Hypothermia in Diabetic Ketoacidosis

Jm, Guérin; Meyer, Philippe; Segrestaa, J. M.

doi:10.2337/diacare.10.6.801

Cited by 21 publications

(10 citation statements)

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“…Guerin et al [15] evaluated 140 adults with DKA and concluded that total WBC, blood glucose and bicarbonate had little or no value in predicting infection. Slovis et al [7] attempted to identify adults with occult bacterial infections by examining the records of 169 patients with DKA.…”

Section: Discussionmentioning

confidence: 99%

Serological Prediction of infections in Diabetic Patients with Diabetes Ketoacidosis in Penang, Malaysia

Gillani¹,

Sulaiman²,

Sundram³

et al. 2013

Trop. J. Pharm Res

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Section: Discussionmentioning

confidence: 99%

Serological Prediction of infections in Diabetic Patients with Diabetes Ketoacidosis in Penang, Malaysia

Gillani¹,

Sulaiman²,

Sundram³

et al. 2013

Trop. J. Pharm Res

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“…Campbell et al [21] evaluated 140 adults with DKA and concluded that total WBC, blood glucose and bicarbonate had little or no value I predicting infection. Slovis et al [9] attempted to identify adults with occult bacterial infections by examining the records of 169 patients with DKA.…”

Section: Discussionmentioning

confidence: 99%

Prediction and rate of infections in diabetes mellitus patients with diabetes ketoacidosis in Penang, Malaysia

Gillani¹,

Sulaiman²,

Sundram³

2012

OJEpi

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Study aimed to determine the rate and prediction of infection in diabetes mellitus patients ≥ 18 year, with diabetic ketoacidosis (DKA). Retrospective cohort study design was adopted to achieve the objectives. Universal sampling technique was employed for data collection among Diabetes ketoacidosis patients, over a period of 3 years (Jan 2008-Dec 2010). Statistical package for social sciences used to analyze data. Over a 3-year period, total of 967 admissions were identified. Of it, 112 (11.6%) with no infection, 679 (70.2%) with bacterial infection and 176 (18.2%) with presumed viral infection. The mean WBC for all the patients was 18,177 (±9431). 721 (74.6%) had leukocytosis, as defined by a WBC ≥ 15,000/mm 3 . WBC, differential, leukocytosis, as well as sex, temperature were not significant predictors (p > 0.05) of bacterial infection. There was significant (p < 0.05) difference of age between the 3 groups, age above 57 years have high rate of infection as compared to age below and equal 57 years. The infection rate in elderly patients with DKA was high and majority of them had lack of clinical evidence. Major bacterial infections with potential serious sequel were particularly common (33.3%), among every third patient being presumed to have serious consequences.

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“…Hypothermia may not only be caused by diabetes mellitus due to impaired thermoregulation, reduced endogenous heat production and peripheral vasodilation [9,10], but it may also exacerbate diabetic ketoacidosis. For example, increased steroid and adrenalin secretion, reduced insulin release and diminished insulin activity have all been reported on exposure to low temperatures [11,12]. These factors demonstrate that hypothermia and diabetic ketoacidosis may be quite intimately related and may reinforce the adverse effects of each other.…”

Section: Discussionmentioning

confidence: 98%

Erosive gastritis, Armanni-Ebstein phenomenon and diabetic ketoacidosis

Byard

Zhou

2010

Forensic Sci Med Pathol

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The Armanni-Ebstein phenomenon, which is found in the kidneys in diabetic ketoacidosis, has also been proposed as an independent diagnostic postmortem marker for hypothermia. A case is reported to demonstrate the possibility of a more complex inter-related etiology in certain instances. A 44-year-old man with a past history of hospital admission for hypothermia, alcoholism and insulin dependent diabetes mellitus was found dead at his home address. At autopsy there were prominent superficial erosive gastritis (Wischnewsky spots) in keeping with terminal hypothermia. In addition there was also marked cortical pallor of the kidneys due to subnuclear renal tubular epithelial vacuolization (Armanni-Ebstein phenomenon). Thus there was evidence for both hypothermia and Armanni-Ebstein phenomenon, suggesting a relationship. Subsequent biochemical testing of vitreous humor, however, demonstrated markedly elevated levels of glucose (36.5 mmol/l; N = 3.6-6.0 mmol/l), β-hydroxybutyrate (23.2 mmol/l; N < 0.3 mmol/l), and lactate (29.4 mmol/l; N = 0.2-2.0 mmol/l). Death was, therefore, due to diabetic ketoacidosis complicated by hypothermia. Diabetes mellitus has a known association with both hypothermia and Armanni-Ebstein phenomenon, thus, before renal tubular vacuolization can be taken as a marker of hypothermia in isolation, it is important to consider the possibility that in certain cases underlying diabetic ketoacidosis may be present.

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Hypothermia in Diabetic Ketoacidosis

Cited by 21 publications

References 0 publications

Serological Prediction of infections in Diabetic Patients with Diabetes Ketoacidosis in Penang, Malaysia

Serological Prediction of infections in Diabetic Patients with Diabetes Ketoacidosis in Penang, Malaysia

Prediction and rate of infections in diabetes mellitus patients with diabetes ketoacidosis in Penang, Malaysia

Erosive gastritis, Armanni-Ebstein phenomenon and diabetic ketoacidosis

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