Acute pancreatitis concomitant with diabetic ketoacidosis: a cohort from South China

Yuan, Shuguang; Liao, Jinli; Cai, Rong; Xiong, Yan; Zhan, Hong; Zheng, Zijian

doi:10.1177/0300060520912128

Cited by 11 publications

(14 citation statements)

References 19 publications

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“…In this single-center retrospective cohort study of 136 T2DM patients with AP, we found that 27 patients (19.9%) fulfilled the diagnostic criteria of DKA, the incidence of DKA in T2DM patients with AP was much higher than that of patients with AP alone, which was about 1.2% to 2.1% according to published literatures. 5,6 Poorly controlled DM is a risk factor for both AP and DKA. However, we still need large population or epidemiologic studies to confirm the high prevalence of DKA in T2DM patients with AP.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Characteristics of Concomitant Diabetic Ketoacidosis in Type 2 Diabetes Patients with Acute Pancreatitis

Fu¹,

Li²,

Cui³

et al. 2022

DMSO

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Objective:The objective of this retrospective study was to evaluate the clinical characteristics of diabetic ketoacidosis (DKA) in type 2 diabetes mellitus (T2DM) patients with acute pancreatitis (AP) in a cohort from China and to identify simple laboratory parameters to discriminate high-risk patients. Methods: Patients diagnosed with AP and T2DM from January 2015 to December 2020 were retrospectively enrolled. They were divided into DKA group and non-DKA group. We calculated etiologies of AP, compared demographic and clinical features, laboratory findings on admission and clinical course. The receiver operating characteristic (ROC) curve was used to explore the ability of clinical parameters to identify high-risk patients. Results: A total of 136 patients were enrolled, of which 19.9% (27 patients) concomitant with DKA. Compared with patients without DKA, patients with DKA were younger and more obese with higher levels of serum triglycerides (TGs), blood glucose and hemoglobin A 1 c (HbA 1C ). There was a significant difference in etiology between the two groups. Compared with the non-DKA group, the DKA group showed higher rate of HTG, lower rates of gallstones and alcohol abuse. And patients in the DKA group were more likely to be admitted to intensive care unit (ICU) and have longer hospital stays. ROC analyses showed that blood glucose concentration at a cutoff value of 21.75 mmol/L resulted in the highest Youden index with sensitivity and specificity at 81.5% and 94.5%, respectively, for identifying concomitant DKA (AUC = 0.949). Conclusion:The prevalence of concomitant DKA in T2DM patients with AP was 19.9%, concomitant DKA patients tend to be younger, more obese and have higher blood glucose and TGs levels on admission. We found that blood glucose >21.75mmol/L could potentially be used as a simple laboratory parameter to identify high-risk patients.

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Section: Discussionmentioning

confidence: 99%

“…3 The association among T2DM, DKA and AP has been discussed in several literatures. [4][5][6] Previous studies demonstrated that T2DM increased the risk of AP by 1.9-2.9 times, [7][8][9] especially in younger patients with poorly controlled DM. AP as a consequence or cause of DKA has been reported previously.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Concomitant Diabetic Ketoacidosis in Type 2 Diabetes Patients with Acute Pancreatitis

Fu¹,

Li²,

Cui³

et al. 2022

DMSO

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“…Diabetes or impaired glucose tolerance are independent risk factors for AP secondary to HTG [22]. Patients with AP have higher risk of comorbid DKA and a history of diabetes, and serum triglyceride levels are significantly higher in these patients [23]. The long-term glyco-and lipotoxicities identified in our patient resulted in DKA, which is known to result from severe, but partially reversible, β-cell dysfunction.…”

Section: Discussionmentioning

confidence: 65%

Domino effect of pituitary growth hormone tumor complicated by diabetic ketoacidosis and pituitary apoplexy: a case report

