Diabetic Ketoacidosis: Brain Morphology and Cognition



Status:Completed
Healthy:No
Age Range:18 - 50
Updated:10/27/2017
Start Date:February 2015
End Date:October 1, 2017

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Acute and Long-term Neuroanatomical and Cognitive Evaluation of Adult Patients With First and Recurrent Episodes of Diabetic Ketoacidosis

The purpose of this study is to assess brain and memory changes in patients with uncontrolled
diabetes (a condition called diabetic ketoacidosis (DKA))

Diabetic ketoacidosis (DKA) is a common and serious medical problem. Most cases occur when
patients forget or stop insulin injections. Some patients require frequent admissions to the
hospital with DKA after stopping insulin. Many patients do not know why they stop insulin
therapy. The investigators will test if patients with one or more episodes of DKA have poor
memory and brain changes that may lead to poor management.

In this study, the investigators will perform memory testing and brain images in subjects
with initial DKA episode and subjects with more than 3 episodes of DKA. The results will be
compared to subjects with diabetes and no history of DKA and healthy (non-diabetic) subjects.
Each subject with DKA will have an MRI and cognitive testing done shortly after hospital
discharge, 1 month, and 3 months after hospital discharge. Diabetic subjects without DKA and
healthy controls will only come in for a single baseline visit and have a MRI and cognitive
testing done.

Inclusion Criteria:

- Type 1 or type 2 diabetes with diabetic ketoacidosis (DKA)

- Age 18-50 years

- Newly diagnosed or history of noncompliance with insulin therapy as precipitating
cause of DKA

- No significant medical or surgical illness as precipitating cause of DKA

Exclusion Criteria:

- Significant medical/surgical illness as precipitating cause of DKA (i.e. myocardial
infarction, major surgery)

- Associated significant medical or surgical condition within 6 months history

- History of hypoglycemia unawareness

- History of seizures, ischemic stroke or hemorrhage, and severe head trauma

- History of symptomatic stenosis of major intracranial vessels

- Dementia (mini-mental state examination (MMSE) score (r ≤ 24) or inability to
cooperate)

- Liver or renal failure or transplant

- Severe hypertension (systolic blood pressure (BP) >160 mm Hg and/or diastolic BP >100
mm Hg or subjects taking ≥ 2 antihypertensive medications)

- Malignancy

- Current recreational drug or alcohol abuse

- Magnetic resonance imaging (MRI) exclusions: any metal and bio-implants not compatible
with 3 Tesla MRI, claustrophobia
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1648 Pierce Dr NE
Atlanta, Georgia 30322
(404) 727-5640
Phone: 404-778-1665
Emory University School of Medicine Emory University School of Medicine has 2,359 full- and part-time...
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Atlanta, Georgia 30303
Phone: 404-778-1665
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