Case Report
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SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors

Year 2022, Volume 6, Issue 4, 519 - 520, 01.04.2022
https://doi.org/10.28982/josam.979687

Abstract

Diabetic patients are at high risk for mortality after contracting several infections. Additionally, diabetes has been mentioned as an independent factor for progression to severe disease in seasonal influenza and in-hospital deaths due to coronavirus 2019 (COVID-19). Diabetic ketoacidosis is a well-known complication of type-1 diabetes and is characterized by hyperglycemia, metabolic acidosis, and high ketone levels. Euglycemic diabetic ketoacidosis (EDK) is a rare variant of diabetic ketoacidosis in which the blood glucose levels remain within normal limits, but ketoacidosis develops. Although EDK has often been associated with the use of sodium–glucose transport-2 (SGLT-2) inhibitors, it can be induced by several factors, including infectious diseases. EDK may present during the course of an infection, and it also can be a manifestation indicating infection. In this report, two cases of EDK due to pneumonia caused by two different pathogens are presented. Moreover, it is important to emphasize that EDK can occur in type-1 diabetic patients who are not using SGLT-2 inhibitors. Additionally, EDK can be a manifestation of infection and a possible marker of progression to severe disease in patients with type 1 diabetes.

References

  • 1. Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis. 2009;9:737–46.
  • 2. Odegaard JI, Chawla A. Connecting type 1 and type 2 diabetes through innate immunity. Cold Spring Harb Perspect Med. 2012;2:a007724.
  • 3. Schoen K, Horvat N, Guerreiro NFC, de Castro I, de Giassi KS. Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity. BMC Infect Dis. 2019;19:964.
  • 4. Song Z, Xu Y, Bao L, Zhang L, Yu P, Qu Y, et al. From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses. 2019;11:59.
  • 5. Hong KW, Cheong HJ, Choi WS, Lee J, Wie SH, Baek JH, et al. Clinical courses and outcomes of hospitalized adult patients with seasonal influenza in Korea, 2011-2012: hospital-based Influenza Morbidity & Mortality (HIMM) surveillance. J Infect Chemother. 2014;20:9–14.
  • 6. Barron E, Bakhai C, Kar P, Weaver A, Bradley D, Ismail H, et al. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020;8:813-22.
  • 7. Schumann C, Faust M. Diabetic ketoacidosis and hyperosmolar hyperglycemic state. Dtsch Med Wochenschr. 2018;143:384-91.
  • 8. Dass B, Beck A, Holmes C, Morton G. Euglycemic DKA (euDKA) as a presentation of COVID-19. Clin Case Rep. 2020;9:395-8.
  • 9. Abu-Abed Abdin A, Hamza M, Khan MS, Ahmed A. Euglycemic diabetic ketoacidosis in a patient with cocaine intoxication. Case Rep Crit Care. 2016;2016:4275651.
  • 10. Prater J, Chaiban JT. Euglycemic diabetic ketoacidosis with acute pancreatitis in a patient not known to have diabetes. AACE Clin Case Rep. 2015;1:88-91.
  • 11. Franke B, Carr D, Hatem MH. A case of euglycaemic diabetic ketoacidosis in pregnancy. Diabet Med. 2001;18:858-9.
  • 12. Baş VN, Uytun S, Torun YA. Diabetic euglycemic ketoacidosis in newly diagnosed type 1 diabetes mellitus during Ramadan fasting. J Pediatr Endocrinol Metab. 2015;28:333-5.
  • 13. Vitale RJ, Valtis YK, McDonnell ME, Palermo NE, Fisher NDL. euglycemic diabetic ketoacidosis with COVID-19 infection in patients with type 2 diabetes taking SGLT2 inhibitors. AACE Clin Case Rep. 2021;7:10-3.
  • 14. Oriot P, Hermans MP. Euglycemic diabetic ketoacidosis in a patient with type 1 diabetes and SARS-CoV-2 pneumonia: case report and review of the literature. Acta Clin Belg. 2022;77:113-7.
  • 15. Tsai PH, Lai WY, Lin YY, Luo YH, Lin YT, Chen HK, et al. Clinical manifestation and disease progression in COVID-19 infection. J Chin Med Assoc. 2021;84:3-8.

Year 2022, Volume 6, Issue 4, 519 - 520, 01.04.2022
https://doi.org/10.28982/josam.979687

