Related Experiment Videos

Plasma C-reactive protein levels in severe diabetic ketoacidosis

Rory R Dalton1, William H Hoffman, Gregory G Passmore

  • 1Department of Pathology, Medical College of Georgia, Augusta, Georgia 30912, USA.

Annals of Clinical and Laboratory Science
|October 31, 2003
PubMed

Insights

C-reactive protein (CRP) can increase in young patients with severe diabetic ketoacidosis (DKA), even without infection. This suggests DKA itself may trigger a non-infectious inflammatory response.

Area of Science:

  • Biochemistry
  • Immunology
  • Pediatrics

Background:

  • Elevated C-reactive protein (CRP) and Interleukin-6 (IL-6) are infection markers in adults with diabetic ketoacidosis (DKA).
  • CRP and pro-inflammatory cytokines can rise without infection, complicating diagnosis.
  • The role of CRP in pediatric DKA without infection is not well-defined.

Purpose of the Study:

  • To investigate if CRP levels increase in young patients with severe DKA, independent of infection.
  • To determine if CRP elevation in DKA is associated with systemic inflammatory response syndrome (SIRS).
  • To explore the relationship between CRP and key inflammatory cytokines in DKA.

Main Methods:

  • Measured plasma CRP, IL-6, IL-1beta, and TNF-alpha in 7 young patients with severe DKA without infection.
  • Collected samples before, during, and after DKA correction (baseline at 96 hours).
  • Analyzed CRP levels and their correlation with cytokine levels.

Main Results:

  • CRP was transiently elevated in 4 out of 7 patients during or before DKA treatment compared to baseline.
  • Significant positive correlations were found between CRP and IL-6/IL-1beta pre-treatment.
  • CRP also correlated with IL-6, IL-1beta, and TNF-alpha at 6 hours post-treatment, and IL-1beta at 24 hours.

Conclusions:

  • Severe DKA and its treatment can increase CRP levels in young patients, even without infection.
  • DKA may be associated with a non-infectious form of SIRS.
  • CRP may serve as a marker for the systemic inflammatory response in DKA.

Related Concept Videos

Diabetic Ketoacidosis l: Introduction01:25

Diabetic Ketoacidosis l: Introduction

DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
Diabetic Ketoacidosis ll: Pathophysiology01:22

Diabetic Ketoacidosis ll: Pathophysiology

Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
Diabetic Nephropathy01:28

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...
Serum Studies: Renal Function Tests01:24

Serum Studies: Renal Function Tests

Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.