We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
PURITAN MEDICAL

Download Mobile App




Protracted Ketonemia Reported in Hyperglycemic COVID-19 Emergencies

By LabMedica International staff writers
Posted on 03 Aug 2020
Print article
Image: A kit for measuring beta-hydroxybutyrate as a biomarker for diabetic ketoacidosis (Photo courtesy of BioSystems).
Image: A kit for measuring beta-hydroxybutyrate as a biomarker for diabetic ketoacidosis (Photo courtesy of BioSystems).
Diabetes is a major contributor to disease severity and mortality in patients with COVID-19; with an estimated 3.5-times increase in risk of death during hospital admission for patients with type 1 diabetes, and 2.03-times for those with type 2 diabetes.

Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. It occurs when the body starts breaking down fat at a rate that is to rapid. The liver processes the fat into a fuel called ketones, which causes the blood to become acidic. DKA and hyperosmolar hyperglycemic state (HHS) are hyperglycemic emergencies associated with substantial mortality and high blood sugar levels increase cardiovascular (CV) risk in elderly diabetics.

Endocrinologists at the North Middlesex University Hospital (London, UK) and their colleagues carried out a retrospective analysis of recruited eligible patients from three hospitals in north London, UK, March 1–30, 2020. There were 35 patients with COVID-19, presenting with DKA (31.4%), mixed DKA and HHS (37.1%), HHS (5.7%), or hyperglycemic ketosis (25.7%) that were included and evaluated. The median overall HbA1c was 111 mmol/mol (IFCC; diabetes diagnostic cut-off ≥48 mmol/mol) and/or the presence of ketonemia (beta-hydroxybutyrate >0.6mmol/L). The median age of the patients was 60 years, 28 (80%) had type 2 diabetes, five (14%) had type 1 diabetes and two (6%) were "new presentation" of diabetes. Forty percent were African American, 20% Caucasian, 17% mixed ethnic origin, and 14% Asian (6% Chinese and 9% Indian origin).

The scientists reported that there was there was a "striking" type 2 disease overrepresentation in those presenting with DKA (82%), suggesting acute insulinopenia in patients with COVID-19 and with type 2 diabetes, which persisted up until the time of discharge in 30% of patients previously not insulin-treated. The patients developed protracted ketonemia and ketoacidosis, with median time to ketone resolution in DKA of roughly 35 hours (range, 24 to 60 hours). In non-COVID-19 DKA cases, in contrast, the median duration of ketoacidosis was about 12 hours.

Substantial insulin resistance and possibly relative insulinopenia in severe COVID-19 was disproportionate to that seen in critical illness caused by other conditions, which might have contributed to the metabolic decompensation. The team noted that 35% of patients in the study required an increase of the fixed dose insulin infusion above the recommended insulin dose for DKA of 0.1 units/kg per hour.

In conclusion the authors reported that COVID-19 is associated with hyperglycemic emergencies in COVID-19 with overrepresentation of type 2 diabetes in patients presenting with DKA and long-lasting ketosis. The study was published on August 1, 2020 in the journal Lancet Diabetes & Endocrinology.

Related Links:
North Middlesex University Hospital

Platinum Member
COVID-19 Rapid Test
OSOM COVID-19 Antigen Rapid Test
One Step HbA1c Measuring System
GREENCARE A1c
Anti-Cyclic Citrullinated Peptide Test
GPP-100 Anti-CCP Kit
Gold Member
Reagent Reservoirs
Reagent Reservoirs

Print article

Channels

Molecular Diagnostics

view channel
Image: The study showed the blood-based cancer screening test detects 83% of people with colorectal cancer with specificity of 90% (Photo courtesy of Guardant Health)

Blood Test Shows 83% Accuracy for Detecting Colorectal Cancer

Colorectal cancer is the second biggest cause of cancer deaths among adults in the U.S., with forecasts suggesting 53,010 people might die from it in 2024. While fewer older adults are dying from this... Read more

Hematology

view channel
Image: The Gazelle Hb Variant Test (Photo courtesy of Hemex Health)

First Affordable and Rapid Test for Beta Thalassemia Demonstrates 99% Diagnostic Accuracy

Hemoglobin disorders rank as some of the most prevalent monogenic diseases globally. Among various hemoglobin disorders, beta thalassemia, a hereditary blood disorder, affects about 1.5% of the world's... Read more

Microbiology

view channel
Image: The new platform is designed to perform blood-based diagnoses of nontuberculosis mycobacteria (Photo courtesy of 123RF)

New Blood Test Cuts Diagnosis Time for Nontuberculous Mycobacteria Infections from Months to Hours

Breathing in nontuberculous mycobacteria (NTM) is a common experience for many people. These bacteria are present in water systems, soil, and dust all over the world and usually don't cause any problems.... Read more

Industry

view channel
Image: These new assays are being developed for use on the recently introduced DxI 9000 Immunoassay Analyzer (Photo courtesy of Beckman Coulter)

Beckman Coulter and Fujirebio Expand Partnership on Neurodegenerative Disease Diagnostics

Beckman Coulter Diagnostics (Brea, CA, USA) and Fujirebio Diagnostics (Tokyo, Japan) have expanded their partnership focused on the development, manufacturing and clinical adoption of neurodegenerative... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.