Clinical Medicine Insights-Endocrinology and Diabetes最新文献

{"title":"The Relationship Between Low-Grade Inflammation and Common Femoral Artery Intima-Media Thickness in Newly Diagnosed Type 2 Diabetes Mellitus.","authors":"Son Tien Nguyen, Tuan Dinh Le, Hoa Trung Dinh, Lan Ho Thi Nguyen, Giang Thi Nguyen, Trinh Hien Vu, Thong Huy Nguyen, Thuc Luong Cong, Binh Van Nguyen, Toan Duy Nguyen, Huy Quang Nguyen, Ba Van Nguyen, Thuy Dinh Thi Thanh, Hoang Duong Huy","doi":"10.1177/11795514251323837","DOIUrl":"https://doi.org/10.1177/11795514251323837","url":null,"abstract":"<p><strong>Background: </strong>Besides the observed risks in type 2 diabetes mellitus (T2DM), intima-media thickness (IMT) is a surrogate marker for early diagnosing atherosclerosis and assessing the risk of subsequent developing cardiovascular disease. Low-grade inflammation (LGI) plays an important role in the development of intima-media damage of blood vessels in diabetes. Compared with IMT in the carotid artery, thickening IMT in the femoral artery occurs earlier and well reflects atherosclerosis process in diabetes mellitus.</p><p><strong>Objectives: </strong>To investigate the relationship between LGI and common femoral artery IMT in patients with newly diagnosed T2DM.</p><p><strong>Methods: </strong>A descriptive and cross-sectional study on 332 patients with T2DM diagnosed for the first time administered to Vietnam National Hospital of Endocrinology. LGI is defined as patients with high sensitive C-reactive protein (hs-CRP) from 3 to 10 mg/L. hs-CRP-to-albumin ratio (CAR) was used as a marker for LGI. The position for IMT assessment is 2 cm from the bifurcation of the common femoral artery toward the groin following Pignoli's method by B-mode ultrasound.</p><p><strong>Results: </strong>Patients with LGI showed higher IMT than those without LGI (<i>P</i> < .05). In multivariate linear regression, CAR positively correlated with IMT after adjusting with age, waist-to-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and LDL-C, with a standardized beta of 0.296 and <i>P</i> < .001. There were significant differences in CAR among groups stratified by IMT. In the logistic regression model, covariates for gender, BMI, HbA1c, LDL-C, insulin resistance (HOMA-IR), triglyceride, and triglyceride-to-HDL ratio were adjusted. It was determined that the likelihood of an increase in IMT was 3.68 times higher than the baseline (Q1) risk for Q4 and 2.27 times higher for Q2 of CAR. There was a positive correlation between elevated levels of CAR and an increased risk of IMT.</p><p><strong>Conclusion: </strong>In patients with newly diagnosed T2DM, there is a relationship between LGI and common femoral artery IMT. Particularly, IMT positively correlated with CAR.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251323837"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Diabetes Self-Care, Healthy Lifestyle, Social Support, and Demographic Variables on Outcomes HbA1c in Patients With Type 2 Diabetes.","authors":"Wan-Ju Chen, Li-Ying Lin","doi":"10.1177/11795514251331907","DOIUrl":"10.1177/11795514251331907","url":null,"abstract":"<p><strong>Background: </strong>Controlling HbA1c can help reduce the symptoms and complications of diabetes. However, only about 25% of adults with diabetes achieve this diabetes care goal. It can be seen that diabetes requires more research investment and breakthroughs, as well as a more complete discussion of related factors that affect diabetes control, in order to better control the disease. This study explored the effects of diabetes self-care behavior, healthy lifestyle, diabetes symptoms, social support, demographic variables, and physical examination values on HbA1c levels in individuals with type 2 diabetes.</p><p><strong>Methods: </strong>This study used a cross-sectional design and recruited 305 subjects with type 2 diabetes at a medical center. Personal data were collected using a structured questionnaire and same-day outpatient medical records.