- Diabetes, Obesity and Metabolism
- Effect of the Concomitant Use of Subcutaneous Basal Insulin and Intravenous Insulin Infusion in the Treatment of Severe Hyperglycemic Patients
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Yejee Lim, Jung Hun Ohn, Joo Jeong, Jiwon Ryu, Sun-wook Kim, Jae Ho Cho, Hee-Sun Park, Hye Won Kim, Jongchan Lee, Eun Sun Kim, Nak-Hyun Kim, You Hwan Jo, Hak Chul Jang
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Endocrinol Metab. 2022;37(3):444-454. Published online June 3, 2022
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DOI: https://doi.org/10.3803/EnM.2021.1341
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- Background
No consensus exists regarding the early use of subcutaneous (SC) basal insulin facilitating the transition from continuous intravenous insulin infusion (CIII) to multiple SC insulin injections in patients with severe hyperglycemia other than diabetic ketoacidosis. This study evaluated the effect of early co-administration of SC basal insulin with CIII on glucose control in patients with severe hyperglycemia.
Methods Patients who received CIII for the management of severe hyperglycemia were divided into two groups: the early basal insulin group (n=86) if they received the first SC basal insulin 0.25 U/kg body weight within 24 hours of CIII initiation and ≥4 hours before discontinuation, and the delayed basal insulin group (n=79) if they were not classified as the early basal insulin group. Rebound hyperglycemia was defined as blood glucose level of >250 mg/dL in 24 hours following CIII discontinuation. Propensity score matching (PSM) methods were additionally employed for adjusting the confounding factors (n=108).
Results The rebound hyperglycemia incidence was significantly lower in the early basal insulin group than in the delayed basal insulin group (54.7% vs. 86.1%), despite using PSM methods (51.9%, 85.2%). The length of hospital stay was shorter in the early basal insulin group than in the delayed basal insulin group (8.5 days vs. 9.6 days, P=0.027). The hypoglycemia incidence did not differ between the groups.
Conclusion Early co-administration of basal insulin with CIII prevents rebound hyperglycemia and shorten hospital stay without increasing the hypoglycemic events in patients with severe hyperglycemia.
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Citations
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- 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2024
Nuha A. ElSayed, Grazia Aleppo, Raveendhara R. Bannuru, Dennis Bruemmer, Billy S. Collins, Laya Ekhlaspour, Rodolfo J. Galindo, Marisa E. Hilliard, Eric L. Johnson, Kamlesh Khunti, Ildiko Lingvay, Glenn Matfin, Rozalina G. McCoy, Mary Lou Perry, Scott J. Diabetes Care.2024; 47(Supplement): S295. CrossRef - 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2023
Nuha A. ElSayed, Grazia Aleppo, Vanita R. Aroda, Raveendhara R. Bannuru, Florence M. Brown, Dennis Bruemmer, Billy S. Collins, Marisa E. Hilliard, Diana Isaacs, Eric L. Johnson, Scott Kahan, Kamlesh Khunti, Jose Leon, Sarah K. Lyons, Mary Lou Perry, Priya Diabetes Care.2023; 46(Supplement): S267. CrossRef - Effectiveness and safety of early insulin glargine administration in combination with continuous intravenous insulin infusion in the management of diabetic ketoacidosis: A randomized controlled trial
Kitti Thammakosol, Chutintorn Sriphrapradang Diabetes, Obesity and Metabolism.2023; 25(3): 815. CrossRef
- A Case of Graves' Disease with Pheochromocytoma.
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Hye Sook Kim, Hyung Joon Joo, Yoon Seok Choi, Eun Sun Kim, Soo Yeon Park, Yun Jeong Lee, Hee Young Kim, Ji A Seo, Sin Gon Kim, Dong Seop Choi
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J Korean Endocr Soc. 2007;22(6):465-469. Published online December 1, 2007
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DOI: https://doi.org/10.3803/jkes.2007.22.6.465
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- Graves' disease is an autoimmune disorder in which thyrotropin-stimulating hormone receptor antibodies stimulate the thyroid gland. Stress hormones such as catecholamine are known to play important roles in the pathogenesis of Graves' disease. Pheochromocytoma with Graves' disease is extremely rare, and no case has been reported within the Republic of Korea. However, according to previous studies conducted abroad, pheochromocytoma influences the pathogenesis of Graves' disease by producing excessive cathecholamine. In the present report, we describe a 65-year-old female patient with paroxysmal hypertension and rapidly progressive body weight loss who was diagnosed as having Graves'disease with pheochromocytoma.
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- Graves' Disease Accompanied by Pheochromocytoma: Report of a Case
Jin-Hwa Kim, Sang-Jun Lee, Ji-Hye Shin, Mi-Ra You, Jae-Sik Jung, Sang-Yong Kim, Hak-Yeon Bae Journal of Korean Endocrine Society.2009; 24(2): 126. CrossRef
- Diabetic Ketoacidosis in a Patient with Long-term Clozapine Therapy.
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Youn Joo Jeon, Seung Hwan Lee, Se Na Jang, Eun Sun Kim, Jeong Yo Min, Ji Hyun Kim, Soon Hwa Hong, Jae Hyoung Cho, Hyuk Sang Kwon, Kun Ho Yoon, Bong Yun Cha, Ho Young Son
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J Korean Endocr Soc. 2007;22(5):376-380. Published online October 1, 2007
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DOI: https://doi.org/10.3803/jkes.2007.22.5.376
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- With the broad use of atypical anti-psychotics, altered glucose metabolism has become an item of concern to clinicians and patients. Among the atypical anti-psychotics, clozapine and olanzapine are associated with a relatively high incidence of diabetic ketoacidosis and newly developed diabetes. We report a case of diabetic ketoacidosis in a patient with long-term clozapine therapy. A 35-year-old male with schizophrenia, treated with clozapine for 9 years was admitted into hospital because of comatous mentality. Although never diagnosed with diabetes before, his clinical features were consistent with diabetic ketoacidosis and shock. The patient's serum amylase and lipase levels were elevated and an abdominal computed tomography showed peripancreatic fat infiltration, suggesting the possibility of acute pancreatitis. The patient's serum glucose levels normalized shortly after clozapine treatment. Moreover, the patient ceased all glucose lowering agents upon hospital discharge, and maintained normal blood glucose levels thereafter. As observed in this case, clinicians should carefully screen and monitor blood glucose levels and other clinical parameters in patients treated with atypical anti-psychotics.
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- Two Cases of Diabetic Ketoacidosis Associated with Paliperidone Treatment in Schizophrenia
Hyun Ho Kim, Hae Kyung Yang, Hyoju Ham, Ho Wook Jeon, Joon Yub Lee, Sea Won Hwang, Bo Hyun Jang, Gi June Min, Jeong Min Lee, Seung-Hwan Lee The Journal of Korean Diabetes.2014; 15(3): 178. CrossRef - Olanzapine-Induced Diabetic Ketoacidosis and Neuroleptic Malignant Syndrome with Rhabdomyolysis: A Case Report
Young Kyoung Sa, Hyeon Yang, Hee Kyoung Jung, Jang Won Son, Seong Su Lee, Seong Rae Kim, Bong Yeon Cha, Ho Young Son, Chi-Un Pae, Soon Jib Yoo Endocrinology and Metabolism.2013; 28(1): 70. CrossRef
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