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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ketonaemia is well documented as a consequence of prolonged starvation, acute alcoholism, and uncontrolled diabetes mellitus. However, its occurrence in acute pancreatitis has not been described. In this report, three patients who manifested ketoacidosis at the time of presentation of acute pancreatitis are described. In none of these patients could ketoacidosis be attributed to any of the well known pathogenetic factors such as ethanol, diabetes mellitus or prolonged starvation. In one patient, both the serum ketone titres and increased anion gap persisted for several days during the recovery period, despite appropriate therapy (including restriction of oral intake or nasogastric suction, intravenous fluids, and analgesic administration), before declining in parallel with a decrease in serum lipase levels, and became undetectable following near normalisation of serum lipase. Therefore, we believe that pancreatic ketosis or ketoacidosis may be a distinct syndrome with ketogenesis being promoted and maintained by extremely high circulating pancreatic lipase concentrations.
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PMID:Pancreatic ketoacidosis: ketonemia associated with acute pancreatitis. 770 90

Data of 26 patients suffering from severe pancreatitis, who were treated at the anesthesiologic intensive care unit during the years 1991 and 1992, were evaluated with respect to etiologic factors, especially hypertriglyceridemia, stage of the disease and clinical outcome. Hypertriglyceridemia was found in 13 cases (11 men, 2 women, mean age 42 +/- 9 years) with values between 330 mg/dl and 4000 mg/dl. Lipid electrophoresis revealed a pattern typical for type IV hyperlipidemia. Insulin dependent diabetes was present in 4 patients and 5 reported about an unusual high alcohol intake preceding pancreatitis. Beside surgical approaches, including drainage and lavage, and basic intensive care treatment plasmapheresis was performed in 8 patients with hypertriglyceridemia. 5 patients with pancreatitis and hypertriglyceridemia died out of multiorganic failure, and so the mortality rate was 38%. The group of patients with pancreatitis caused by cholelithiasis or chronic alcohol consumption showed a mortality rate of 46%. The poor outcome of pancreatitis associated with hypertriglyceridemia demonstrates the importance of the treatment of hypertriglyceridemia in order to prevent the development of pancreatitis. The determination of plasma triglyceride values should belong to the routine diagnostic procedures in acute pancreatitis.
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PMID:[Hypertriglyceridemia and acute pancreatitis]. 770 9

A female patient with hereditary chronic pancreatitis is described. She presented initially at the age of 18 years with abdominal pain due to acute pancreatitis. Predisposing etiological factors were not recognized. During the ensuing years she had recurrent episodes of abdominal pain and chronic pancreatitis with extensive pancreatic calcifications was finally demonstrated. Six other family members within three generations were affected by chronic pancreatitis suggesting an autosomal dominant mode of transmission. None of the affected patients showed signs of diabetes mellitus, aminoaciduria or hyperparathyroidism.
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PMID:Hereditary pancreatitis--a case report. 788 74

Inflammatory diseases of the pancreas are not uncommon in the elderly; although acute and chronic pancreatitis in this age group are essentially the same diseases as in younger patients, some features are unique to the old patient. Acute pancreatitis in the elderly is more commonly of gallstone etiology; it is also more likely to have an atypical clinical presentation, making recognition more difficult. In acute necrotizing pancreatitis, the elderly patient has an increased risk of complications including multisystem failure; for this reason, such patients should be more carefully monitored and aggressively treated. Chronic pancreatitis with initial onset older than 60 years is rare in the elderly, and generally without apparent cause; much more commonly, it is seen as the advanced stage of a disease started in youth. Diffuse glandular destruction and resulting severe insufficiency are usually present; thus, rather than pain, the most frequent clinical manifestations are steatorrhea and diabetes. These complications should be adequately treated to avoid malnutrition, which may seriously affect the well-being and quality of life in the elderly.
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PMID:Pancreatitis in the elderly. 793 Apr 38

This chapter reviews the therapeutic use of octreotide in a variety of pancreatic disorders, including acute pancreatitis, in the prevention of postoperative and post-ERCP pancreatitis, in the control of postoperative pancreatic fistulae, and in chronic pancreatitis for the control of pain and of pseudocysts and ascites. The review also discusses the use of octreotide in intestinal disorders of motility, gastrointestinal bleeding, intestinal fistulae and refractory diarrhoea, including the diarrhoeas of AIDS, diabetes, short gut, chemotherapy, ileostomy and gastric surgery. The use of octreotide in neuroendocrine tumours, both for therapy and diagnostic imaging, is reviewed briefly. The paucity of adequately controlled studies in many of these situations is indicated and the potential usefulness of octreotide estimated.
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PMID:Expanding uses of octreotide. 794 61

