RESUMO
Euglycemic diabetic ketoacidosis (euDKA) is a rare but serious adverse effect caused by sodium-glucose cotransporter-2 (SGLT2) inhibitors, and it can be challenging to identify in the emergency room (ER). In this report, we present a case of a type 2 diabetic patient whose diagnosis was delayed due to the absence of marked hyperglycemia. A 39-year-old female presented to the ER with a four-day history of nausea, vomiting, sweating, dyspnea, and generalized weakness after initiating dapagliflozin, along with a low carbohydrate diet and moderate exercise to curb her newly diagnosed type 2 diabetes mellitus (DM). However, this had resulted in strict avoidance of carbohydrates. Despite seeking medical attention twice, a proper diagnosis had been delayed due to the absence of marked hyperglycemia. Her blood glucose level at our hospital was 181 mg/dl and urine analysis showed ketonuria and glucosuria. She was admitted to the ICU with a diagnosis of euDKA related to SGLT2 inhibitor use. She was successfully treated with insulin and glucose supplementation.
RESUMO
Gold nanoparticles were supported by a phloroglucinolcarboxylic acid-formaldehyde (PF) gel, a new organic gel with a 30 nm spheroid-like structure. The surface area of the PF gel with gold nanoparticles was 550 m(2)/g. Gold nanoparticles supported on a PF gel exhibited catalytic activity in the reduction of 4-nitrophenol with a reaction rate constant of 7.4 x 10(-3) s(-1), which is high in the reported heterogeneous reaction system. The adsorption behavior of 4-nitrophenol into the gel support was observed by ultraviolet-visible absorption spectroscopy. Gold nanoparticles in the PF network were characterized by scanning electron microscopy, atomic force microscopy, and transmission electron microscopy observation. The high reduction rate would be attributed to the extraction and diffusion of the reactant through the pores of a PF gel support to encounter the highly dispersed gold nanoparticles on the surface and inside the material.