the management of diabetes mellitus since the technique and equipment for self-monitoring of blood glucose has become available. However, most physicians have experienced pitfalls in the management of diabetes mellitus when insulin dosage is adjusted daily based solely on the patient's monitoring of blood glucose. There have also been recent reports suggesting the use of urine glucose testing as a reliable and a reasonable alternative to monitoring of blood glucose in the management of diabetic subjects, including those using insulin as the mode of therapy. In this report, we describe a patient in whom diabetic ketoacidosis occurred during hospitalization as a result of inadequate insulin administration due to inaccurate capillary blood glucose test results. Furthermore, urine glucose and ketone values obtained simultaneously had been disregarded. If insulin therapy had been adjusted according to urine glucose results rather than blood glucose readings, diabetic ketoacidosis could have been averted in this patient. urine glucose testing may provide a reliable backup for suspect whole blood glucose values and may prevent catastrophic events requiring expensive hospitalization. This report also delineates several potential procedural problems that exist in the technique of whole blood glucose monitoring and provides recommendations to overcome these deficiencies.- - - - - - - - - - ranking = 1keywords = ketoacidosis (Clic here for more details about this article) |
2/5. Latent autoimmune diabetes mellitus in children (LADC) with autoimmune thyroiditis and celiac disease.Latent autoimmune diabetes mellitus in adults (LADA) is characterized by clinical presentation as type 2 diabetes mellitus after 25 years of age, initial control achieved with oral hypoglycemic agents for at least 6 months, presence of autoantibodies and some immunogenetic features of type 1 diabetes mellitus. An 8.3 year-old girl was referred to our pediatric endocrinology department because of incidental glucosuria. She did not complain of polyuria, polydipsia, or weight loss. Her body mass index (BMI) was at the 80th percentile. fasting glucose was 126 mg/dl, and OGTT glucose level at 120 min was 307 mg/dl. Although c-peptide levels were normal, her first phase insulin response (FIR) was lower than the 1st percentile. Anti-insulin antibody (AIA), islet cell antibody (ICA), and anti-glutamic acid decarboxylase (antiGAD) were negative. According to the clinical and laboratory findings, she was diagnosed as having type 2 diabetes mellitus. She was started with oral anti-diabetic treatment for a period of 1 year. insulin had to be initiated for worsening of HbA1c levels. In the fourth year of follow-up, she was admitted to our hospital with diabetic ketoacidosis although she was on an intensive insulin regimen. At this time, c-peptide levels were low, antiGAD and AIA were positive with HLA DR3/DQ2 haplotype. In addition, her thyroid peroxidase antibody and endomysium antibody were found to be high at follow-up. Small intestinal biopsy revealed celiac disease. This patient may represent the first case of latent autoimmune diabetes mellitus in children (LADC) with autoimmune thyroiditis and celiac disease.- - - - - - - - - - ranking = 0.5keywords = ketoacidosis (Clic here for more details about this article) |
3/5. organophosphate poisoning presenting as diabetic ketoacidosis.A 3-year-old boy was admitted to hospital following rapid-onset coma. Laboratory tests demonstrated hyperglycemia, glycosuria and keto-acidosis. Organophosphorus poisoning was the cause of the coma since he had been in contact with parathion, serum cholinesterase activity was undetectable and his condition returned to normal under atropine therapy.- - - - - - - - - - ranking = 2keywords = ketoacidosis (Clic here for more details about this article) |
4/5. Cerebral edema complicating diabetic ketoacidosis in childhood.Three patients who developed fatal cerebral edema in the diabetes camp setting were reviewed with 14 previously reported instances in persons under 21 years of age. Seven occurred in the initial episode of diabetic ketoacidosis. Minimal blood glucose levels less than 250 mg/dl were recorded in 8/17. Rate of fluid administration, rate of Na or K infusion, and hyponatremia or hypokalemia were not consistent factors. Two of the 17 patients received oral fluids only. An etiologic role for rate of blood glucose correction or speed of hydration was not substantiated by this experience and review.- - - - - - - - - - ranking = 2.5keywords = ketoacidosis (Clic here for more details about this article) |
5/5. blood glucose normalization-induced haemolysis in three adolescents with type 1 diabetes mellitus at onset and unknown G-6-PD deficiency.We present three adolescents unknown to be G-6-PD deficient who developed haemolytic anaemia after admission for diabetes at onset uncomplicated by ketoacidosis. These patients had no bacterial infections and had not ingested haemolytic drugs. The fall in glucose availability after the correction of hyperglycaemia is proposed as capable of inducing haemolysis in G-6-PD deficiency.- - - - - - - - - - ranking = 0.5keywords = ketoacidosis (Clic here for more details about this article) |