alexa Ketosis Prone Diabetes- A Clinical View
ISSN: 2155-6156

Journal of Diabetes & Metabolism
Open Access

Like us on:
OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

International Conference on Diabetes and Diabetic Nursing Care
September 20-21, 2017 Charlotte, USA

Eleanor Cramer
Columbia University, New York
Posters & Accepted Abstracts: J Diabetes Metab
DOI: 10.4172/2155-6156-C1-070
Abstract
Introduction: Ketosis Prone Type 2 Diabetes (KPD) is also known as “Flatbush Diabetes”, due to the cluster of patients identified in the Flatbush section of Brooklyn, NY with new onset of type 2 diabetes accompanied by Diabetic Ketoacidosis (DKA) as the first manifestation. These patients have an absence (A-) or presence (A+) of islet cell autoantibodies and quantitive differences in beta cell function. The A-B+ is the most frequent manifestation. These patient’s parameters resemble type 2 diabetes, in that it usually occurs in the adult population, they are overweight or obese, a strong family history of type 2 diabetes, do not have islet cell autoantibodies, and have a plentiful reserve of pancreatic beta cells, which have been measured after the “index” case of KPD. They may also have physical signs such as acanthosis nigricans and abdominal straie. They have an unprovoked episode of diabetic ketoacidosis (DKA), and may have blurred vision, nausea, vomiting or abdominal pain, which bring them to the emergency department. They may also have polyuria resulting in dehydration secondary to blood glucose numbers far in excess of type 1 diabetics. Treatment is the same as for any DKA patient, and they usually are treated with a basal/bolus regimen, along with metformin, which is increased as tolerated. They generally have rapid beta cell recovery and many eventually stay on metformin as a preventative measure; some require only lifestyle modifications. This holiday period may last from months to years. The most common subtype of KPD is A- B+ (54%). Case: 33-year-old African American woman, With a BMI of 42 mg/kg m2, G 6, P 2. Her children are aged 15 and 5. She had little prenatal care with her first child, and at time of labor she was found to have gestational diabetes (GDM). She was started on basal bolus insulin with levemir and lispro, which was continued post-partum, but eventually eliminated over the course of several months, and she did not require metformin. She was carefully followed with the second child, and was treaded with insulin throughout her pregnancy, and discontinued in the immediate post-partum period. In the five years since, she has had no recurrence of diabetes, until this DKA event. No precipitating cause, such as infection, increased stress or steroid use was identified. She had a blood glucose more 700 mg/dL, and a HBA1c of 13%. She responded rapidly to insulin and rehydration, and was weaned from insulin to metformin, and finally just diet control over the next three months. One year later she still has not had a recurrence of DKA or evidence of persistent diabetes, with decrease of HBA1c to high normal range. Discussion: This case is a good example of the need for identification of presence or absence of autoantibodies in a younger patient who presents in DKA who could quite possibly have type 1 diabetes. It also shows that with careful monitoring and titration, medication can be temporary for a significant amount of time. This patient had the desire for another pregnancy, and was referred to high risk OB care to reinforce the need for keeping with her diet to lose weight and to decrease her HBA1c to prepare her body for pregnancy and prevent the known teratogenic effects of hyperglycemia to the developing fetus.
Biography

Eleanor Cramer is a family nurse practitioner (FNP) who spent the last three semesters as a Doctor of Nursing Practice student (DNP) in the Endocrine Department at a metropolitan academic medical center in New York, NY. She collaborates with a DNP certified diabetic educator and an attending endocrinologist as a consultant for endocrine services for the adult population. The endocrine team covers consultations throughout the hospital and outpatient setting. She is a DNP candidate for October 2017 at Columbia University in New York, NY. She also received her Master of Science degree in Nursing as a Family Nurse Practitioner from Columbia, and is ANCC certified. She completed her Bachelor of Science in Nursing at Villanova University, Villanova, PA, after graduating from St. Joseph’s Hospital School of Nursing, Reading Pennsylvania. Prior to becoming an FNP, she spent 37 years as a critical care nurse, working in various critical care settings.

image PDF   |   image HTML
 

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version