Examining the "Killer K" of Diabetic Ketoacidosis at a Tertiary Care Hospital: An Exploratory Study.

Abstract:

OBJECTIVES:Hypokalemia, a frequently cited complication of diabetic ketoacidosis (DKA) treatment, can have critical implications, including arrhythmias and death. We assessed the prevalence of hypokalemia and its associated factors in patients with DKA at our tertiary-care centre and identified opportunities to improve care. METHODS:We conducted a retrospective chart review to establish the prevalence of hypokalemia in patients diagnosed with DKA between July 2012 and July 2013. A focused root-cause analysis was subsequently performed to identify Canadian Diabetes Association DKA clinical practice guideline deviations and preventable errors that resulted in significant hypokalemia (K<3.3 mmol/L) during the first 48 hours of management. Clinical and management details were reviewed to determine the type, preventability and root cause(s) of each error. RESULTS:We identified 40 cases of DKA during the study period. The overall prevalence of hypokalemia during DKA treatment was 38% (15/40), with 25% in type 1 and 56% in type 2 diabetes. Males were more likely to experience hypokalemia (87%), and 47% of hypokalemic incidents occurred in the first presentation of diabetes. All 10 cases of significant hypokalemia were reviewed. We identified 23 errors in 6 (60%) cases, of which 87% were deemed to be preventable. The most common errors were noncessation of insulin infusion during hypokalemia (60%), inadequate potassium supplementation (50%) and infrequent biochemical monitoring (50%). CONCLUSIONS:Hypokalemia occurs frequently during acute DKA management and is often preventable. Our findings suggest that interventions targeted at enhancing awareness of guidelines may reduce hypokalemia rates.

journal_name

Can J Diabetes

authors

Wong B,Cheng A,Yu C,Goguen J

doi

10.1016/j.jcjd.2015.10.002

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

204-9

issue

3

eissn

1499-2671

issn

2352-3840

pii

S1499-2671(15)00764-9

journal_volume

40

pub_type

杂志文章
  • WITHDRAWN: Glucagon-like Peptide-1 Receptor Agonists: A Class Update for Treating Type 2 Diabetes.

    abstract::The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.jcjd.2017.02.003. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-busines...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2017.02.003

    authors: Lovshin JA

    更新日期:2017-04-05 00:00:00

  • Inadequate sleep as a contributor to obesity and type 2 diabetes.

    abstract::Epidemiological studies suggest that adults and children who are habitual short sleepers tend to have a higher body mass index, fat percentage and abdominal circumference when compared to average-duration sleepers. Reduced or disturbed sleep is also associated with certain predictors of type 2 diabetes, such as glucos...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,评审

    doi:10.1016/j.jcjd.2013.02.060

    authors: McNeil J,Doucet É,Chaput JP

    更新日期:2013-04-01 00:00:00

  • Developing and Implementing a Food Insecurity Screening Initiative for Adult Patients Living With Type 2 Diabetes.

    abstract:OBJECTIVES:Routine food insecurity screening is recommended in diabetes care to inform more tailored interventions that better support diabetes self-management among food-insecure patients. This pilot study explored the acceptability and feasibility of a food insecurity screening initiative within a diabetes care setti...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2017.06.004

    authors: Thomas B,Fitzpatrick S,Sidani S,Gucciardi E

    更新日期:2018-06-01 00:00:00

  • Perceived Barriers to and Facilitators of Patient-to-Provider E-Mail in the Management of Diabetes Care.

    abstract:OBJECTIVES:1) to describe current utilization of e-mail in the clinical care of patients with diabetes; and 2) to identify barriers to and facilitators of the adoption of e-mail in diabetes care. METHODS:Participants included diabetes care providers, including 9 physicians and 7 allied health professionals (AHPs). Par...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2015.07.001

    authors: Popeski N,McKeen C,Khokhar B,Edwards A,Ghali WA,Sargious P,White D,Hebert M,Rabi DM

    更新日期:2015-12-01 00:00:00

  • Diabetes and related metabolic conditions in an aboriginal cree community of quebec, Canada.

    abstract:OBJECTIVE:We evaluated the prevalence of type 2 diabetes, obesity and metabolic syndrome according to International Diabetes Federation criteria in the First Nations Cree community of Mistissini, Quebec. METHODS:A cross-sectional study of 172 adults was performed as part of a broader regional environmental study. RES...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/S1499-2671(09)33006-3

    authors: Chateau-Degat ML,Pereg D,Egeland GM,Nieboer E,Bonnier-Viger Y,Laouan-Sidi EA,Dannenbaum D,Dewailly E

    更新日期:2009-01-01 00:00:00

  • Adolescents, parents and physicians: a comparison of perspectives on type 1 diabetes self-care.