During hospitalization for severe acute necrotizing pancreatitis, a connection between the onset of retinopathy of pancreatitis and multiple-organ failure was studied. Ophthalmoscopy was repeated every second day and continuous staging for multiple-organ failure was performed in 38 patients. Typical retinopathy of pancreatitis developed in 7 of 10 patients with multiple-organ failure and only in 4 of the 28 patients without multiple-organ failure. Retinopathy of pancreatitis was observed in 7 of the 18 cases leading to lethal outcome and only in 4 of the 20 surviving patients. No correlation was observed between the development of retinopathy of pancreatitis and hemodialysis, pre-existing diabetes mellitus, abnormal platelet count, result of hemoculture, c reactive protein value, fraction of inspired oxygen and adult respiratory distress syndrome. In the 21 control patients in grave general state but without acute pancreatitis, retinopathy of pancreatitis was never observed. In our prospective study the onset of retinopathy of pancreatitis had clinical prognostic value and indicated multiple-organ failure and poor prognosis in severe acute necrotizing pancreatitis.
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PMID:Retinopathy of pancreatitis indicates multiple-organ failure and poor prognosis in severe acute pancreatitis. 801 83

The experiment has shown that the serum of rabbits with acute pancreatitis produces proliferative effect on pancreatic islets' B-cells in rats with the acute form of experimental diabetes. The stimulation of miotic activity of B-cells, processes of acino-insular transformation, compensation of the insular function in rats with alloxan diabetes proved to be lower than in rabbits under the same experimental conditions. This testities to relative species specificity of factors in the serum of rabbits with pancreatic gland trauma.
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PMID:[Species specificity of serum factors in rabbits with acute pancreatitis in stimulated regeneration of pancreatic islet B-cells in experimental diabetes]. 804 48

In two male patients the deficiency of G-6-PD in erythrocytes became manifested in 27th year of age with severe hemolytic crisis. In the first case hemolysis appeared after three days of heavy alcohol drinking. There was no evident relation between alcohol and hemolysis. In the second patient (an Iraqi Student) suffering from diabetes since adolescence, hemolysis was provoked by respiratory tract infection, antiinflammatory drugs and concomitant ketosis. Pneumonia, renal insufficiency and acute pancreatitis complicated the course of illness. The patient required a consecutive erythrocyte concentrate transfusions. Aplastic crisis was treated with folic acid.
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PMID:[Glucose-6-phosphate dehydrogenase deficiency in erythrocytes observed in two cases]. 823 7

A 19 years old patient who presented grade D acute pancreatitis by abdominal CT with marked hypertriglyceridemia during a diabetic ketoacidosis (DKA) in the onset of a type I diabetes mellitus is described. The pancreatitis and DKA were resolved with the usual treatment, and the levels of triglycerides became normal within one week. Hyperamylasemia is frequent in DKA although of uncertain significance. Acute pancreatitis coinciding with DKA has been described, in this case radiologic findings demonstrated the diagnosis. No other bibliographic references have been found in which pathologic imaging in abdominal CT are described in a situation of DKA with hyperamylasemia. Moderate hypertriglyceridemia is common upon initiation of diabetes mellitus and likewise it usually presents during the course of acute pancreatitis. Pancreatitis could be secondary to hypertriglyceridemia and the latter to the insulin deficiency.
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PMID:[Acute pancreatitis in newly diagnosed type I diabetes mellitus with diabetic ketoacidosis and hypertriglyceridemia]. 796 98

A ten-fold increase in daily insulin requirements during the administration of total parenteral nutrition (TPN) is described in a patient with congenital generalized lipodystrophy, insulin-requiring diabetes mellitus, and acanthosis nigricans during an episode of acute pancreatitis secondary to hypertriglyceridaemia. After a period of 13 days on TPN, insulin requirements increased dramatically to an average of 1428 units per day for a period of 12 days, to achieve a mean blood glucose level of 10.9 mmol l-1. When the patient resumed feeding and the TPN was discontinued, the average daily insulin requirement was 104 units with a mean 24 h blood glucose of 11.8 mmol l-1. Parenteral administration of energy substrates in a rare case of diabetes mellitus and congenital lipodystrophy complicated by acute pancreatitis resulted in a severe insulin insensitive state due to the combination of the hypermetabolism conferred by the pancreatitis plus transient impairments of the glucose disposal mechanism by the energy substrates provided.
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PMID:Insulin requirements in lipodystrophic diabetes. 828 34


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