Top

Published in:

01-12-2020 | Insulins | Letter to the Editor

Ketoacidosis in type 1 diabetics: we should return to pediatric guidelines

Authors: Sébastien Redant, David De Bels, Jacques Massaut, Jacques Devriendt, Xavier Beretta-Piccoli, Rachid Attou, Patrick M. Honore

Published in: Annals of Intensive Care | Issue 1/2020

Excerpt

We read with interest the study of Balmier et al. about initial management of patients with ketoacidosis (KA) according to diabetes type [1]. Authors report a high rate of hypoglycemia in type 1 diabetics compared to type 2, secondary diabetes and newly diagnosed diabetes. Authors also report a significantly high rate of hypokalemia in newly diagnosed diabetes, as being the witness of a more profound potassium depletion in the context of a prolonged osmotic diuresis and cetonuria. Balmer et al. advocate for dose-adjustment according to diabetes type. We would like to emphasize on returning to pediatric guidelines in type 1 adult diabetics with KA. …

Balmier A, Dib F, Serret-Larmande A, De Montmollin E, Pouyet V, Sztrymf B, Megarbane B, Thiagarajah A, Dreyfuss D, Ricard JD, Roux D. Initial management of diabetic ketoacidosis and prognosis according to diabetes type: a French multicentre observational retrospective study. Ann Intensive Care. 2019;9(1):91. https://doi.org/10.1186/s13613-019-0567-y.CrossRefPubMedPubMedCentral

Arieff AI, Kleeman CR. Studies on mechanisms of cerebral edema in diabetic comas. Effects of hyperglycemia and rapid lowering of plasma glucose in normal rabbits. J Clin Invest. 1973;52(3):571–83. https://doi.org/10.1172/JCI107218.CrossRefPubMedPubMedCentral

Edge JA, Jakes RW, Roy Y, Hawkins M, Winter D, Ford-Adams ME, et al. The UK case–control study of cerebral oedema complicating diabetic ketoacidosis in children. Diabetologia. 2006;49(9):2002–9. https://doi.org/10.1007/s00125-006-0363-8.CrossRefPubMed

Nallasamy K, Jayashree M, Singhi S, Bansal A. Low-dose vs standard-dose insulin in pediatric diabetic ketoacidosis: a randomized clinical trial. JAMA Pediatr. 2014;168(11):999–1005. https://doi.org/10.1001/jamapediatrics.2014.1211.CrossRefPubMed

Rosenbloom AL. The management of diabetic ketoacidosis in children. Diab Ther. 2010;1(2):103–20. https://doi.org/10.1007/s13300-010-0008-2.CrossRef

Goyal N, Miller JB, Sankey SS, Mossallam U. Utility of initial bolus insulin in the treatment of diabetic ketoacidosis. J Emerg Med. 2010;38(4):422–7. https://doi.org/10.1016/j.jemermed.2007.11.033.CrossRefPubMed

Title: Ketoacidosis in type 1 diabetics: we should return to pediatric guidelines
Authors: Sébastien Redant
David De Bels
Jacques Massaut
Jacques Devriendt
Xavier Beretta-Piccoli
Rachid Attou
Patrick M. Honore
Publication date: 01-12-2020
Publisher: Springer International Publishing
Keywords: Insulins
Ketoacidosis
Hypoglycemia
Hypokalemia
Insulins
Cerebral Oedema
Published in: Annals of Intensive Care / Issue 1/2020
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-020-0639-z

ACC 2024 Congress

Springer Medicine

Ketoacidosis in type 1 diabetics: we should return to pediatric guidelines

Excerpt

ACC 2024 Congress

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 1/2020

Electrical impedance tomography: the solution for lung morphology assessment?

Caution about early intubation and mechanical ventilation in COVID-19

Optimal mean airway pressure during high-frequency oscillatory ventilation in an experimental model of acute respiratory distress syndrome: EIT-based method

Respiratory virus-associated infections in HIV-infected adults admitted to the intensive care unit for acute respiratory failure: a 6-year bicenter retrospective study (HIV-VIR study)

Are single-lumen 5Fr and triple-lumen 6Fr PICCs suitable for hemodynamic assessment by trans-pulmonary thermodilution? A pilot study

Correction to: Early sepsis markers in patients admitted to intensive care unit with moderate‑to‑severe diabetic ketoacidosis