Severe hypernatremia in soft drink ketoacidosis and hyperglycemic hyperosmolar state at the onset of type 2 diabetes mellitus: a case series of three adolescents
Clinical Pediatric Endocrinology
; 31(2):81-86, 2022.
Article
in English
| EMBASE | ID: covidwho-1883580
ABSTRACT
Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies. Some patients with a hyperglycemic crisis can present with an overlap of DKA and HHS. The coexistence of DKA and HHS is associated with higher mortality than in isolated DKA and HHS. In addition, electrolyte derangements caused by global electrolyte imbalance are associated with potentially life-threatening complications. Here, we describe three cases of mixed DKA and HHS with severe hypernatremia at the onset of type 2 diabetes mellitus. All patients had extreme hyperglycemia and hyperosmolarity with acidosis at the onset of diabetes mellitus. They consumed 2 to 3 L/d of high-carbohydrate drinks prior to admission to relieve thirst. They showed severe hypernatremia with renal impairment. Two patients recovered completely without any complications, while one died. Severe hypernatremia with mixed DKA and HHS is rare. However, it may be associated with excess carbohydrate beverage consumption. Reduced physical activity during the COVID19 pandemic and unhealthy eating behaviors worsened the initial presentation of diabetes mellitus. We highlight the impact of lifestyle factors on mixed DKA and HHS.
albumin; amylase; C peptide; creatine kinase; creatinine; dobutamine; dopamine; epinephrine; hemoglobin A1c; high density lipoprotein; hypertensive agent; insulin; low density lipoprotein; noradrenalin; sodium chloride; triacylglycerol; triacylglycerol lipase; adolescent; article; blood gas analysis; body mass; body weight loss; carbonated beverage; case report; child; clinical article; computer assisted tomography; diabetic ketoacidosis; diet therapy; echocardiography; electrolyte disturbance; fever; fluid therapy; heart arrest; human; hyperglycemia; hypernatremia; hypotension; hypovolemic shock; male; myalgia; nausea; neutral insulin injection; non insulin dependent diabetes mellitus; obesity; polydipsia; polyuria; resuscitation; soft drink ketoacidosis; tachycardia; vomiting; waist circumference
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Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Clinical Pediatric Endocrinology
Year:
2022
Document Type:
Article
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