</p><p><strong>Results: </strong>Multiple linear regression analysis identified significant predictors of HbA1c levels. These include insulin treatment (<i>P</i> < .001), age (<i>P</i> < .001), gender (<i>P</i> < .001), diabetes duration (<i>P</i> = .003), proteinuria (<i>P</i> < .001), diabetes self-care behaviors (<i>P</i> = .021), physical activity (running; <i>P</i> = .018), and spousal involvement in care (<i>P</i> = .031). Female gender, insulin treatment, longer diabetes duration, spousal involvement in care, and the presence of proteinuria were positively associated with higher HbA1c levels. In contrast, higher age, better diabetes self-care behaviors, and regular physical activity (running) were associated with lower HbA1c levels. These findings underscore the importance of considering both demographic factors and lifestyle behaviors in the management of HbA1c levels.</p><p><strong>Conclusions: </strong>For reasons that hinder subjects from controlling HbA1c levels, individual self-management intervention programs should be provided to improve the effectiveness of subjects in controlling HbA1c levels. The care giver should be included in the educational program of diabetes management. Running exercise contributes to the control of HbA1c levels.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251331907"},"PeriodicalIF":2.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and Clinical Characterization of Complex Glycerol Kinase Deficiency in Two Male Siblings: A Case Report.","authors":"Kakha Bregvadze, Nino Kheladze, Nana Nino Tatishvili, Nino Dikhaminjia, Mariam Ghughunishvili, Shorena Tchankvetadze, Tinatin Tkemaladze","doi":"10.1177/11795514251317419","DOIUrl":"10.1177/11795514251317419","url":null,"abstract":"<p><p>Complex glycerol kinase deficiency (CGKD), also known as Xp21 contiguous gene deletion syndrome, is a rare X-linked recessive disorder resulting from partial deletion of the Xp21.3 chromosomal region. CGKD encompasses several loci, including glycerol kinase (<i>GK</i>), Duchenne muscular dystrophy (<i>DMD</i>), X-linked adrenal hypoplasia congenita (<i>NR0B1</i>), and intellectual developmental disorder (<i>IL1RAPL1</i>). We present the cases of two male siblings diagnosed with CGKD. The elder sibling was initially suspected of having congenital adrenal hypoplasia (CAH). Whole exome sequencing (WES) revealed an interstitial deletion of 6.6 Mb on Xp21.3p21.1, encompassing critical genes including <i>GK</i>, <i>DMD</i>, <i>NR0B1</i>, and <i>IL1RAPL1.</i> The younger sibling was diagnosed shortly after birth based on family history, clinical and biochemical findings. The presented report highlights the diagnostic challenges associated with CGKD and the important role of genetic testing in confirming the diagnosis. A multidisciplinary team approach is necessary.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251317419"},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes-Associated Osteoporosis: A Case of Vertebral Compression Fracture in a Middle-Aged Man with Poor Glycemic Control.","authors":"Saleh Shalalfa, Neveen Shalalfa, Mays Najjar, Zeina Sheeb, Ahmad Barakat","doi":"10.1177/11795514251326838","DOIUrl":"10.1177/11795514251326838","url":null,"abstract":"<p><p>Diabetes mellitus is associated with an increased risk of osteoporosis and fractures due to impaired bone metabolism and increased fall risk. This case report highlights a 49-year-old Palestinian man with long-standing poorly controlled type 2 diabetes who presented with progressive back pain following a hypoglycemic syncopal episode. Clinical assessment and imaging, including magnetic resonance imaging (MRI) and Dual-Energy X-ray Absorptiometry (DEXA), confirmed a vertebral compression fracture at D12-L1 and severe osteoporosis. Laboratory investigations ruled out secondary causes of osteoporosis. The patient was treated with zoledronic acid, pain management, and improved glycemic control, leading to symptom relief and better metabolic outcomes after 6 months. This case underscores the importance of early osteoporosis screening in diabetic patients and highlights the need for an integrated approach to managing both diabetes and bone health to prevent fractures in high-risk individuals.