Effect Of Diabetic Ketoacidosis Research Articles

Mitochondrial proteins as therapeutic targets in diabetic ketoacidosis: evidence from Mendelian randomization analysis.

Diabetic ketoacidosis (DKA) is a severe and potentially fatal acute complication in diabetic patients, commonly occurring in type 1 diabetes (T1D) but also seen in type 2 diabetes (T2D). The pathogenesis of DKA involves complex physiological processes that are not fully understood, especially the role of mitochondria. Mitochondria, known as the powerhouse of cells, plays a crucial role in oxidative phosphorylation and ATP production, which is vital in various metabolic diseases, including diabetes. However, the exact causal relationship between mitochondrial dysfunction and DKA remains unclear. This study employed Mendelian randomization (MR) analysis and protein-protein interaction (PPI) networks to systematically explore the causal relationships between mitochondrial DNA copy number (mtDNA-CN) and specific mitochondrial proteins with DKA. We used bidirectional MR analysis and genome-wide association study (GWAS) data from openGWAS database to investigate the causal effects of mtDNA-CN and 64 mitochondrial-related proteins on DKA and its subtypes (T1DKA, T2DKA, unspecified-DKA). The study revealed that increased mtDNA-CN significantly reduces the risk of DKA, whereas the effect of DKA on mtDNA-CN was not significant. Mitochondrial-related proteins such as MRPL32, MRPL33, COX5B, DNAJC19, and NDUFB8 showed a negative causal relationship with DKA, indicating their potential protective roles. Conversely, ATP5F1B and COX4I2 have a positive causal relationship with DKA, indicating that excessive ATP production in diabetic patients may be detrimental to health and increase the risk of severe complications such as DKA. The results emphasize the necessity of protecting mitochondrial function in order to reduce the risk of DKA. The study offers novel perspectives on the molecular pathways involved in DKA, emphasizing the critical functions of mt-DNA and distinct proteins. These evidences not only enhance our comprehension of the implications of mitochondrial dysfunction in diabetes-related complications but also identify potential therapeutic targets for individualized treatment approaches, thereby making a substantial contribution to clinical care and public health initiatives.

The effect of diabetic ketoacidosis in childhood on heart rate variability: Prospective study

The effect of diabetic ketoacidosis in childhood on heart rate variability: Prospective study

Diabetic Ketoacidosis Was Associated with High Morbidity and Mortality in Hospitalized Patients with COVID-19 in the NYC Public Health System

Background: COVID-19 has been associated with a higher risk of death in patients with diabetes mellitus (DM). However, there is a dearth of data regarding the effects of diabetic ketoacidosis (DKA) in these patients. We explored the in-hospital outcomes of patients who presented with COVID-19 and DKA. Methods: A propensity score-matched observational retrospective cohort study was conducted in hospitalized patients with COVID-19 in the public healthcare system of New York City from 1 March 2020 to 31 October 2020. Patients were matched, and a subgroup analysis of patients with DKA and COVID-19 and patients without COVID-19 was conducted. Results: 13,333 (16.0%) patients with COVID-19 and 70,005 (84.0%) without COVID-19 were included in the analysis. The in-hospital mortality rate was seven-fold in patients with DKA and COVID-19 compared to patients with COVID-19 and without DKA (80 (36.5%) vs. 11 (5.4%), p < 0.001). Patients with COVID-19 and DKA had a two-fold higher likelihood for in-hospital death (OR: 1.95; 95% CI: 1.41–2.70; p < 0.001) after adjusting for multiple variables. Conclusions: DKA was associated with significantly higher in-hospital mortality in hospitalized patients with COVID-19.

Comparison of the clinical characteristics and outcomes of pediatric patients with and without diabetic ketoacidosis at the time of type 1 diabetes diagnosis.

