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Alghamdi MA, Alzahrani AM, Alshams HA, Al-Saif MH, Moafa AM, Alenzi MM, Seadawi LE, Ali AKA, Al-Hufayyan NS, Mujallid MF. Hyperosmolar hyperglycemic state management in the emergency department. ARCHIVES OF PHARMACY PRACTICE 2021. [DOI: 10.51847/8gxto9c75t] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Lenahan CM, Holloway B. Differentiating Between DKA and HHS. J Emerg Nurs 2015; 41:201-7; quiz 270. [PMID: 25442808 DOI: 10.1016/j.jen.2014.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 07/15/2014] [Accepted: 08/30/2014] [Indexed: 12/14/2022]
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DE HERT MARC, COHEN DAN, BOBES JULIO, CETKOVICH-BAKMAS MARCELO, LEUCHT STEFAN, M. NDETEI DAVID, W. NEWCOMER JOHN, UWAKWE RICHARD, ASAI ITSUO, MÖLLER HANSJURGEN, GAUTAM SHIV, DETRAUX JOHAN, U. CORRELL CHRISTOPH. Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry 2011; 10:138-51. [PMID: 21633691 PMCID: PMC3104888 DOI: 10.1002/j.2051-5545.2011.tb00036.x] [Citation(s) in RCA: 545] [Impact Index Per Article: 41.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Physical disorders are, compared to the general population, more prevalent in people with severe mental illness (SMI). Although this excess morbidity and mortality is largely due to modifiable lifestyle risk factors, the screening and assessment of physical health aspects remains poor, even in developed countries. Moreover, specific patient, provider, treatment and system factors act as barriers to the recognition and to the management of physical diseases in people with SMI. Psychiatrists can play a pivotal role in the improvement of the physical health of these patients by expanding their task from clinical psychiatric care to the monitoring and treatment of crucial physical parameters. At a system level, actions are not easy to realize, especially for developing countries. However, at an individual level, even simple and very basic monitoring and treatment actions, undertaken by the treating clinician, can already improve the problem of suboptimal medical care in this population. Adhering to monitoring and treatment guidelines will result in a substantial enhancement of physical health outcomes. Furthermore, psychiatrists can help educate and motivate people with SMI to address their suboptimal lifestyle, including smoking, unhealthy diet and lack of exercise. The adoption of the recommendations presented in this paper across health care systems throughout the world will contribute to a significant improvement in the medical and related psychiatric health outcomes of patients with SMI.
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Affiliation(s)
- MARC DE HERT
- University Psychiatric Center, Catholic University
Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
| | - DAN COHEN
- Department for Severe Mental Illness, Mental
Health Organization North-Holland North, Heerhugowaard; Department of Epidemiology,
University of Groningen, The Netherlands
| | - JULIO BOBES
- CIBERSAM; Department of Medicine - Psychiatry,
University of Oviedo, Spain
| | - MARCELO CETKOVICH-BAKMAS
- Department of Psychiatry, Institute of Cognitive
Neurology, and Department of Psychiatry, Institute of Neurosciences, Favaloro
University Hospital, Buenos Aires, Argentina
| | - STEFAN LEUCHT
- Department of Psychiatry and Psychotherapy,
Technische Universität München, Munich, Germany
| | - DAVID M. NDETEI
- University of Nairobi and Africa Mental Health
Foundation, Nairobi, Kenya
| | - JOHN W. NEWCOMER
- Department of Psychiatry, Washington University
School of Medicine, St. Louis, MO, USA
| | - RICHARD UWAKWE
- Faculty of Medicine, Nnamdi Azikiwe University,
Nnewi Campus, Nigeria
| | - ITSUO ASAI
- Japanese Society of Transcultural Psychiatry
| | | | - SHIV GAUTAM
- Psychiatric Centre, Medical College, Jaipur,
India
| | - JOHAN DETRAUX
- University Psychiatric Center, Catholic University
Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
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Abstract
Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome are two serious and potentially life-threatening complications of diabetes mellitus. Understanding pathophysiology is crucial to the proper management of veterinary patients with these disorders. This article reviews the biochemical alterations contributing to these conditions, and discusses traditional and controversial management strategies.
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Affiliation(s)
- Mauria A O'Brien
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana-Champaign, 1008 West Hazelwood Drive, Urbana, IL 61802, USA.
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Abstract
Diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar state (HHS) are both diabetic emergencies associated with hyperglycaemia and can be fatal if healthcare professionals fail to recognize and intervene appropriately. While many students and qualified nurses may be able to recall common signs and symptoms related to DKA and HHS - for example polyuria, polydipsia and elevated blood sugars - understanding the physiological mechanisms behind abnormal observations and restoring homeostasis through appropriate management is far more complex. Health educators can play a significant role in contextualizing difficult concepts, such as DKA and HHS, so that these complex conditions can be recognized with greater confidence and competence in clinical practice.
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Affiliation(s)
- Maria Kisiel
- Critical Care, Birmingham City, Univeristy, Birmingham, UK
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Weber C, Kocher S, Neeser K, Joshi SR. Prevention of diabetic ketoacidosis and self-monitoring of ketone bodies: an overview. Curr Med Res Opin 2009; 25:1197-207. [PMID: 19327102 DOI: 10.1185/03007990902863105] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Diabetic ketoacidosis (DKA) is associated with significant morbidity and mortality. Self-monitoring of ketone bodies by diabetes patients can be done using blood or urine. We compared the two self-monitoring methods and summarized recent developments in the epidemiology and management of DKA. METHODS MEDLINE and EMBASE were searched for relevant publications addressing the epidemiology, management and prevention of DKA up to 2009. The current, relevant publications, along with the authors' clinical and professional experience, were used to synthesize this narrative review. FINDINGS Despite considerable advances in diabetes therapy, key epidemiological figures related to DKA remained nearly unchanged during the last decades at a global level. Prevention of DKA - especially in sick day management - relies on intensive self-monitoring of blood glucose and subsequent, appropriate therapy adjustments. Self-monitoring of ketone bodies during hyperglycemia can provide important, complementary information on the metabolic state. Both methods for self-monitoring of ketone bodies at home are clinically reliable and there is no published evidence favoring one method with respect to DKA prevention. CONCLUSIONS DKA is still a severe complication potentially arising during prolonged hyperglycemic episodes with possibly fatal consequences. Education of patients and their social environment to promote frequent testing - especially during sick days - and to lower their glucose levels, as well as to recognize the early symptoms of hyperglycemia and DKA is of paramount importance in preventing the development of severe DKA. Both methods for self-monitoring of ketone bodies are safe and clinically reliable.
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Affiliation(s)
- Christian Weber
- IMIB Institute for Medical Informatics and Biostatistics, Basel, Switzerland
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Hwang HS, Lee NY, Han SB, Kwak GY, Lee SY, Chung SY, Kang JH, Jeong DC. Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study. KOREAN JOURNAL OF PEDIATRICS 2008. [DOI: 10.3345/kjp.2008.51.11.1158] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Hui Seung Hwang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
| | - Na Young Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
| | - Seung Beom Han
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
| | - Ga Young Kwak
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
| | - Soo Young Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
| | - Seung Yun Chung
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
| | - Dae Chul Jeong
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea
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