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251326838"},"PeriodicalIF":2.7,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile and Management of Patients with Newly Diagnosed Type 2 Diabetes Mellitus in Hospital Setting.","authors":"Diego Muñoz Moreno, Gilberto Pérez López, Luis Antonio Álvarez-Sala Walther, José Antonio Rueda Camino, Javier Martín Vallejo, Olga González Albarrán","doi":"10.1177/11795514251323831","DOIUrl":"10.1177/11795514251323831","url":null,"abstract":"<p><strong>Background: </strong>New-onset type 2 diabetes mellitus (T2DM) is a common clinical scenario in the hospital settings. However, data on the baseline characteristics of these patients at diagnosis in Spain remain limited.</p><p><strong>Objectives: </strong>This study aims to describe the characteristics of 165 patients admitted to a Spanish tertiary hospital with new-onset T2DM. We analysed the use of different treatment regimens at discharge and metabolic control during follow-up.</p><p><strong>Methods: </strong>A retrospective, single-centre cohort study was conducted at General University Gregorio Marañón Hospital, between January 2018 and April 2021.</p><p><strong>Results: </strong>A total of 165 patients participated, with a mean age of 56.4 years, 62.4% of whom were men. Diabetes-related complications were observed in 24.8% of patients at diagnosis. Combined antidiabetic treatment was required in 87% of cases. The mean baseline HbA1c was 10.8%, which decreased by 4.9% after 8 months of follow-up.</p><p><strong>Conclusion: </strong>The clinical heterogeneity and severity of hyperglycaemia in this cohort presented management challenges, in contrast to outpatient settings. Monotherapy was rarely used, with higher adoption of SGLT-2 inhibitors and GLP-1 receptor agonists compared to other studies. Additional research is needed to refine treatment strategies and optimize care for patients with newly diagnosed T2DM.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251323831"},"PeriodicalIF":2.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Ketoacidosis Caused by Acute Pancreatitis Results in Severe Hypertriglyceridemia: A Case Report.","authors":"Amirpasha Mansour, Shima Ghasemzade","doi":"10.1177/11795514251323826","DOIUrl":"10.1177/11795514251323826","url":null,"abstract":"<p><p>Diabetic ketoacidosis (DKA) is an acute complication of diabetes that mainly occurs in type 1 diabetes. However, it can also occur in type 2 diabetes, although less commonly. One of the rare causes of this condition is acute pancreatitis. While hypertriglyceridemia is a known complication of DKA, triglyceride levels higher than 2000 are an unusual finding. We present a case of undiagnosed type 2 diabetes mellitus in a patient who came to the hospital with epigastric pain, nausea, and vomiting. Subsequent blood tests revealed hyperglycemia, ketonuria, metabolic acidosis, and increased levels of amylase and lipase, leading to a simultaneous diagnosis of DKA, acute pancreatitis, and very severe hypertriglyceridemia. In patients experiencing abdominal pain and severe diabetic complications, acute pancreatitis should always be considered as a possible diagnosis, and triglyceride levels should be tested to identify hypertriglyceridemia as a potential cause of pancreatitis or complications of DKA.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251323826"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Term Outcomes After Flexor Tendon Tenotomy of the Diabetic Foot.","authors":"Jonas Askø Andersen, Anne Rasmussen, Marie Frimodt-Møller, Klaus Kirketerp-Møller, Peter Rossing","doi":"10.1177/11795514251314787","DOIUrl":"10.1177/11795514251314787","url":null,"abstract":"<p><strong>Background: </strong>Hammertoes is one if not the most common deformity that afflicts the diabetic foot and leads to increased risk of diabetic foot ulcers. Flexor tendon tenotomy treatment of the diabetic hammertoe has gained increased interest and is now recommended in international guidelines as a treatment of hammertoes to prevent diabetic foot ulcers. There is however no published data on the long term outcomes following tenotomy treatment.</p><p><strong>Introduction: </strong>The objectives of this study was to describe the demographics and long-term outcomes following tenotomy treatment of individuals with diabetes who had flexor tendon tenotomies of hammertoes performed between 2006 and 2009.</p><p><strong>Methods: </strong>This was an observational study of a cohort from a prior study. The study was performed at Steno Diabetes Center Copenhagen between 1st of January 2020 and 31st of June 2020. Participants from the prior study were invited to join the study, consisting of one visit where foot examination was performed by orthopedic surgeon. Information on medical history was obtained from medical records.