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

Fu, Yan; Li, Xue; Cui, Beichen; Liu, Zhiwei; Zhao, Bin

doi:10.2147/dmso.s336619

Cited by 4 publications

(2 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This result contradicts that of Paragomi et al [11], who used a large international registry, APPRENTICE, that preexisting DM had no significant impact on the need for ICU admission. The results of other relatively recent studies [8,18,19], including one meta-analysis [7], were similar to ours. The higher rate of ICU admission might be explained by the frailty of DM patients, as many of them suffer from systemic impact complications of DM such as nephropathy, neuropathy, macroangiopathy, and vulnerability to infections.…”

Section: Discussionsupporting

confidence: 91%

Acute Pancreatitis and Type 2 Diabetes Mellitus: The Chicken–Egg Paradox—A Seven-Year Experience of a Large Tertiary Center

Pahomeanu,

Ojog,

Nițu

et al. 2024

JCM

View full text Add to dashboard Cite

(1) Background: Preexisting type 2 diabetes mellitus (T2DM) has been shown in some studies as a risk factor and a severity factor for acute pancreatitis (AP). In this study, we aimed to demonstrate the link between T2DM and AP using data from a large retrospective epidemiological registry in a tertiary center. (2) Methods: We conducted a retrospective, large-cohort study of 1855 cases of AP and recurrent AP drawn from the seven-year consecutive hospitalization electronic health records of the largest acute-care tertiary teaching center in Romania. (3) Results: We observed a significant association between T2DM and a more severe course of the disease, and between T2DM and admission to the intensive care unit (ICU) due to AP, in our cohort using a chi-square test. However, we did not see a meaningful difference in comparing LoS-ICU between T2DM-AP and OAP (other known cause of AP). AP patients with T2DM had a greater probability of a severe course of the disease and were more likely to be admitted to the ICU than to the OAP. (4) Conclusions: The association between T2DM and AP remains a topic very representative of the “chicken–egg paradox”. We need further research on DM-related AP and their bidirectional association as our study is limited by its retrospective design.

show abstract

Section: Discussionsupporting

confidence: 91%

Acute Pancreatitis and Type 2 Diabetes Mellitus: The Chicken–Egg Paradox—A Seven-Year Experience of a Large Tertiary Center

Pahomeanu,

Ojog,

Nițu

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…Complications such as AKI, systemic inflammatory response syndrome (sirs), sepsis, and parenteral nutrition were significantly more common in patients with DKA than in those with AP alone. DKA patients required a more extended hospital stay and more life-threatening treatment [ 66 ]. A case presentation by AlHarmi et al [ 67 ] in a 52-year-old woman with morbid obesity and T2D developed AP after COVID-19 treatment.…”

Section: Management Of Covid-19 With Ap and Dkamentioning

confidence: 99%

Risks associated with acute pancreatitis (AP) with diabetic ketoacidosis (DKA) in COVID-19 patients: a literature review

Devi¹,

Pamreddy²,

Narendra³

2023

J Diabetes Metab Disord

View full text Add to dashboard Cite

Background SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) has become a global pandemic, and medical experts are scrambling to understand the wide range of symptoms and consequences of the virus. Although acute pancreatitis (AP) and pancreatic damage have been associated with SARS-CoV-2, the mechanism behind this is still unclear. The current article explores whether COVID-19 is an additional cause of AP and diabetic ketoacidosis (DKA). The article illustrates the conditions associated with AP and DKA among COVID-19 patients and diabetes mellitus (DM). Another critical condition is acute kidney injury (AKI), often associated with DKA. Methods A search strategy for the article was assigned and retrieved from PubMed, Web of Science, and Scopus databases from 2020 to June 2022. The articles which discussed case studies on AP, DKA, and AKI were included in the study. Results The present review of 24 reported case studies represented conditions of AP (12), DKA (5), AP and DKA (5), AP and AKI (1), and DKA and AKI (1) among COVID-19 participants, and showed a potential relationship between the complications. Conclusion Healthcare during the COVID-19 pandemic plays a major role among AP, DKA, and AKI-associated COVID-19 patients. A compilation of case studies suggests effective management of COVID-19 infection-related complications such as AP, DKA, and AKI.

show abstract

A retrospective study on comparison of clinical characteristics and outcomes of diabetic ketoacidosis patients with and without acute pancreatitis

Khan

Ata

Yousaf

et al. 2023

Sci Rep

View full text Add to dashboard Cite

The co-existence of diabetic ketoacidosis (DKA) with acute pancreatitis (AP) is associated with unfavorable clinical outcomes. However, diagnosing AP in DKA patients is challenging and often missed due to overlapping symptoms. The aim of this retrospective observational study was to compare the clinical characteristics and outcomes of patients with concomitant DKA and AP or DKA alone. Data of patients with DKA admitted between January 2015 to August 2021 to four hospitals in Qatar was extracted from the electronic health record (Cerner). American Diabetes Association criteria and Atlanta criteria were used for DKA and AP diagnosis, respectively. Independent T-test or Mann–Whitney U test was used to analyze continuous variables, whereas categorical variables were analyzed via Chi-square or Fischer exact tests as appropriate. Univariate and multivariate logistic regression models were generated to assess the correlations. A p-value of < 0.05 was considered statistically significant. Of 936 patients with DKA, 84 (9.0%) had coexisting AP. AP was most common in the Asian race (66%, p < 0.001). Patients with DKA and AP were older, had higher admission anion-gap, white cell count, hemoglobin (hb), neutrophil/lymphocyte ratio, urea, creatinine, maximum blood glucose during the episode, total cholesterol and triglyceride level (TGL) (p < 0.05). They had a lower admission venous pH and bicarbonate at 6 h. Patients in the DKA with AP group also had a longer length of stay (LOS), DKA duration and a higher rate of ICU admission (p-values ≤ 0.001). In-hospital mortality, 3-month all-cause readmission, 6-month and 12-month DKA recurrence did not differ between the two groups. Univariate logistic regression analysis showed age, Asian ethnicity, male gender, T2D, admission WBC count, hb, urea, creatinine, potassium, venous pH, bicarbonate, anion gap, total cholesterol, TGL and LDL level were significantly associated with the development of DKA with AP (p < 0.05). In multivariate logistic regression analysis, age and total cholesterol level were associated with concomitant DKA and AP (p < 0.05). Patients with concomitant DKA and AP have more severe derangement in markers of DKA severity, inflammation, kidney injury and metabolic profile, along with a longer DKA duration, LOS and requirement for ICU support compared to DKA patients without AP. This highlights the clinical significance of diagnosing the co-existence of DKA with AP, as the combination results in significantly worse clinical outcomes and greater healthcare utilization than in patients with only DKA.

show abstract

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

Cited by 4 publications

References 32 publications

Acute Pancreatitis and Type 2 Diabetes Mellitus: The Chicken–Egg Paradox—A Seven-Year Experience of a Large Tertiary Center

Acute Pancreatitis and Type 2 Diabetes Mellitus: The Chicken–Egg Paradox—A Seven-Year Experience of a Large Tertiary Center

Risks associated with acute pancreatitis (AP) with diabetic ketoacidosis (DKA) in COVID-19 patients: a literature review

A retrospective study on comparison of clinical characteristics and outcomes of diabetic ketoacidosis patients with and without acute pancreatitis

Contact Info

Product

Resources

About