2021

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Background Patients with growth hormone (GH)-secreting adenoma usually develop glucose intolerance. GH increases metabolic rate and, when secreted aberrantly, may result in metabolic syndrome. Herein, we examine the associations of pituitary tumor-induced secretion of hormone with insulin resistance and metabolic syndrome, and determine the relation of pituitary tumor apoplexy-induced diabetic ketoacidosis (DKA) and acute pancreatitis. Case presentation A 44-year-old male with a history of hypertension presented to the emergency department of our hospital on February 14, 2019 with symptoms of headache, dizziness, and vomiting. Computed tomography of the head revealed pituitary tumor with bleeding. An ultrasound scan of the abdomen revealed fatty liver and acute pancreatitis. Further examination revealed the presence of DKA, hypertriglyceridemia, cortical hypofunction crisis and acute kidney injury. Surgical endoscopic resection of the pituitary tumor resection via the transsphenoidal approach was performed. The patient’s postoperative recovery was remarkable. Conclusions Long-term growth hormone abnormality may trigger insulin resistance, leading to metabolic syndrome and impaired glucose and lipid metabolism. The pituitary adenoma apoplexy may also directly induce DKA, creating a domino effect, which further deteriorate the aberrant metabolism of glucose and lipids.

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“…[ 16 ] However, the treatment of pancreatitis needs to inhibit pancreatic secretion and pancreatic activity and to prevent enterogenous infectious diseases and promote gastrointestinal peristalsis. Yuan et al [ 17 ] and Chen et al [ 18 ] have confirmed that there is a cascade reaction of inflammatory cells in the body of patients with pancreatitis, and it is necessary to give central nervous system analgesia on the basis of a conventional anti-infection treatment to relieve abdominal pain symptoms. Ulinastatin, also known as urinary trypsin inhibitor, is a special glycoprotein hydrolase inhibitor extracted from the fresh urine of healthy adult men.…”

Section: Discussionmentioning

confidence: 99%

The effect of insulin pump combined with ulinastatin on the levels of PCT, TG, PTX-3, and CX3CL1 in patients with diabetic ketoacidosis and pancreatitis

Wei

Yin

et al. 2021

Medicine

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The aim of this research is to observe the effect of insulin pump combined with Ulinastatin on the levels of procalcitonin (PCT), triglycerides (TG), pentraxin-3(PTX-3), and C-X3-C motif chemokine ligand 1 (CX3CL1) in patients with diabetic ketoacidosis and pancreatitis. A total of 72 patients with diabetic ketoacidosis and pancreatitis who were admitted to our hospital from February 2016 to February 2020 were selected as the research subjects. They were divided into study groups (36 cases, given insulin pump combined Ulinastatin treatment) and control group (36 cases, given insulin pump treatment). Statistics of changes in blood amylase (AMS), blood glucose, blood ketones, glycosylated hemoglobin (HbA1c), PCT, TG, PTX-3, and chemokine CX3CL in pancreatic tissue before and after treatment. After treatment, the clinical efficacy of the study group was significantly higher than that of the control group (94.44% vs 75.00%), the difference was significant ( P < .05). After treatment, the clinical symptoms (abdominal distension, abdominal pain, body temperature, blood sugar, HbA1c and blood amylase) in the study group were significantly less time-to-normal than in the control group, and the difference was significant ( P < .05). After treatment, the AMS, blood sugar, HbA1c, and blood ketones of the 2 groups were all lower than before treatment, and the study group's AMS, blood sugar, HbA1c, and blood ketones were all lower In the control group, the difference was significant ( P < .05). After treatment, the 2 groups of PCT, TG, PTX-3, and CX3CL were all lower than before treatment, among which the study group PCT, TG, PTX-3, and CX3CL1 were lower than the control group, the difference was significant ( P < .05). After treatment, the total adverse reaction rate of the 2 groups was not significantly different ( P > .05), but the total adverse reaction rate of the study group was lower than that of the control group. The combination of insulin pump and ulinastatin in the treatment of patients with diabetic ketoacidosis complicated with acute pancreatitis has a effect, which can shorten the recovery time of clinical symptoms, reduce the levels of PCT, TG, PTX-3, and CX3CL1, and has fewer adverse reactions. It is worthy of clinical application.

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Acute pancreatitis concomitant with diabetic ketoacidosis: a cohort from South China

Cited by 11 publications

References 19 publications

Clinical Characteristics of Concomitant Diabetic Ketoacidosis in Type 2 Diabetes Patients with Acute Pancreatitis

Clinical Characteristics of Concomitant Diabetic Ketoacidosis in Type 2 Diabetes Patients with Acute Pancreatitis

Domino effect of pituitary growth hormone tumor complicated by diabetic ketoacidosis and pituitary apoplexy: a case report

The effect of insulin pump combined with ulinastatin on the levels of PCT, TG, PTX-3, and CX3CL1 in patients with diabetic ketoacidosis and pancreatitis

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