PurposeWe investigated the possible effects of diabetic ketoacidosis (DKA) at the initial diagnosis of type 1 diabetes mellitus (T1DM) on the clinical outcomes of pediatric patients.Methods Medical records of children and adolescents with newly diagnosed T1DM seen in the Ajou University Hospital from January 2008 to August 2020 were reviewed and analyzed.ResultsAmong 129 diagnosed T1DM patients, 40.3% presented with DKA. Although demographic and basic characteristics did not differ between DKA and non-DKA patients, DKA patients needed a significantly higher insulin dosage than non-DKA patients for 2 years after diagnosis. However, control of glycated hemoglobin was not different between the DKA and non-DKA groups during the observation period. In the biochemical analysis, C-peptide, insulin-like growth factor-1, and insulin-like growth factor binding protein 3, high-density lipoprotein cholesterol, free T4, and T3 values were lower, but thyroid-stimulating hormone, initial serum glucose, uric acid, total cholesterol, triglyceride, and low-density lipoprotein cholesterol values were higher in DKA patients than non-DKA patients at the diagnosis of T1DM; however, these differences were temporarily present and disappeared with insulin treatment. Other clinical outcomes, such as height, thyroid function, and urine microalbumin level, did not vary significantly between the DKA and non-DKA groups during 5 years of follow-up.ConclusionsDKA at initial presentation reflects the severity of disease progression, and the deleterious effects of DKA seem to impact insulin secretion. Although no difference in long-term prognosis was found, early detection of T1DM should help to reduce DKA-related islet damage and the socioeconomic burden of T1DM.

Diabetic ketoacidosis (DKA) induced cerebral edema complicating small chronic subdural hematoma/hygroma/ at Zewuditu memorial hospital: a case report

BackgroundWhile both DKA & CSDH/subdural hygroma/ are known to cause significant morbidity and mortality, there is no a study that shows the role & effect of DKA on CSDH/subdural hygroma/ & vice versa to authors’ best knowledge; hence this work will show how important relation does exist between DKA & CSDH/ hygroma.Case summaryThis study highlights the diagnostic & management challenges seen for a case of a 44 years old female black Ethiopian woman admitted with a diagnosis of newly diagnosed type 1 DM with DKA + small CSDH/subdural hygroma/ after she presented with sever global headache and a 3 month history of lost to her work. She needed burrhole & evacuation for complete clinical improvement besides DKA’s medical treatment.ConclusionDKA induced cerebral edema on the CSDH/subdural hematoma/ can have a role in altering any of the parameters (except the thickness of CSDH) for surgical indication of patients with a diagnosis of both CSDH +DM with DKA. Hence, the treating physicians should be vigilant of different parameters that suggests tight brain &/ cerebral edema (including midline shift, the status of cisterns, fissures & sulci) and should not be deceived of the thickness of the CSDH/subdural hygroma/alone; especially when there is a disproportionately tight brain for the degree of collection. Whether DKA induced cerebral edema causes a subdural hygroma is unknown and needs further study.

The effect of diabetic ketoacidosis (DKA) and its treatment on clot microstructure: Are they thrombogenic?

Diabetic ketoacidosis (DKA) is a medical emergency with a high mortality rate and is associated with severe metabolic acidosis and dehydration. DKA patients have an increased risk of arterial and venous thromboembolism, however little is known about this metabolic derangement in the first 24 hours of admission and to assess its effect on coagulation. We therefore utilised a novel functional marker of clot microstructure (fractal dimension - df) to assess these changes within the first 24 hours. Prospective single centre observational study to demonstrate whether the tendency of blood clot formation differs in DKA patients. 15 DKA patients and 15 healthy matched controls were recruited. Mean df in the healthy control group was 1.74±0.03. An elevated df of 1.78±0.07 was observed in patients with DKA on admission. The mean pH on admission was 7.14±0.13 and the lactate was 3.6±2.0. df changed significantly in response to standard treatment and was significantly reduced to 1.68±0.09 (2-6& h) and to 1.66±0.08 at 24& h (p < 0.01 One-way ANOVA). df also correlated significantly with lactate and pH (Pearson correlation coefficient 0.479 and -0.675 respectively, p < 0.05). DKA patients at presentation have a densely organising less permeable thrombogenic clot microstructure as evidenced by high df. These structural changes are due to a combination of dehydration and a profound metabolic acidosis, which was reversed with treatment. These changes were not mirrored in standard clinical markers of thromboge-nicity.

