Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty-nine instances of intracerebral complications of diabetic ketoacidosis (DKA), including 29 unpublished occurrences, were analyzed to determine predictive factors, the frequency of other disorders resembling cerebral edema, the effectiveness of intervention to reduce intracranial pressure, and whether any etiologic considerations appeared valid. The review failed to implicate rate of hydration, tonicity of administered fluids, rate of correction of glycemia, or use of bicarbonate. Infants and young children (less than 5 yr of age) were disproportionately represented (33%), as were new-onset patients (62%). Approximately 20% of patients were found to have localized basilar edema, hemorrhage, thromboses, or infection by computed tomography scan or on postmortem examination. The histories of 50% of the patients suggested a period of dramatic neurological change preceding respiratory arrest (RA) during which intervention might be effective. Twenty-three patients were treated for increased intracranial pressure before RA; 13 patients survived in an independent functional state, and 3 survived in a severely disabled or vegetative state. Only 3 of the remaining 46 patients survived normally: 2 were untreated and never developed RA, and 1 was given mannitol at the onset of apnea. This review supports close neurological monitoring and intervention to reduce intracranial pressure when there are definite signs of neurological compromise. However, treatment appears to be successful in only 50% of patients who give sufficient warning for such intervention, and they comprised half of the study population. Therefore, prevention of DKA remains the most important goal to avoid intracerebral complications.
Diabetes Care 1990 Jan
PMID:Intracerebral crises during treatment of diabetic ketoacidosis. 210 95

Diabetic ketoacidosis may occur in women treated with intravenous beta-sympathomimetic agents for tocolysis. We describe diabetic ketoacidosis and transient severe insulin resistance in a woman with diabetes who was treated with subcutaneous terbutaline infusion. Subcutaneous terbutaline infusion may precipitate transient insulin resistance and diabetic ketoacidosis in women with diabetes.
 ...
PMID:Diabetic ketoacidosis and insulin resistance with subcutaneous terbutaline infusion: a case report. 211 90

Ketoacidosis, severe hyperosmolality due to hyperglycemia, and severe hypoglycemia are all life-threatening emergencies that often occur in the absence of any history of diabetes mellitus. The key to management of diabetic ketoacidosis is understanding that treatment is aimed more at the breakdown and metabolism of triglycerides in adipose tissue than at hyperglycemia per se. The diabetic hyperosmolar state is most easily treated with aggressive fluid management, with the caveat that too-rapid administration of hypotonic fluids may increase the already significant mortality from this condition. Life-threatening hypoglycemia most commonly occurs with administration of oral hypoglycemic drugs or insulin, although other drugs and any malnourished state may also be precipitating factors. Acute administration of glucagon or dextrose alleviates life-threatening hypoglycemia. Success in managing these diabetic emergencies depends on rapidity of recognition and institution of direct treatment measures.
 ...
PMID:'Diabetic' emergencies. They happen with or without diabetes. 211 37

Urinary excretion of various renal prostaglandins was measured by radioimmunoassay and gas chromatography-mass spectrometry in children who had different degrees of metabolic control. Excretion in PGE2 in diabetic children was twice control values irrespective of the presence or absence of diabetic ketoacidosis (DKA). The urinary excretion of PGF2 alpha was significantly increased in diabetic children with ketoacidosis, but not when diabetes was well controlled. The excretion of 13, 14 dihydro-15-keto PGE2, the major metabolite of circulating PGE2, was increased in all diabetic children, and was most elevated in ketoacidosis when it averaged 10 times basal excretion. Urinary excretion of PGF2 alpha and of 6-keto-PGF1 alpha, the metabolite of PGI2, was approximately doubled in DKA compared with values from healthy subjects. Excretion of PGE2 was twice control values in children with stable diabetes, whereas the equivalent value for TXB2, the metabolite of the active vasoconstrictor TXA2, was reduced by approximately 50%. We suggest that the increased excretion of prostacyclin metabolite may result from a protective biological action on the kidney opposing other vasoconstrictor hormone activity. PGE2 appears not to be involved in this process. The highly elevated excretion of PGE2 metabolite may represent an activation of systemic PGE metabolism during DKA.
 ...
PMID:Urinary prostaglandins in hyperglycaemic ketoacidosis of type I diabetes mellitus. 211 82

A detailed description of the role to be played by the Nursing personnel before a patient with diabetic ketoacidosis is made. The current treatment of this complication of diabetes mellitus is reported. A detailed description of care and management in each of the treatment stages is made. In addition, the techniques for diagnosis, equipment and different drugs necessary for the current treatment of this complication are described.
 ...
PMID:[Nursing care in diabetic ketoacidosis]. 212 Jul 46

