非高血糖性糖尿病酮症酸中毒的研究进展

Research progress of euglycemic diabetic ketoacidosis

非高血糖性糖尿病酮症酸中毒(euglycemic diabetic ketoacidosis,EDKA)是糖尿病最严重和危及生命的急性并发症之一,临床上相对少见。EDKA首诊科室主要是急诊科,临床表现与酮症酸中毒(diabetic ketoacidosis,DKA)相似,但其血糖水平比DKA低,且临床表现为非特异性,往往导致诊断延迟。近年来,随着钠-葡萄糖共转运蛋白2抑制剂(sodium-glucose cotransporter-2 inhibitors,SGLT2i)广泛使用,EDKA的发病率较前上升。为了进一步提高对EDKA的了解,本文对EDKA的流行病学、发病机制、诊断及治疗进行综述。

Euglycemic diabetic ketoacidosis(EDKA) is one of the most serious and life-threatening acute complications of diabetes,which is relatively rare in clinical practice.The first diagnosis department of EDKA is mainly the emergency department,and its clinical features are similar to diabetic ketoacidosis(DKA),but its blood glucose level is lower than that of DKA,and the clinical features are non-specific,which often leads to delayed diagnosis.In recent years,with the widespread use of sodium-glucose cotransporter-2 inhibitors(SGLT2 i),the incidence of EDKA has increased.In order to improve the understanding of EDKA,this article reviews the epidemiology,pathogenesis,diagnosis and treatment of EDKA.