</p><p><strong>Results: </strong>Of the original 38 operated participants, 21 (55.3%) had died during the follow-up period, one (2.6%) had moved away, and one (2.6%) had incorrect procedure performed originally. At follow-up (mean 149.7 months (±17)), age of the remaining 15 participants (86.7% male) was 66.6 years (±11.4), diabetes duration was 32.2 years (±13.3), all had neuropathy and 14 (93.3%) had palpable foot pulses. The 15 Included participants had 22 toes tenotomized in the original study, of which five toes (22.7%) in four participants (26.7%) had recurrent hammertoe deformities. Of the 15 participants, 14 (93.3%) had incurred at least one ulcer during the observation period, and eight (53.3%) had incurred an amputation.</p><p><strong>Conclusion: </strong>This study reports an undescribed risk of recurrence of deformities after tenotomies and supports that this population is at high risk of new ulcers, amputations, and have a high mortality rate.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251314787"},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Different Metabolic Indicators on Ventricular Repolarization Indices in Obese Children: A Case Control Study.","authors":"Asmaa A El Sehmawy, Rasha Abd El Samad Fawaz, Nadia Ahmed Agiba, Eman Aziz Elsherbiny, Nglaa Fathi Agaba, Doaa Sayed Mohammed, Haidy Mahmoud Nasr, Fatma Elzhraa Ae Diab, Amal M Ahmed, Shorouk Issa Mahfouz, Heba T Okda, Doaa Sadek Ahmed","doi":"10.1177/11795514251316248","DOIUrl":"10.1177/11795514251316248","url":null,"abstract":"<p><strong>Background: </strong>Obesity, insulin resistance, and dyslipidemia may impact ventricular repolarization in children.</p><p><strong>Objectives: </strong>The study aimed to identify the relationship between various metabolic indicators and ventricular repolarization indices among obese children compared to healthy ones.</p><p><strong>Methods: </strong>A case-control study included 90 children, divided into two groups: 45 obese children (cases) and 45 children with normal weight (controls). Electrocardiogram (ECG) readings were analyzed to calculate several parameters, including corrected QT (QTc), QTc dispersion (QTcd), JTc dispersion, and the TpTe interval, using 12-lead surface ECGs. Both groups were also assessed for lipid profiles, fasting plasma glucose (FPG), and serum insulin to calculate the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR).</p><p><strong>Results: </strong>Obese children had significantly higher serum levels of triglycerides, cholesterol, LDL, fasting insulin, and HOMA-IR compared to controls. Also, they significantly had longer mean values of QTcd and JTcd with no significant difference in TpTe interval between both groups. A significant positive correlation was detected between QTc and JTc dispersion and the following variables: waist circumference, body mass index (BMI), blood pressure, fasting insulin, HOMA-IR index, and LDL. Additionally, no significant difference was revealed between obese children with and without metabolic syndrome regarding ventricular repolarization ECG parameters.</p><p><strong>Conclusion: </strong>Greater JTc dispersion (ms) and QTc dispersion (ms) were observed in obese children with a positive correlation to waist circumference, BMI, and insulin resistance.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514251316248"},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between LRP-5 and LRP-6 Gene Mutations and Postmenopausal Type 2 Diabetes and Obesity.","authors":"Jun Li, Ya Li, Yunqiu Lu, Siyuan Li, Yecheng Zhu, Chuanbing Sun, Partab Rai, Xuehai Jia","doi":"10.1177/11795514241307180","DOIUrl":"10.1177/11795514241307180","url":null,"abstract":"<p><strong>Background: </strong>Single nucleotide polymorphisms (SNPs) in the low-density lipoprotein receptor-related protein 5 (LRP5) and the low-density lipoprotein receptor-related protein 5 (LRP6) genes have been implicated in the pathogenesis of type 2 diabetes mellitus (T2DM) and obesity (OB). This study aimed to evaluate the polymorphisms in LRP5 and LRP6 genes in postmenopausal patients with T2DM and OB.