Effects of Diabetic Ketoacidosis on Executive Function in Children With Type 1 Diabetes: Evidence From Wisconsin Card Sorting Test Performance

Diabetic ketoacidosis (DKA) in patients with type 1 diabetes mellitus (T1DM) is known to affect memory function, but little is known about its impact on executive function. This study aimed to determine whether a history of DKA was associated with changes in executive function in children with T1DM. The sample consisted of 99 patients with T1DM with histories of DKA, 82 patients with T1DM without DKA, and 100 healthy controls aged 7 to 18 years. Neuropsychological function and emotion assessments were performed in all participants. The Wisconsin Card Sorting Test (WCST) was used to assess executive function. Compared with healthy controls, the DKA group (but not the non-DKA group) had a significantly lower mean intelligence quotient (IQ; p = .006, Cohen d = 0.528) and a significantly higher rate of WCST perseverative errors (p = .006, Cohen d = 0.475). In the DKA group, the age at DKA onset was significantly associated with the IQ (p = .001) and the number of completed WCST categories (p = .046). Higher hemoglobin A1c levels were associated significantly with lower IQ (p < .001), increased rate of WCST perseverative errors (p = .015), and completion of fewer WCST categories (p = .027). DKA has implications for executive function in children with T1DM. These findings emphasize the importance of DKA prevention in patients with known T1DM, especially younger children with newly diagnosed T1DM.

Effect of Diabetic Ketoacidosis on Some Biochemical and Immunological Variables

Background: This study included people who suffer from high percentage of diabetic ketoacidosis, where the tests were conducted on three groups of people with diabetes type 1 and patients with diabetes type II and the last group was control. Biochemical and immunological tests were performed and compared to control. Material and methods: Samples were collected from patients who had a high level of diabetic ketoacidosis and were divided into 20 patients with type 1 diabetes, 20 patients with diabetes type 2 and 20 samples that were healthy for control. Biochemical tests included RBS, HBA1c, GOT, GPT, folic acid. Result and discussion: the percentage of RBS and HBA1c in patients suffering from high ketoacidosis, where the highest percentage of RBS and HBA1c in the blood was recorded in patients with diabetes type I, reaching 445 and 11.7, compared to the rates of RBS and HBA1c in patients with diabetes type II, which reached 216, 8, respectively, and compared to control, where the ratios were 83 and 8, respectively. How to Cite this Article Pubmed Style Halim OA, Abdullah QK, jumaa Aw. of Diabetic Ketoacidosis on Some Biochemical and Immunological Variables. SRP. 2020; 11(9): 239-242. doi:10.31838/srp.2020.9.39 Web Style Halim OA, Abdullah QK, jumaa Aw. of Diabetic Ketoacidosis on Some Biochemical and Immunological Variables. http://www.sysrevpharm.org/?mno=6352 [Access: March 29, 2021]. doi:10.31838/srp.2020.9.39 AMA (American Medical Association) Style Halim OA, Abdullah QK, jumaa Aw. of Diabetic Ketoacidosis on Some Biochemical and Immunological Variables. SRP. 2020; 11(9): 239-242. doi:10.31838/srp.2020.9.39 Vancouver/ICMJE Style Halim OA, Abdullah QK, jumaa Aw. of Diabetic Ketoacidosis on Some Biochemical and Immunological Variables. SRP. (2020), [cited March 29, 2021]; 11(9): 239-242. doi:10.31838/srp.2020.9.39 Harvard Style Halim, O. A., Abdullah, . Q. K. & jumaa, . A. w. (2020) of Diabetic Ketoacidosis on Some Biochemical and Immunological Variables. SRP, 11 (9), 239-242. doi:10.31838/srp.2020.9.39 Turabian Style Halim, Oqbah Abdul, Qasim Khlaif Abdullah, and Asmaa wajeh jumaa. 2020. of Diabetic Ketoacidosis on Some Biochemical and Immunological Reviews in Pharmacy, 11 (9), 239-242. doi:10.31838/srp.2020.9.39 Chicago Style Halim, Oqbah Abdul, Qasim Khlaif Abdullah, and Asmaa wajeh jumaa. Effect of Diabetic Ketoacidosis on Some Biochemical and Immunological Variables. Systematic Reviews in Pharmacy 11 (2020), 239-242. doi:10.31838/srp.2020.9.39 MLA (The Modern Language Association) Style Halim, Oqbah Abdul, Qasim Khlaif Abdullah, and Asmaa wajeh jumaa. Effect of Diabetic Ketoacidosis on Some Biochemical and Immunological Variables. Systematic Reviews in Pharmacy 11.9 (2020), 239-242. Print. doi:10.31838/srp.2020.9.39 APA (American Psychological Association) Style Halim, O. A., Abdullah, . Q. K. & jumaa, . A. w. (2020) of Diabetic Ketoacidosis on Some Biochemical and Immunological Reviews in Pharmacy, 11 (9), 239-242. doi:10.31838/srp.2020.9.39