Grave hyperkalemic is a serious metabolic disorder. Its treatment fell into the fields of urgent medicine because of the risk of malignant cardiac arrhythmias that can be fatal for the patient. The article deals with the treatment of a 49-year-old female patient with decompensated liver cirrhosis and diabetes mellitus in whom grave hyperkalemia (9 mmol/1) with typical electrocardiographic changes was provoked by potassium saving diuretics combined with furosemide and the additional potassium substituted drugs, as well as development of diabetic ketoacidosis. Thanks to intensive medicinal treatment and constant follow-up of the patient rapid disappearance of hyperkalemia and ketoacidosis was observed. The success of medicinal therapy can be expected in cases of extreme hyperkalemia and relative hypokaliaemia. Intracellular hyperkaliaemia must be treated, without delay, with dialysis. Potassium saving diuretics and furosemide do not require additional potassium drugs, especially in risk patients in whom hyperkalemia may develop because of other existing diseases.
 ...
PMID:[Treatment of extreme hyperkalemia caused by diabetic ketoacidosis, potassium-sparing diuretics and potassium substitutes]. 212 65

Continuous subcutaneous insulin infusion (CSII) therapy using external infusion pumps provides an alternative to multiple daily injections (MDI) for insulin-dependent diabetics who require intensive insulin therapy. CSII allows for the delivery of regular insulin continuously at preset basal rates and at bolus doses, which can be varied in response to insulin needs of the patient. Intensive insulin therapy by CSII or MDI was administered to diabetics to improve control of their blood glucose levels and to assess its effects on the development of complications such as retinopathy and nephropathy. CSII appeared to be as effective as MDI in attaining near-normoglycemia and improving metabolic control in patients with insulin-dependent diabetes mellitus who required intensive insulin therapy. It was not clear, however, whether the improved control of the blood glucose levels resulted in the prevention or progression of the diabetic complications. The risks of having adverse effects, such as diabetic ketoacidosis or hypoglycemia, were higher with CSII as compared with MDI; both methods having higher risks of these complications in comparison to conventional insulin therapy. CSII may be beneficial for patients requiring intensive insulin therapy who may need greater lifestyle flexibility with regard to meal timing, work, and recreational scheduling.
 ...
PMID:Reassessment of external insulin infusion pumps. 212 78

An annual audit of diabetic ketoacidosis and hyperosmolar non-ketotic state was made in one hospital from 1971 to 1988. There were 846 episodes of ketoacidosis and 126 episodes of hyperosmolar state. A relative fall occurred in the number of episodes of ketoacidosis compared with hyperosmolar state over this time (p less than 0.05), and there was a change of female:male ratio for episodes of ketoacidosis occurring in established diabetes from 2.79 to 1.59 (p less than 0.01). In contrast the female:male ratio remained unchanged (mean 1.16) for episodes of hyperosmolar state and remained less than 1.0 for all episodes of ketoacidosis in previously undiagnosed diabetes mellitus. Among patients who suffered recurrent ketoacidosis there was a reduction in the number of episodes occurring in female patients and an increase in the number of episodes occurring in male patients in each successive 6-year period with consequent change in female:male ratio for this subgroup from 7.33 to 4.75 to 1.12 (p less than 0.001).
 ...
PMID:Changing sex ratio in diabetic ketoacidosis. 214 72

To examine the effect of steroid therapy on insulin antibody titer in insulin-dependent diabetes mellitus, we studied a 58 year-old gentleman with recurrent diabetic ketoacidosis. No any overt precipitating factors could be accounted for, except limited pancreatic beta cell reserve and high titers of anti insulin antibodies. Despite the persistence of high titers of plasma antiinsulin antibodies, the clinical manifestations of diabetic ketoacidosis improved greatly by the administration of steroid. Nevertheless, the patient still showed the great excursion of plasma glucose concentration.
 ...
PMID:Intractable diabetic ketoacidosis due to insulin antibody--response to steroid therapy. 216 54

Herein, epidemiological data on influenza pneumonia and mortality, results of clinical studies, and the outcome of influenza vaccination trials are reviewed. All excess mortality studies that specify for underlying disease list diabetes as one of the major risk factors. During influenza epidemics, death rates among patients with diabetes mellitus may increase by 5-15%. Diabetes mellitus is also mentioned as a risk factor in most clinical studies, making up 3-14% of the patients studied. Even in recent studies, diabetes mellitus is only preceded as a risk factor by cardiovascular disease and chronic pulmonary disorders. To what extent cardiovascular disease and old age contribute to the increased influenza mortality and morbidity in diabetic patients remains unclear. The influence of epidemic influenza on the incidence of diabetic acidosis in combination with an impaired immune response to both Staphylococcus aureus and the influenza virus suggests that diabetes mellitus itself is the main risk factor. It is concluded that all patients with diabetes mellitus should receive annual vaccinations and that, in official recommendations, patients with diabetes mellitus should be mentioned as a separate risk group. Whole-virus vaccines are preferred over subunit vaccines.
Diabetes Care 1990 Aug
PMID:Influenza infection and diabetes mellitus. Case for annual vaccination. 220 23


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>