Diabetic ketoacidosis complicated by the use of ecstasy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Ecstasy (3,4-methylenedioxymethamphetamin), a hallucinogenic amphetamine, is often used by young people, especially at 'raves'. This illicit drug can cause many metabolic changes and its use, when associated with prolonged exercise, may exacerbate ketoacidosis in type 1 diabetic patients.</p> <p>Case presentation</p> <p>This is a case of ketoacidosis complicated by the use of ecstasy in a 19-year-old insulin-dependent diabetic Caucasian woman.</p> <p>Conclusion</p> <p>The use of ecstasy may trigger diabetic ketoacidosis in patients with a preexisting metabolic disorder</p

Association of Adiposity, Cardiorespiratory Fitness and Exercise Practice with the Prevalence of Type 2 Diabetes in Brazilian Elderly Women

Background: Diabetes incidence in people with advanced age is increasing at an alarming rate, and for this reason the screening of high-risk individuals such as elderly women is critically important. Objective: To analyze the association of adiposity, cardiorespiratory fitness and exercise practice with type 2 diabetes (T2D) in elderly Brazilian women. Methods: Participated of this cross sectional study 1,059 elderly women (mean 69.5 yr; SD 6.1), who self-reported family history of cardiovascular disease, smoking status, hypertension, and T2D diagnosed previously by a physician. The following independent variables were assessed: exercise practice, body mass index, waist circumference, and cardiorespiratory fitness. Logistic regression analysis was used to investigate the association between each independent variable with T2D using adjusted-models. Results: T2D prevalence was 16%. General and central adiposity were directly associated with T2D, whereas cardiorespiratory fitness was inversely related with T2D. The joint effect of exercise practice and central adiposity showed that inactive women had higher odds ratio for T2D when compared with active ones, within the same WC group. Inactive women with WC &#8805; 94.0 cm had an odds ratio of 5.8 (95%IC 1.3-25.3). Conclusions: A direct positive association was found between general and central adiposity, as well as an inverse relation between CRF and exercise practice with T2D. Elderly women who practice exercise regularly had lower odds for T2D. Health professionals should encourage individuals of all ages to engage on regular exercise practice, which could reduce body fatness and may be beneficial in reducing the prevalence of T2D in older ages.</p

Recomendaciones para el tratamiento de las pacientes con diabetes pregestacional. Sociedad Argentina de Diabetes - Grupo Latinoamericano de Diabetes y Embarazo

La diabetes mellitus (DM) pregestacional afecta al desarrollo de la gestación y se asocia a complicaciones maternas y fetoneonatales. Si bien hace algunos años la mayoría de las pacientes con diabetes pregestacional (DPG) eran diabéticas tipo 1, la prevalencia de mujeres con diabetes tipo 2 en edad reproductiva ha aumentado, asociada al incremento de obesidad. La paciente con DPG con mal control tiene mayor riesgo de complicaciones desde el inicio y hasta el final del embarazo. El control metabólico adecuado, el correcto estado nutricional y el tratamiento de las complicaciones maternas previenen las complicaciones o reducen su severidad. Por ello es fundamental la programación del embarazo para prevenir el daño en las primeras semanas de gestación. Además, es necesario el riguroso seguimiento clínico durante todo el embarazo. En este contexto, mediante el estudio de evidencias científicas y estudios vinculados, surgen estas recomendaciones para mujeres con diabetes pregestacional.Pregestational DM affects normal gestation and is associated with maternal and fetal-neonatal complications. Although a few years ago most of the patients with pregestational diabetes had type 1 diabetes, the prevalence of type 2 diabetes in women in childbearing age has increased, associated with an increase in obesity. Patients with poorly controlled pregestational diabetes are at higher Pregestational DM affects normal gestation and is associated with maternal and fetal-neonatal complications. Although a few years ago most of the patients with pregestational diabetes had type 1 diabetes, the prevalence of type 2 diabetes in women in childbearing age has increased, associated with an increase in obesity. Patients with poorly controlled pregestational diabetes are at higher risk of complications from the beginning to the end of pregnancy. Adequate metabolic control, proper nutritional status and treatment of maternal complications prevent complications or reduce their severity. For this reason, pregnancy programming is essential to prevent harm from the first weeks of gestation. In addition, rigorous clinical follow-up is required throughout pregnancy. In this context and through the study of scientific evidences and related studies, these recommendations for women with pregestational diabetes emerge.Fil: Rovira, Maria Gabriela. Hospital Británico de Buenos Aires; ArgentinaFil: Jawerbaum, Alicia Sandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; Argentina. Hospital Materno Infantil de San Isidro; ArgentinaFil: Glatstein; Liliana. Universidad Nacional de Córdoba; ArgentinaFil: Sucani, Stella. Universidad Nacional de Córdoba; ArgentinaFil: Bertona, Celina. Hospital Universitario de Mendoza; ArgentinaFil: Argerich, Maria Inés. Hospital Perupato; ArgentinaFil: Gomez Martin, Carolina. Centro Integral de Endocrinologíay Diabetes ; ArgentinaFil: Tedesco, Jorge Fabián. Hospital San Martín; ArgentinaFil: Capobianco, Evangelina Lorena. Universidad de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Rivas, Eugenia. Gobierno de la Ciudad Autonoma de Buenos Aires. Hospital Materno Infantil Ramon Sarda; ArgentinaFil: Rodríguez, María Elena. Hospital Materno Infantil de San Isidro; ArgentinaFil: Basualdo, María Natalia. Gobierno de la Ciudad Autonoma de Buenos Aires. Hospital Materno Infantil Ramon Sarda; Argentina. Universidad de Carabobo.; VenezuelaFil: Alvariñas, Jorge. Hospital Enrique Tornu; ArgentinaFil: Salzberg, Susana. Instituto Centenario; ArgentinaFil: Faingold, María Cristina. Hospital Dr. César Milstein; ArgentinaFil: Gorban de Lapertosa, Silvia Beatriz. Universidad Nacional del Nordeste. Facultad de Medicina; ArgentinaFil: Rivas Blasco, Aleida. Hospital Materno Infantil de San Isidro Carlos Giannantonio; ArgentinaFil: Rodríguez, María Elena. Hospital Materno Infantil de San Isidro Carlos Giannantonio; ArgentinaFil: Mendes, Patricio. Policlinico Neuquén; ArgentinaFil: Marmol, Marta. No especifíca;Fil: Falcon de Legal, Edith. Universidad Nacional de Asunción; ParaguayFil: Ribeiro Gama, Mirnaluci Paulino. Hospital Universitario Evangélico de Curitiba; BrasilFil: Barbero, Roxana. Centro Integral de Medicina, Endocrinología y Diabetes; BrasilFil: Barragán, Derek. Hospital San Gabriel; Bolivi