    abstract:OBJECTIVE:No research to date has compared the beliefs of adolescents, parents and physicians with respect to type 1 diabetes mellitus self-care perceptions and barriers. This study examined how adolescents with type 1 diabetes, their parents and physicians perceive 4 key diabetes self-care behaviours (testing blood gl...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2013.02.057

    authors: Palladino DK,Helgeson VS

    更新日期:2013-06-01 00:00:00

  • Meaning of Health: The Perspectives of Aboriginal Adults and Youth in a Northern Manitoba First Nations Community.

    abstract:OBJECTIVE:To explore perspectives on the meaning of health to Aboriginal adults and youth living in a northern Manitoba First Nations community. METHODS:Six focus groups with 29 youth and individual interviews with 10 adults were audio-recorded, transcribed verbatim and thematically analyzed. RESULTS:Adults and older...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/S1499-2671(08)22008-3

    authors: Isaak CA,Marchessault G

    更新日期:2008-01-01 00:00:00

  • Efficacy and Cardiovascular Safety of Linagliptin as an Add-On to Insulin in Type 2 Diabetes: A Pooled Comprehensive Post Hoc Analysis.

    abstract:OBJECTIVE:With the expanding armamentarium of noninsulin therapies for type 2 diabetes mellitus, the use of insulin with various oral agents is becoming more common. In this study, we assessed the efficacy and cardiovascular (CV) safety of the dipeptidyl peptidase-4 inhibitor linagliptin as add-on to insulin in patient...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.jcjd.2015.06.010

    authors: Zinman B,Ahrén B,Neubacher D,Patel S,Woerle HJ,Johansen OE

    更新日期:2016-02-01 00:00:00

  • Insulin infusion therapy in critically ill patients.

    abstract::While dysglycemia (hyperglycemia, hypoglycemia and glucose variability) is clearly associated with increased mortality in critically ill patients, target range of blood glucose control remains controversial. Standardized insulin infusion protocols constitute the basis of treatment of these patients. The choice of prot...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,评审

    doi:10.1016/j.jcjd.2014.01.016

    authors: Boutin JM,Gauthier L

    更新日期:2014-04-01 00:00:00

  • Trends in Blood Glucose Test Strip Utilization: A Population-Wide Analysis in Saskatchewan, Canada.

    abstract:OBJECTIVES:To describe trends in blood glucose test strip (TS) utilization and cost in Saskatchewan. METHODS:A retrospective analysis of TS use between January 1, 1996, and December 31, 2013, was conducted using population-based health administrative databases in Saskatchewan. The prescription drug database was used t...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2017.01.004

    authors: Kosar L,Alsabbagh W,Lu X,Lix LM,Shevchuk Y,Teare GF,Champagne A,Blackburn DF

    更新日期:2018-02-01 00:00:00

  • Diet, inflammation and prediabetes-impact of quality of diet.

    abstract::Low grade inflammation has been linked to risk of type 2 diabetes and atherosclerotic vascular diseases. Obesity and, in particular, abdominal obesity increase the risk of diabetes and atherosclerotic vascular diseases. One of the mechanisms could be low grade inflammation and vascular endothelial dysfunction. Permane...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,评审

    doi:10.1016/j.jcjd.2013.07.029

    authors: Uusitupa M,Schwab U

    更新日期:2013-10-01 00:00:00

  • Alberta Healthy Living Program--a model for successful integration of chronic disease management services.

    abstract::The most common presentation of chronic disease is multimorbidity. Disease management strategies are similar across most chronic diseases. Given the prevalence of multimorbidity and the commonality in approaches, fragmented single disease management must be replaced with integrated care of the whole person. The Albert...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2013.04.001

    authors: Morrin L,Britten J,Davachi S,Knight H

    更新日期:2013-08-01 00:00:00

  • The Role of the Kidney and SGLT2 Inhibitors in Type 2 Diabetes.

    abstract::Effective glycemic control reduces the risk for diabetes-related complications. However, the majority of patients with type 2 diabetes still do not achieve glycemic targets. Beyond metformin therapy, current practice guidelines for the management of type 2 diabetes recommend individualized treatment based on patient a...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,评审

    doi:10.1016/j.jcjd.2015.09.001

    authors: Katz PM,Leiter LA

    更新日期:2015-12-01 00:00:00

  • Short-Term Dietary Oatmeal Interventions in Adults With Type 2 Diabetes: A Forgotten Tool.

    abstract::Dietary modifications play a central role in the treatment of diabetes. Educating and empowering individuals to make better dietary choices is a challenging task. In this context, 1 potential dietetic approach to achieve better glycemic control in type 2 diabetes is often overlooked: the use of short-term dietary oatm...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2019.08.020

    authors: Storz MA,Iraci F

    更新日期:2020-06-01 00:00:00

  • Associations Between Depressive Symptoms and Indices of Obesity in Adults With Prediabetes and Normal Blood Glucose Levels: Results From the Emotional Health and Wellbeing Study.