Effects of diabetic ketoacidosis in the respiratory system.

Diabetes affects approximately 30 million persons in the United States. Diabetes ketoacidosis is one of the most serious and acute complications of diabetes. At the time of presentation and during treatment of diabetic ketoacidosis (DKA), several metabolic and electrolyte derangements can ultimately result in respiratory compromise. Most commonly, hypokalemia, hypomagnesemia and hypophosphatemia can eventually lead to respiratory muscles failure. Furthermore, tachypnea, hyperpnea and more severely, Kussmaul breathing pattern can develop. Also, hydrostatic and non-hydrostatic pulmonary edema can occur secondary to volume shifts into the extracellular space and secondary to increased permeability of the pulmonary capillaries. The presence of respiratory failure in patients with DKA is associated with higher morbidity and mortality. Being familiar with the causes of respiratory compromise in DKA, and how to treat them, may represent better outcomes for patients with DKA.

Inhibition of Nox-1 Activity Attenuates Diabetic Ketoacidosis-Induced Blood Brain Barrier Permeability and Edema Formation

Diabetic ketoacidosis (DKA) is a condition characterized by hyperglycemia and high ketone bodies production conducting to acidosis. DKA is highly prevalent in pediatric patients. Approximately 0.5%-1% of these children develop cerebral edema, with a mortality rate of 20-90%. Our research examined the effects of DKA in Blood Brain Barrier (BBB) permeability using Ins2Akita mice as a T1D model. Using magnetic resonance (MR)-based detection of the contrast agent gadolinium diethylenetriaminepenta-acetic acid (Gd-DTPA) we observed BBB permeability and fluid accumulation in the brain, during DKA episodes from day 1 to 5. Our data indicated that increased BBB permeability was present in the thalamus, partial cortex and basal forebrai. Furthermore, the analysis of the morphological and functional changes of BBB under DKA conditions both in vitro and in vivo in vitro showed alterations in TJ proteins, manifested as a slight alteration in ZO-1 and Claudin-5 expression which could represent the ground for BBB leakage. We have further identified that DKA promotes the high production of ROS due to Nox-1 activation, leading to actin reorganization, the subsequent TJ disorganization and increased BBB permeability. The inhibition of Nox-1 activity via Nox-1 inhibitor ML-17 improved the BBB integrity and reduced leakage. Collectively, these studies will provide new information related to novel therapeutic strategies to prevent or reverse vascular hyperpermeability in DKA. Disclosure G. Martinez-Revollar: None.