Abstract

References

  • 1. Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis. 2009;9:737–46.
  • 2. Odegaard JI, Chawla A. Connecting type 1 and type 2 diabetes through innate immunity. Cold Spring Harb Perspect Med. 2012;2:a007724.
  • 3. Schoen K, Horvat N, Guerreiro NFC, de Castro I, de Giassi KS. Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity. BMC Infect Dis. 2019;19:964.
  • 4. Song Z, Xu Y, Bao L, Zhang L, Yu P, Qu Y, et al. From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses. 2019;11:59.
  • 5. Hong KW, Cheong HJ, Choi WS, Lee J, Wie SH, Baek JH, et al. Clinical courses and outcomes of hospitalized adult patients with seasonal influenza in Korea, 2011-2012: hospital-based Influenza Morbidity & Mortality (HIMM) surveillance. J Infect Chemother. 2014;20:9–14.
  • 6. Barron E, Bakhai C, Kar P, Weaver A, Bradley D, Ismail H, et al. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020;8:813-22.
  • 7. Schumann C, Faust M. Diabetic ketoacidosis and hyperosmolar hyperglycemic state. Dtsch Med Wochenschr. 2018;143:384-91.
  • 8. Dass B, Beck A, Holmes C, Morton G. Euglycemic DKA (euDKA) as a presentation of COVID-19. Clin Case Rep. 2020;9:395-8.
  • 9. Abu-Abed Abdin A, Hamza M, Khan MS, Ahmed A. Euglycemic diabetic ketoacidosis in a patient with cocaine intoxication. Case Rep Crit Care. 2016;2016:4275651.
  • 10. Prater J, Chaiban JT. Euglycemic diabetic ketoacidosis with acute pancreatitis in a patient not known to have diabetes. AACE Clin Case Rep. 2015;1:88-91.
  • 11. Franke B, Carr D, Hatem MH. A case of euglycaemic diabetic ketoacidosis in pregnancy. Diabet Med. 2001;18:858-9.
  • 12. Baş VN, Uytun S, Torun YA. Diabetic euglycemic ketoacidosis in newly diagnosed type 1 diabetes mellitus during Ramadan fasting. J Pediatr Endocrinol Metab. 2015;28:333-5.
  • 13. Vitale RJ, Valtis YK, McDonnell ME, Palermo NE, Fisher NDL. euglycemic diabetic ketoacidosis with COVID-19 infection in patients with type 2 diabetes taking SGLT2 inhibitors. AACE Clin Case Rep. 2021;7:10-3.
  • 14. Oriot P, Hermans MP. Euglycemic diabetic ketoacidosis in a patient with type 1 diabetes and SARS-CoV-2 pneumonia: case report and review of the literature. Acta Clin Belg. 2022;77:113-7.
  • 15. Tsai PH, Lai WY, Lin YY, Luo YH, Lin YT, Chen HK, et al. Clinical manifestation and disease progression in COVID-19 infection. J Chin Med Assoc. 2021;84:3-8.

Details

Primary Language English
Subjects Emergency Medicine, Endocrinology and Metabolism, Critical Care Medicine
Journal Section Case report
Authors

Özge TELCİ ÇAKLILI
Istanbul University School of Medicine, Department of Endocrinology and Metabolic Diseases
0000-0001-7566-5427
Türkiye


Hande GÜRBÜZ (Primary Author)
University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Anesthesiology and Reanimation
0000-0002-3562-9517
Türkiye

Publication Date April 1, 2022
Published in Issue Year 2022, Volume 6, Issue 4

Cite

Bibtex @case report { josam979687, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2022}, volume = {6}, pages = {519 - 520}, doi = {10.28982/josam.979687}, title = {SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors}, key = {cite}, author = {Telci Çaklılı, Özge and Gürbüz, Hande} }
APA Telci Çaklılı, Ö. & Gürbüz, H. (2022). SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors . Journal of Surgery and Medicine , 6 (4) , 519-520 . DOI: 10.28982/josam.979687
MLA Telci Çaklılı, Ö. , Gürbüz, H. "SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors" . Journal of Surgery and Medicine 6 (2022 ): 519-520 <https://jsurgmed.com/en/pub/issue/69115/979687>
Chicago Telci Çaklılı, Ö. , Gürbüz, H. "SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors". Journal of Surgery and Medicine 6 (2022 ): 519-520
RIS TY - JOUR T1 - SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors AU - Özge Telci Çaklılı , Hande Gürbüz Y1 - 2022 PY - 2022 N1 - doi: 10.28982/josam.979687 DO - 10.28982/josam.979687 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 519 EP - 520 VL - 6 IS - 4 SN - -2602-2079 M3 - doi: 10.28982/josam.979687 UR - https://doi.org/10.28982/josam.979687 Y2 - 2022 ER -
EndNote %0 Journal of Surgery and Medicine SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors %A Özge Telci Çaklılı , Hande Gürbüz %T SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors %D 2022 %J Journal of Surgery and Medicine %P -2602-2079 %V 6 %N 4 %R doi: 10.28982/josam.979687 %U 10.28982/josam.979687
ISNAD Telci Çaklılı, Özge , Gürbüz, Hande . "SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors". Journal of Surgery and Medicine 6 / 4 (April 2022): 519-520 . https://doi.org/10.28982/josam.979687
AMA Telci Çaklılı Ö. , Gürbüz H. SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors. J Surg Med. 2022; 6(4): 519-520.
Vancouver Telci Çaklılı Ö. , Gürbüz H. SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors. Journal of Surgery and Medicine. 2022; 6(4): 519-520.
IEEE Ö. Telci Çaklılı and H. Gürbüz , "SARS-CoV-2 and community-acquired pneumonia leading to euglycemic diabetic ketoacidosis in two patients with type-1 diabetes mellitus who were not using SGLT2 inhibitors", Journal of Surgery and Medicine, vol. 6, no. 4, pp. 519-520, Apr. 2022, doi:10.28982/josam.979687

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