• Title/Summary/Keyword: diabetic ketoacidosis

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A Case of Endobronchial Mucormycosis Complicating Lung Abscess Associated with Diabetic Ketoacidosis (당뇨성 케톤산증에서 폐농양이 합병된 기관지모균증 1예)

  • Jeon, Young-Joo;Baek, Hyo-Jong;Lee, Ju-Hyung;Lee, Byung-Ki;Kim, Won-Ho;Lee, Choong-Ki;Sohn, Kyung-Rak;Moon, Sae-Kwang
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.3
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    • pp.317-323
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    • 1991
  • Pulmonary mucormycosis is an uncommon opportunistic fungal infection associated with diabetis mellitus, leukemia, lymphoma & other debilitating diseases. Their clinical presentations depend on the associated underlying disorders. Generally patients with leukemia and lymphoma often have rapidly progressive clinical course, and may cause diffuse parenchymal disease refractory to medical and surgical therapies. However, some diabetics with pulmonary mucormycosis have a striking tendency to develop a localized endobronchial disease in major airway which is amenable to therapy with surgery and Amphotericin B. We have experienced a case of endobronchial mucormycosis complicating lung abscess associated with diabetic ketoacidosis, which was cured without specific antifungal therapy or surgery. A brief review of the literature was given.

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A Survey of Knowledge of Diabetes in Patients with Type 2 Diabetes (제2형 당뇨병 환자의 질병관련 지식)

  • Kim Hee-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.11 no.1
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    • pp.67-73
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    • 2004
  • Purpose: The purpose of this study was to investigate the knowledge of diabetes and insulin use in patients with type 2 diabetes. Method: Participants (139) were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. Knowledge of diabetes knowledge was measured by a brief diabetes knowledge test which had two components: a 14-item general test and a 9-item insulin-use subscale. Result: The average scores for knowledge of diabetes and insulin were 62.4 and 41.8 respectively. Scores were lower for items on the definition of glycosylated hemoglobin, diabetic diet, signs of ketoacidosis, and insulin reaction compared to other items. Knowledge scores were significantly lower for older participants, those who had lower levels of education, those who did not have a spouse, those who did not have a job, those who were not being treated with insulin, and those who tested their blood glucose less than 3 times a day. Conclusion: Definition of glycosylated hemoglobin, diabetic diet, signs of ketoacidosis, and insulin reaction should be included in education for patients with type 2 diabetes. Special education programs should be developed for elderly people, those with low levels of education those without a spouse, or without a job, or who are not being treated with insulin.

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A Case of Pulmonary Mucormycosis Mimicking Bilateral Pulmonary Edema on Chest X-ray (당뇨성 케톤산증에서 폐부종과 유사하게 나타난 폐모균증 (Pulmonary Mucormycosis) 1예)

  • Yu, Seung-Chul;Suhr, Ji-Won;Bae, Hye-Kyung;Lee, Jong-Min;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Seok-Yeong;Lee, Eun-Hee;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.213-221
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    • 1998
  • Pulmonary mucormycosis is an uncommon, but important opportunistic fungal infection associated with diabetes mellitus, leukemia, lymphoma and other immunocompromised states. Mucor species grow best in acidic-high glucose medium. which explaining the particular susceptibility of diabetic patient who are ketoacidic. Early consideration of this diagnosis, along with aggressive diagnostic evaluation, is critical to effective therapy and patient survival. We have experienced a case of pulmonary murcomycosis mimicking bilateral pulmonary edema on chest Xray that associated with diabetic ketoacidosis. A brief review of the literature was given.

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Anti-Diabetic Effect of Cotreatment with Quercetin and Resveratrol in Streptozotocin-Induced Diabetic Rats

  • Yang, Dong Kwon;Kang, Hyung-Sub
    • Biomolecules & Therapeutics
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    • v.26 no.2
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    • pp.130-138
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    • 2018
  • Quercetin and resveratrol are known to have beneficial effects on the diabetes and diabetic complication, however, the effects of combined treatment of these compounds on diabetes are not fully revealed. Therefore, the present study was designed to investigate the combined antidiabetic action of quercetin (QE) and resveratrol (RS) in streptozotocin (STZ)-induced diabetic rats. To test the effects of co-treated with these compounds on diabetes, serum glucose, insulin, lipid profiles, oxidative stress biomarkers, and ions were determined. Additionally, the activities of hepatic glucose metabolic enzymes and histological analyses of pancreatic tissues were evaluated. 50 male Sprague-Dawley rats were divided into five groups; normal control, 50 mg/kg STZ-induced diabetic, and three (30 mg/kg QE, 10 mg/kg RS, and combined) compound-treated diabetic groups. The elevated serum blood glucose levels, insulin levels, and dyslipidemia in diabetic rats were significantly improved by QE, RS, and combined treatments. Oxidative stress and tissue injury biomarkers were dramatically inhibited by these compounds. They also shown to improve the hematological parameters which were shown to the hyperlactatemia and ketoacidosis as main causes of diabetic complications. The compounds treatment maintained the activities of hepatic glucose metabolic enzymes and structure of pancreatic ${\beta}-cells$ from the diabetes, and it is noteworthy that cotreatment with QE and RS showed the most preventive effect on the diabetic rats. Therefore, our study suggests that cotreatment with QE and RS has beneficial effects against diabetes. We further suggest that cotreatment with QE and RS has the potential for use as an alternative therapeutic strategy for diabetes.