</p><p><strong>Methods: </strong>Participants were categorized into the Non-T2DM group (n = 53) and the T2DM group (n = 89) based on glycemic levels. Baseline data and biochemical indices were collected, Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry, and SNPs at the LRP5 and LRP6 loci were assessed by time-of-flight mass spectrometry.</p><p><strong>Results: </strong>1. There was a statistical difference in the distribution of genotypes (CC/CT) at locus rs4988331 (χ2 = 67.940, <i>P</i> = .000) and in the distribution of alleles (C/T) between the T2DM and non-T2DM groups (χ2 = 50.506, <i>P</i> = .000). Additionally, there were significant differences in the allele (G/A) at locus rs11054704, and both allele (G/T) and genotype (GG/GT) distributions at locus rs1181334 between the OB group and the normal weight group (<i>P</i> < .05). 2. OB was identified as a risk factor for T2DM in individuals with the wild-type at locus rs1181334, and the interaction between wild-type and mutant was significant (<i>P</i> < .05). 3. Multifactorial logistic regression analysis revealed that BMD (OR 3.755; 95% CI, 1.215-11.608) and triglyceride-glucose (TyG) index (OR 2.855; 95% CI, 1.361-5.986) were risk factors for T2DM in postmenopausal women, whereas alkaline phosphatase (ALP; OR 0.970; 95% CI, 0.945-0.995) and rs4988331 mutation (OR 0.018; 95% CI, 0.006-0.060) were protective factors.</p><p><strong>Conclusion: </strong>Mutations at the LRP5-rs4988331 locus, as well as the LRP6-rs11054704 and rs1181334 loci, may be associated with the development of T2DM and OB in postmenopausal women.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514241307180"},"PeriodicalIF":2.7,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Ketoacidosis in Pregnancy: A Systematic Review of the Reported Cases.","authors":"Dimitra Stathi, Florence Ning Lee, Mili Dhar, Stergios Bobotis, Elisavet Arsenaki, Taruna Agrawal, Konstantinos Katsikas Triantafyllidis, Konstantinos S Kechagias","doi":"10.1177/11795514241312849","DOIUrl":"10.1177/11795514241312849","url":null,"abstract":"<p><strong>Background: </strong>Diabetic ketoacidosis (DKA) is a rare but serious complication that can develop during pregnancy, with up to 30% of patients presenting with euglycemia, making prompt recognition challenging. It is associated with increased perinatal mortality rates, although the exact risk of maternal mortality remains unclear. The purpose of this systematic review was to examine the available literature and provide an overview of reported cases of DKA during pregnancy.</p><p><strong>Methods: </strong>PubMed, Web of Science and Scopus library databases were screened from inception until January 2024. Included studies provided data on classic or euglycemic DKA during pregnancy. All study designs were considered eligible for inclusion.</p><p><strong>Results: </strong>We identified 66 eligible articles, which included 57 case reports and case series with individual patient data, and 9 studies without individual patient data. The mean age at diagnosis was 28.8 years, and the average gestational age at diagnosis was 29.5 weeks. The majority of women had type 1 diabetes mellitus (T1DM) (45.9%), followed by gestational diabetes (GDM) (40.5%). Most cases were classified as classic DKA (70.3%), with nearly one-third developing euglycemic DKA (29.7%). The most common trigger factors were infections (28%), followed by poor adherence to treatment (13.5%). The most frequent symptoms included nausea (32.4%), vomiting (32.4%), osmotic symptoms (21.6%), and abdominal pain (20.2%). All cases were treated with intravenous insulin and fluids. The vast majority (98.9%) of women eventually fully recovered, with only 1 reported death due to organ failure (1.3%). Intrauterine death or stillbirth occurred in one-third of cases (35.2%), including 1 instance of a twin pregnancy.</p><p><strong>Conclusions: </strong>DKA is a condition that clinicians may encounter during pregnancy. Although rare, increased awareness and early recognition are crucial for optimal management and improved maternal and neonatal outcomes.</p>","PeriodicalId":44715,"journal":{"name":"Clinical Medicine Insights-Endocrinology and Diabetes","volume":"18 ","pages":"11795514241312849"},"PeriodicalIF":2.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}