Purpose: Our aim was to observe the transient hyperopia during the intense glucose reduction in patients with newly diagnosed diabetes and severe hyperglycemia. Study Design: Consecutive cases were observed. Results: Totally 4 men and 1 woman with a mean age of 48 years were enrolled. In the 4 patients who received insulin, the hyperopia developed at 4.2 days after the initiation of treatment on average and reached a peak at 11.7 days; they recovered at 64.0 days. The other subject who received oral hypoglycemia agents revealed a peak change at 17 days and recovered at 70 days. A broader hyperopic change of 6.25 dpt was found in the patient with high myopia (–16 dpt). No significant difference was observed in the corneal curvature, axial length, lens thickness or depth of the anterior chamber during the course. The stable value of the accommodation amplitude and lens thickness may indicate that the cause of refraction change was due to the alteration in the reflection index of the lens. Conclusion: Intensive glucose reduction may cause transient hyperopia changes in newly diabetic patients and results in blurred vision.

Cardiopulmonary arrest during and proximate to hemodialysis is rare but highly fatal. Studies have examined peridialytic sudden cardiac event risk factors, but no study has considered associates of cardiopulmonary arrests (fatal and nonfatal events including cardiac and respiratory causes). This study was designed to elucidate patient and procedural factors associated with peridialytic cardiopulmonary arrest. Data for this case-control study were taken from the hemodialysis population at Fresenius Medical Care, North America. 924 in-center cardiopulmonary events (cases) and 75,538 controls were identified. Cases and controls were 1 : 5 matched on age, sex, race, and diabetes. Predictors of cardiopulmonary arrest were considered for logistic model inclusion. Missed treatments due to hospitalization, lower body mass, coronary artery disease, heart failure, lower albumin and hemoglobin, lower dialysate potassium, higher serum calcium, greater erythropoietin stimulating agent dose, and normalized protein catabolic rate (J-shaped) were associated with peridialytic cardiopulmonary arrest. Of these, lower albumin, hemoglobin, and body mass index; higher erythropoietin stimulating agent dose; and greater missed sessions had the strongest associations with outcome. Patient health markers and procedural factors are associated with peridialytic cardiopulmonary arrest. In addition to optimizing nutritional status, it may be prudent to limit exposure to low dialysate potassium (<2 K bath) and to use the lowest effective erythropoietin stimulating agent dose.