The Effectiveness of Blood β-ketone Testing in Patients with Diabetic Ketosis: A Systematic Review & Meta-analysis (당뇨환자에서 자가관리형 베타케톤검사의 유효성: 체계적 문헌 고찰 및 메타분석)

  • Mo, Jin A;Jang, Sunyoung;Bang, Hee Young
    • Korean Journal of Health Education and Promotion
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    • v.31 no.4
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    • pp.1-10
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    • 2014
  • Objectives: The effectiveness of Blood ${\beta}$-ketone testing by using self-monitoring strip on diabetic patients. Methods: Clinical effectiveness of blood ${\beta}$-ketone testing was assessed through correlation with reference test that measured blood ${\beta}$-ketone value through gas chromatography or enzyme method, diagnostic accuracy, time taken for the test and time taken for confirmative diagnosis of diabetic ketosis by selecting literatures on researches that conducted this test on ketosis(suspected) patients or diabetic ketosis(suspected) patients. Each of the stages from literature search to application of selection standards and extraction of data were carried out independently by the Subcommittee along with 2 researchers. Results: 7 reports were selected. ${\beta}$-ketone testing displayed high level of correlation in the range of r=0.92~0.99 with test using enzyme method as the reference standard. Regarding the diagnostic accuracy, sensitivity of 0.82, specificity of 0.74. The time taken for the test was 30seconds for the index test, which is shorter than reference standard test. Conclusion: Blood ${\beta}$-ketone testing was assessed to be a safe and effective test to monitor ketosis and assess the level of risk of ketosis by measuring the blood ${\beta}$-ketone on ketosis patients and diabetic ketosis patients since it has high level of correlation with reference test and short period of testing.

Hepatic glycogenosis in type 1 diabetes mellitus mimicking Mauriac syndrome

  • Jung, In Ah;Cho, Won Kyoung;Jeon, Yeon Jin;Kim, Shin Hee;Cho, Kyoung Soon;Park, So Hyun;Jung, Min Ho;Suh, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.58 no.6
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    • pp.234-237
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    • 2015
  • Hepatic glycogenosis in type 1 diabetes mellitus (DM) can be caused by poor glycemic control due to insulin deficiency, excessive insulin treatment for diabetic ketoacidosis, or excessive glucose administration to control hypoglycemia. Mauriac syndrome, which is characterized by hepatomegaly due to hepatic glycogenosis, growth retardation, delayed puberty, and Cushingoid features, is a rare diabetic complication. We report a case of hepatic glycogenosis mimicking Mauriac syndrome. A 14-year-old girl with poorly controlled type 1 DM was admitted to The Catholic University of Korea, Seoul St. Mary's Hospital for abdominal pain and distension. Physical examination revealed hepatomegaly and a Cushingoid face. The growth rate of the patient had decreased, and she had not yet experienced menarche. Laboratory findings revealed elevated liver enzyme levels. A liver biopsy confirmed hepatic glycogenosis. Continuous glucose monitoring showed hyperglycemia after meals and frequent hypoglycemia before meals. To control hyperglycemia, we increased insulin dosage by using an insulin pump. In addition, we prescribed uncooked cornstarch to prevent hypoglycemia. After strict blood glucose control, the patient's liver functions and size normalized. The patient subsequently underwent menarche. Hepatic glycogenosis is a complication of type 1 DM that is reversible with appropriate glycemic control.

Poly(Dimethylaminoethyl Methacrylate)-Based pH-Responsive Hydrogels Regulate Doxorubicin Release at Acidic Condition

  • Lee, Seung-Hun;You, Jin-Oh
    • Journal of the Korean Applied Science and Technology
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    • v.32 no.2
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    • pp.202-214
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    • 2015
  • Stimuli-responsive biomaterials that alter their function through sensing local molecular cues may enable technological advances in the fields of drug delivery, gene delivery, actuators, biosensors, and tissue engineering. In this research, pH-responsive hydrogel which is comprised of dimethylaminoethyl methacylate (DMAEMA) and 2-hydroxyethyl methacrylate (HEMA) was synthesized for the effective delivery of doxorubicin (Dox) to breast cancer cells. Cancer and tumor tissues show a lower extracellular pH than normal tissues. DMAEMA/HEMA hydrogels showed significant sensitivity by small pH changes and each formulation of hydrogels was examined by scanning electron microscopy, mechanical test, equilibrium mass swelling, controlled Dox release, and cytotoxicity. High swelling ratios and Dox release were obtained at low pH buffer condition, low cross-linker concentration, and high content of DMAEMA. Dox release was accelerated to 67.3% at pH 5.5 for 6-h incubation at $37^{\circ}C$, while it was limited to 13.8% at pH7.4 at the same time and temperature. Cell toxicity results to breast cancer cells indicate that pH-responsive DMAEMA/HEMA hydrogels may be used as an efficient matrix for anti-cancer drug delivery with various transporting manners. Also, pH-responsive DMAEMA/HEMA hydrogels may be useful in therapeutic treatment which is required a triggered release at low pH range such as gene delivery, ischemia, and diabetic ketoacidosis.