INCREASED P WAVE DISPERSION IN PATIENTS WITH DIABETIC KETOACIDOSIS

Introduction: Diabetic ketoacidosis (DKA) is the most common hyperglycemic emergency in patients with diabetes mellitus (DM). Further, atrial fibrillation (AF) incidence is higher in diabetic patients. P wave dispersion (PWD) is a non-invasive electrocardiographic parameter and increases in patients with atrial arrhythmias such as AF. The aim of this study was to examine the effect of DKA on PWD. Methods: Fifty-three type 2 DM patients with DKA were included in the study. All patients had sinus rhythm and laboratory parameters such as blood glucose, urinary ketones, electrolytes, urea, creatinine, arterial blood gas were measured. We performed the standard 12-lead electrocardiogram to all patients and PWD was calculated as the difference between the longest and shortest P wave duration (PWD=Pmax-Pmin). Pmax, Pmin and PWD were measured during ketoacidosis and reevaluated at least six hours later from urinary ketone being negative. Results: The majority of the patients were female (F/M: 37/16) and the mean age was 53.1±15.0 years. The mean plasma glucose level was 400.6±119.1 mg/dL. We detected that PWD and Pmax during ketoacidosis was higher than six hours later from urinary ketone being negative [60 (40-100) ms; 40 (20-60) ms, (p<0.001) and 110 (100-140) ms; 80 (80-120) ms, (p<0.001) respectively]. There was no significant relationship between PWD and Pmax with regard to any biochemical and demographic data. Conclusion: The results showed that PWD, which is a predictor factor for atrial artyhythmias, is increased during ketoacidosis and decreased after treatment of ketoacidosis. Therefore, we suggest that these patients should be monitored during ketoacidosis treatment for following up arrhythmias.

Effects of Diabetic Ketoacidosis on Visual and Verbal Neurocognitive Function in Young Patients Presenting with New-Onset Type 1 Diabetes

Effects of Diabetic Ketoacidosis on Visual and Verbal Neurocognitive Function in Young Patients Presenting with New-Onset Type 1 Diabetes

Effects of Diabetic Ketoacidosis on Visual and Verbal Neurocognitive Function in Pediatric Patients Presenting with New Onset Type 1 Diabetes

Effects of Diabetic Ketoacidosis on Visual and Verbal Neurocognitive Function in Pediatric Patients Presenting with New Onset Type 1 Diabetes

Diabetic Ketoacidosis Promotes a Prothrombotic State

Cerebrovascular accidents are one of the life‐threatening complications of diabetic ketoacidosis (DKA) in children and adolescents. Our objective was to evaluate the effect of DKA and its treatment on factors known to affect thrombotic activity (protein C; protein S; von Willebrand factor; fibrinogen; homocysteine; and folate) by comparing seven adolescents with DKA prior to treatment and at 6, 24, and 120 hours after initiation of treatment. We found that protein C activity was significantly decreased by DKA, but normalized slowly following treatment. Free protein S was low throughout the study. Protein C antigen and protein S antigen showed varying degrees of change within the first 24 hours, but remained in the normal range, with the exception of the initial value of protein C antigen, which was elevated. von Willebrand factor (vWF) antigen and vWF activity were both significantly increased prior to treatment, but decreased with treatment. However, vWF activity remained elevated at 120 hours. Fibrinogen concentrations showed no significant changes throughout the study. Homocysteine was significantly decreased prior to treatment and increased with the initiation of treatment. Folate was significantly increased prior to treatment, and decreased to high normal levels. The increased vWF and the decreased levels of protein C activity and of free protein S support the hypothesis that DKA and its treatment results in a prothrombotic state and activation of the vascular endothelium, which, in turn, predispose to cerebrovascular accidents.