    abstract:OBJECTIVES:This study describes associations between depressive symptoms and indices of obesity in a community sample of adults with prediabetes. The strengths of these associations were compared to those observed in individuals with normal blood glucose levels. METHODS:Cross-sectional data came from the baseline asse...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2018.05.005

    authors: Burns RJ,Deschênes SS,Schmitz N

    更新日期:2018-12-01 00:00:00

  • Screening for Atherosclerotic Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus: Controversies and Guidelines.

    abstract::If a disease state is highly prevalent and its consequences are severe, it may be appropriate to seek methods to identify it early to forestall its development and complications. Diabetes mellitus is a proven risk factor for the development of atherosclerosis, although its face and outcome are changing, as shown in co...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,评审

    doi:10.1016/j.jcjd.2019.08.009

    authors: Raggi P

    更新日期:2020-02-01 00:00:00

  • Comorbidity Burden and Health Services Use in Community-Living Older Adults with Diabetes Mellitus: A Retrospective Cohort Study.

    abstract:OBJECTIVES:Diabetes frequently coexists with other conditions, resulting in poorer diabetes self-management and quality of life, higher risk for diabetes-related complications and higher health service use compared to those with diabetes only. Few Canadian studies have undertaken a comprehensive, population-level analy...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2015.09.002

    authors: Gruneir A,Markle-Reid M,Fisher K,Reimer H,Ma X,Ploeg J

    更新日期:2016-02-01 00:00:00

  • Basal Glucose on Tolerance Test During Pregnancy Predicts Impaired Fasting Glucose and Type 2 Diabetes Within 2 Months After Gestational Diabetes.

    abstract:OBJECTIVES:Postpartum mothers with gestational diabetes may remain with either type 2 diabetes mellitus, impaired glucose tolerance or impaired fasting glucose. Our aim in this study was to identify maternal variables that could predict 1 or more of these conditions. METHODS:In 193 singleton pregnancies with gestation...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2020.06.008

    authors: Olmos P,Borzone G,Poblete A

    更新日期:2020-06-17 00:00:00

  • Effects of Changing the Amount and Source of Dietary Carbohydrates on Symptoms and Dietary Satisfaction Over a 1-Year Period in Subjects with Type 2 Diabetes: Canadian Trial of Carbohydrates in Diabetes (CCD).

    abstract:OBJECTIVES:To determine the long-term effects of changing the amount or source of dietary carbohydrate on quality of life (QOL), symptoms and dietary satisfaction in people with type 2 diabetes. METHODS:Subjects with diabetes treated by diet alone (n=162) were randomly assigned to high-carbohydrate/high-glycemic-index...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.jcjd.2016.08.223

    authors: Wolever TM,Chiasson JL,Josse RG,Leiter LA,Maheux P,Rabasa-Lhoret R,Rodger NW,Ryan EA

    更新日期:2017-04-01 00:00:00

  • Antibody-Mediated Insulin Resistance: When Insulin and Insulin Receptor Act as Autoantigens in Humans.

    abstract::We report the case of a patient with diabetes presenting a severe insulin-resistance syndrome due to the production of insulin autoantibodies by a lymphocytic lymphoma. We describe the various mechanisms leading to the production of insulin autoantibodies and insulin receptor autoantibodies and review the therapeutic ...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2016.02.007

    authors: Liminet C,Vouillarmet J,Chikh K,Disse E

    更新日期:2016-10-01 00:00:00

  • Understanding the Experiences of East African Immigrant Women With Gestational Diabetes Mellitus.

    abstract:OBJECTIVES:East African (EA) women are a subpopulation who are at very high risk for gestational diabetes (GDM) and poor obstetric outcomes, but little is known about the care experiences of this understudied group. The objective of this study was to document the impact of a diagnosis of GDM and the perceptions of diab...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2018.01.013

    authors: Siad FM,Fang XY,Santana MJ,Butalia S,Hebert MA,Rabi DM

    更新日期:2018-12-01 00:00:00

  • Association between Physical Activity and Health-Related Quality of Life in Adults with Type 2 Diabetes.

    abstract:OBJECTIVES:To examine the association between meeting physical-activity recommendations and health-related quality of life (HRQL) in adults with type 2 diabetes. METHODS:Data from the Alberta's Caring for Diabetes cohort were used. Self-report questionnaires were mailed to patients with type 2 diabetes who were living...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2016.07.004

    authors: Thiel DM,Al Sayah F,Vallance JK,Johnson ST,Johnson JA

    更新日期:2017-02-01 00:00:00

  • Perinatal Outcomes Among Different Asian Groups With Gestational Diabetes Mellitus in Ontario: A Cohort Study.

