Megu Yamaguchi Baden1, Akihisa Imagawa1, Hiromi Iwahashi1, Iichiro Shimomura1, Takuya Awata2, Hiroshi Ikegami3, Yasuko Uchigata4, Haruhiko Osawa5, Hiroshi Kajio6, Eiji Kawasaki7,8, Yumiko Kawabata3, Akira Shimada9, Kazuma Takahashi10, Shoichiro Tanaka11, Kazuki Yasuda12, Hisafumi Yasuda13, Tetsuro Kobayashi14, Toshiaki Hanafusa15. 1. 1Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, 565-0871 Japan. 2. 2Department of Diabetes, Endocrinology and Metabolism, International University of Health and Welfare Hospital, Tochigi, Japan. 3. 3Department of Endocrinology, Metabolism and Diabetes, Kinki University Faculty of Medicine, Osaka, Japan. 4. 4Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. 5. 5Department of Laboratory Medicine, Ehime University School of Medicine, Ehime, Japan. 6. 6Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan. 7. 7Department of Endocrinology and Metabolism, Nagasaki University Hospital, Nagasaki, Japan. 8. 8Department of Diabetes and Endocrinology, Shin-Koga Hospital, Kurume, Japan. 9. 9Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan. 10. 10Department of Diabetes and Metabolism, Iwate Medical University, Iwate, Japan. 11. 11Third Department of Internal Medicine, University of Yamanashi, Yamanashi, Japan. 12. 12Department of Metabolic Disorder, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan. 13. 13Division of Health Sciences, Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan. 14. 14Okinaka Memorial Institute for Medical Research, Tokyo, Japan. 15. 15Department of Internal Medicine (I), Osaka Medical College, Takatsuki, Japan.
Abstract
AIMS: The onset of fulminant type 1 diabetes mellitus is sometimes accompanied by sudden death or cardiac arrest. The aim of this study was to determine the risk factors for the development of these conditions at the onset of fulminant type 1 diabetes mellitus. METHODS: We conducted a search of the literature on fulminant type 1 diabetes and sudden death or cardiac arrest published up to 2012 in PubMed and Ichushi (a Japanese article database), and a questionnaire survey was administered to the authors of the articles and to diabetes specialists affiliated to the Japan Diabetes Society. We analyzed the clinical data at disease onset of 17 patients with fulminant type 1 diabetes mellitus who experienced sudden death or cardiac arrest, and those of 257 patients who did not develop these conditions. RESULTS: Patients with sudden death or cardiac arrest were younger, had a higher rate of impaired consciousness, more severe acidosis, hyperglycemia, hyponatremia, hyperkalemia, and hypochloremia, a higher serum blood urea nitrogen level, a higher serum creatinine level, and a higher plasma osmolality level than the other patients. In multiple logistic regression analyses, plasma glucose level was positively associated with sudden death or cardiac arrest. Receiver operating characteristic curve analyses showed that patients with a plasma glucose level over 1000 mg/dl (55.5 mmol/l) were at a high risk of cardiac arrest. CONCLUSIONS: Severe metabolic derangement, especially a high plasma glucose level, is associated with sudden death or cardiac arrest at the onset of fulminant type 1 diabetes mellitus.
AIMS: The onset of fulminant type 1 diabetes mellitus is sometimes accompanied by sudden death or cardiac arrest. The aim of this study was to determine the risk factors for the development of these conditions at the onset of fulminant type 1 diabetes mellitus. METHODS: We conducted a search of the literature on fulminant type 1 diabetes and sudden death or cardiac arrest published up to 2012 in PubMed and Ichushi (a Japanese article database), and a questionnaire survey was administered to the authors of the articles and to diabetes specialists affiliated to the Japan Diabetes Society. We analyzed the clinical data at disease onset of 17 patients with fulminant type 1 diabetes mellitus who experienced sudden death or cardiac arrest, and those of 257 patients who did not develop these conditions. RESULTS: Patients with sudden death or cardiac arrest were younger, had a higher rate of impaired consciousness, more severe acidosis, hyperglycemia, hyponatremia, hyperkalemia, and hypochloremia, a higher serum blood urea nitrogen level, a higher serum creatinine level, and a higher plasma osmolality level than the other patients. In multiple logistic regression analyses, plasma glucose level was positively associated with sudden death or cardiac arrest. Receiver operating characteristic curve analyses showed that patients with a plasma glucose level over 1000 mg/dl (55.5 mmol/l) were at a high risk of cardiac arrest. CONCLUSIONS: Severe metabolic derangement, especially a high plasma glucose level, is associated with sudden death or cardiac arrest at the onset of fulminant type 1 diabetes mellitus.
Entities:
Keywords:
Cardiac arrest; Fulminant type 1 diabetes mellitus; Risk factors; Sudden death
Authors: N Sekine; T Motokura; T Oki; Y Umeda; N Sasaki; M Hayashi; H Sato; T Fujita; T Kaneko; Y Asano; K Kikuchi Journal: JAMA Date: 2001-03-07 Impact factor: 56.272
Authors: K Sayama; A Imagawa; K Okita; S Uno; M Moriwaki; J Kozawa; H Iwahashi; K Yamagata; S Tamura; Y Matsuzawa; T Hanafusa; J Miyagawa; I Shimomura Journal: Diabetologia Date: 2005-07-01 Impact factor: 10.122