Correlation of Clinical and Biochemical Findings with Diabetic Ketoacidosis–Related Cerebral Edema in Children Using Magnetic Resonance Diffusion-Weighted Imaging

Glaser, Nicole; Marcin, James P.; Wootton‐Gorges, Sandra L.; Buonocore, Michael H.; Rewers, Arleta; Strain, John D.; DiCarlo, Joseph; Neely, E. Kirk; Barnes, Patrick D.; Kuppermann, Nathan

doi:10.1016/j.jpeds.2008.04.048

Cited by 90 publications

(119 citation statements)

References 22 publications

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“…DWI is able to effectively provide information on pathological changes in the brain, including information on the diffusion rate of water molecules in tissues, transport of intracellular and extracellular water molecules, and microscopic and geometric structures of tissues, thus it offers an important basis for early diagnosis of diabetic encephalopathy (14). DWI may be used to calculate ADC, a measure of the diffusion capacity of water molecules in tissues, which can assess the degree of microstructural injuries in human tissues.…”

Section: Discussionmentioning

confidence: 99%

Diffusion-weighted imaging of injuries to the visual centers of the brain in patients with type 2 diabetes and retinopathy

Liang

Chen

Xue

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The present study aimed to investigate the ability of diffusion-weighted imaging (DWI) to identify injury to the visual centers of the brain in patients with type 2 diabetes with retinopathy. The study included 84 cases (63 patients with type 2 diabetic retinopathy and 21 healthy individuals) that were assessed using DWI. Diabetic patients were equally divided into three groups: Proliferative diabetic retinopathy (PDR), non-proliferative diabetic retinopathy (NPDR) and diabetic without retinopathy. The results demonstrated that individuals in the PDR group had significantly higher disease duration and glycated hemoglobin levels than the diabetic without retinopathy group (P<0.05). Apparent diffusion coefficient (ADC) values were significantly higher in functional brain areas of the PDR group compared with the NPDR group (P<0.001), whose values were significantly higher compared with the diabetic without retinopathy and control groups (P<0.001). In addition, glycated hemoglobin levels and disease duration were positively correlated with mean ADC values in the same functional areas of the brain. In conclusion, DWI-measured ADC values may be an effective indicator of brain dysfunction in individuals with type 2 diabetic retinopathy. DWI is able to assess brain injury in individuals with early diabetic retinopathy, which may make the diagnostic technique a useful predictor of early ocular disease.

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Section: Discussionmentioning

confidence: 99%

Diffusion-weighted imaging of injuries to the visual centers of the brain in patients with type 2 diabetes and retinopathy

Liang

Chen

Xue

et al. 2017

Experimental and Therapeutic Medicine

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“…Thalamus is a region that may be affected by conditions associated with Type 1 DM including hyperglycaemia and ketoacidosis. 4,29,30 RD is the mean of the diffusivities perpendicular to the vector with the largest eigenvalue and reflects the degree of myelination. 5 Axonal degeneration and demyelination will increase RD.…”

Section: Discussionmentioning

confidence: 99%

Relationships of DTI findings with neurocognitive dysfunction in children with Type 1 diabetes mellitus

Toprak¹,

Yetiş²,

Alkan³

et al. 2016

BJR

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“…However, there is evidence that subclinical cerebral oedema may be present before treatment is started [43]. The exact cause of this phenomenon is unknown; recent studies suggest that cerebral hypoperfusion with subsequent re-perfusion may be the mechanism operating [38,44,45]. …”

Section: Cerebral Oedemamentioning

confidence: 99%

Joint British Diabetes Societies guideline for the management of diabetic ketoacidosis

Savage

Dhatariya²,

Kilvert³

et al. 2011

Diabetic Medicine

291

297

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The Joint British Diabetes Societies guidelines for the management of diabetic ketoacidosis (these do not cover Hyperosmolar Hyperglycaemic Syndrome) are available in full at: This article summarizes the main changes from previous guidelines and discusses the rationale for the new recommendations. The key points are: Monitoring of the response to treatment (i) The method of choice for monitoring the response to treatment is bedside measurement of capillary blood ketones using a ketone meter.(ii) If blood ketone measurement is not available, venous pH and bicarbonate should be used in conjunction with bedside blood glucose monitoring to assess treatment response.(iii) Venous blood should be used rather than arterial (unless respiratory problems dictate otherwise) in blood gas analysers.(iv) Intermittent laboratory confirmation of pH, bicarbonate and electrolytes only.Insulin administration (i) Insulin should be infused intravenously at a weight-based fixed rate until the ketosis has resolved.(ii) When the blood glucose falls below 14 mmol ⁄ l, 10% glucose should be added to allow the fixed-rate insulin to be continued.(iii) If already taking, long-acting insulin analogues such as insulin glargine (Lantus Ò

show abstract

Correlation of Clinical and Biochemical Findings with Diabetic Ketoacidosis–Related Cerebral Edema in Children Using Magnetic Resonance Diffusion-Weighted Imaging

Cited by 90 publications

References 22 publications

Diffusion-weighted imaging of injuries to the visual centers of the brain in patients with type 2 diabetes and retinopathy

Diffusion-weighted imaging of injuries to the visual centers of the brain in patients with type 2 diabetes and retinopathy

Relationships of DTI findings with neurocognitive dysfunction in children with Type 1 diabetes mellitus

Joint British Diabetes Societies guideline for the management of diabetic ketoacidosis

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