    abstract:OBJECTIVE:The aim of this study was to determine whether perinatal outcomes differ between Caucasian and Asian subgroups of women with gestational diabetes mellitus (GDM) through use of standard vs ethnicity-specific birthweight curves. METHODS:This retrospective cohort study included 537 women with GDM, within the et...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2019.06.006

    authors: Kwong W,Ray JG,Wu W,Feig DS,Lowe J,Lipscombe LL

    更新日期:2019-12-01 00:00:00

  • The Short Version of the Activities-Specific Balance Confidence Scale for Older Adults with Diabetes-Convergent, Discriminant and Concurrent Validity: A Pilot Study.

    abstract:OBJECTIVES:The short version of the Activities-Specific Balance Confidence Scale (ABC-6) is advantageous in busy clinical or research settings because it can be administered in less time than the original 16-item Activities-Specific Balance Confidence Scale (ABC-16). This pilot study examined the convergent, discrimina...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2016.10.007

    authors: Hewston P,Deshpande N

    更新日期:2017-06-01 00:00:00

  • Modulatory effects of diosgenin on attenuating the key enzymes activities of carbohydrate metabolism and glycogen content in streptozotocin-induced diabetic rats.

    abstract:OBJECTIVE:Fenugreek and its active compound diosgenin are ancient herbal medicines recommended by the World Health Organization. In this study, the effect of diosgenin on changes in carbohydrate metabolic enzymes and glycogen content in muscle and kidneys of streptozotocin-induced diabetes rats were evaluated. METHODS...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2014.02.004

    authors: Saravanan G,Ponmurugan P,Deepa MA,Senthilkumar B

    更新日期:2014-12-01 00:00:00

  • Classification of Support Needs for Elderly Outpatients with Diabetes Who Live Alone.

    abstract:OBJECTIVES:To investigate the support needs of elderly patients with diabetes and to classify elderly patients with diabetes living alone on the basis of support needs. METHODS:Support needs were derived from a literature review of relevant journals and interviews of outpatients as well as expert nurses in the field o...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jcjd.2015.09.005

    authors: Miyawaki Y,Shimizu Y,Seto N

    更新日期:2016-02-01 00:00:00

  • WITHDRAWN: Performance of Community Blood Glucose Meters in Calgary, Alberta: An Analysis of Quality Assurance Data.

    abstract:OBJECTIVE:The self-monitoring of blood glucose plays a critical role in management of diabetes mellitus. Although laboratory comparisons of glucose meter accuracy are often acceptable, clinical comparisons show frequent inaccuracies. In this paper, we evaluate the accuracy of self-monitoring blood glucose meters using ...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,撤回出版物

    doi:10.1016/j.jcjd.2016.04.004

    authors: Naugler C,Zhang Z,Redman L

    更新日期:2016-05-01 00:00:00

  • Use patterns of antidiabetic regimens by patients with type 2 diabetes.

    abstract:OBJECTIVE:To describe the use patterns of metformin-based antidiabetic regimens in patients with type 2 diabetes and to identify predictors of initiating metformin monotherapy. METHODS:By using administrative databases from Alberta, Canada, we identified all metformin users ages 65 years and older between 1998 and 201...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2013.04.008

    authors: Abdelmoneim AS,Eurich DT,Gamble JM,Simpson SH

    更新日期:2013-12-01 00:00:00

  • Is Age a Risk Factor for Cerebral Edema in Children With Diabetic Ketoacidosis? A Literature Review.

    abstract::Cerebral edema (CE) is a rare but potentially fatal complication of diabetic ketoacidosis (DKA) in children with type 1 diabetes. CE is frequently mentioned as being more common in young children. The primary objective of this study was to review the evidence suggesting that younger age is a risk factor for the develo...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章,评审

    doi:10.1016/j.jcjd.2019.04.013

    authors: Glackin S,Metzger D,Hanas R,Chanoine JP

    更新日期:2020-02-01 00:00:00

  • Impact of Resistance Training on Factors Involved in the Development of New-Onset Diabetes After Transplantation in Renal Transplant Recipients: An Open Randomized Pilot Study.

    abstract:OBJECTIVES:New-onsetdiabetes after transplant (NODAT) is a major contributor to cardiovascular disease after transplantation. Kidney transplantation (KT) recipients have low levels of exercise capacity. Resistance training (RT) might be of special benefit in this population because underlying disease and immunosuppress...

    journal_title:Canadian journal of diabetes

    pub_type: 杂志文章

    doi:10.1016/j.jcjd.2015.08.014

    authors: Karelis AD,Hébert MJ,Rabasa-Lhoret R,Räkel A

    更新日期:2016-10-01 00:00:00