A CASE REPORT OF RHINOCEREBRAL MUCORMYCOSIS ASSOCIATED WITH UNCONTROLLED DIABETES MELLITUS (당뇨병과 연관된 비대뇌형 모균증의 증례)

  • Choi, Sung-Weon;Yun, Dong-Hee;Kim, Jung-Su;Kang, Bo-Won;Kim, Sung-Moon;Lim, Jae-Suk;Kwon, Jong-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.152-156
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    • 1994
  • Rhinocerebral mucormycosis is an acute fulminant opportunistic fungal infection in debilitated patients with underlying pathologic conditions, which are diabetic ketoacidosis, immunosuppressed disease. We experienced a case of rhinocerebral mucormycosis. The patient was 41 year-old female, who had diabetes for five years and suffered from left facial swelling and pain, left ophthalmoplegia and facial skin necrosis. Total maxillectomy was done combined with systemic Amphotericin B therapy, Biopsy proved mucormycosis but she expired.

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Neonatal Diabetes Mellitus Due to KCNJ11 (KIR6.2) Mutation Successfully Treated with Sulfonylurea

  • Jang, Sehun;Yang, Misun;Ahn, So Yoon;Sung, Se In;Chang, Yun Sil;Park, Won Soon
    • Neonatal Medicine
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    • v.28 no.2
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    • pp.94-98
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    • 2021
  • Neonatal diabetes mellitus (NDM) is a rare disease that occurs at less than 6 months of age and is presumably caused by a mutation in the gene that affects pancreatic beta-cell function. Approximately 80% of NDM cases reveal a known genetic mutation, and mutations in potassium inwardly rectifying channel subfamily J member 11 (KCNJ11) and ABCC8 affecting the pancreatic beta-cell adenosine triphosphate-sensitive potassium channel may be treated with oral sulfonylurea. Early recognition of mutations in KCNJ11 and ABCC8 is important because early administration of sulfonylurea can not only control blood glucose levels but also improve neurodevelopmental outcomes. In the present study, we report a case of NDM that initially presented as diabetic ketoacidosis at the age of 1 month, accompanied by seizures during hospitalization. After confirmation of the KCNJ11 gene mutation (c.989A>C), we started administering oral sulfonylurea (glimepiride) at the age of 2 months. After gradually increasing the dosage of glimepiride, insulin was discontinued at the age of 3 months. To date, the infant's blood glucose levels have been well controlled without significant hypoglycemic events. No further episodes of seizures have occurred, and his developmental status is favorable.

Tumor Necrosis Factor and Lymphotoxin-α Gene Polymorphism in Korean Children with Type 1 Diabetes (한국 소아 1형 당뇨병에서 종양괴사인자 및 림프독소-α 유전자 다형성)

  • Suh, Jin Soon;Park, So Young;Jung, Min Ho;Suh, Byung Kyu;Kim, Tae Gyu;Lee, Byung Churl
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.871-876
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    • 2005
  • Purpose : Recently, it was reported that tumor necrosis factor(TNF) and $lymphotoxin-{\alpha}$($LT-{\alpha}$) gene regions might be a susceptible loci to type 1 diabetes in Japanese. The purpose of this study was to investigate the association of TNF and $LT-{\alpha}$ gene polymorphisms with disease susceptibility in Korean children with type 1 diabetes. Methods : Forty-nine Korean children with type 1 diabetes(29 girls and 20 boys) and 94 healthy Koreans were investigated in this study. Genotyping for -857T/C polymorphism in the TNF promoter region and $LT-{\alpha}$ gene polymorphism were performed by PCR-RFLP(restriction fragment length polymorphism). TNF promoter -1031C/T polymorphism was detected by allele-specific PCR. Results : The distribution of the -857T/C and -1031C/T genotype in the TNF promoter region was not different between diabetic children and the controls. The frequency of TT genotype in the distribution of TNF -1031C/T polymorphism in diabetic children with diabetic ketoacidosis(DKA) at diagnosis was significantly lower than those without DKA(P<0.05). No significant difference in the distribution of $LT-{\alpha}$ gene polymorphism was observed between diabetic children and the controls. There was no association between clinical characteristics of type 1 diabetes and $LT-{\alpha}$ gene polymorphisms. Conclusion : These results suggest that TNF promoter -857T/C and $LT-{\alpha}$ gene polymorphisms are not associated with susceptibility to type 1 diabetes in Korean children. TNF promoter -1031C/T polymorphism might be related to clinical manifestations(DKA) of type 1 diabetes.