Diabetic ketoacidosis(DKA)and hyperosmolar hyperglycemia state(HHS)are two life-threatening metabolic complications of diabetes that significantly increase mortality and morbidity.Despite major advances,reaching a uni...Diabetic ketoacidosis(DKA)and hyperosmolar hyperglycemia state(HHS)are two life-threatening metabolic complications of diabetes that significantly increase mortality and morbidity.Despite major advances,reaching a uniform consensus regarding the diagnostic criteria and treatment of both conditions has been challenging.A significant overlap between these two extremes of the hyperglycemic crisis spectrum poses an additional hurdle.It has well been noted that a complete biochemical and clinical patient evaluation with timely diagnosis and treatment is vital for symptom resolution.Worldwide,there is a lack of large-scale studies that help define how hyperglycemic crises should be managed.This article will provide a comprehensive review of the pathophysiology,diagnosis,and management of DKA-HHS overlap.展开更多
Diabetic ketoacidosis(DKA) is defined as an acute metabolic disorder, which is characterized by an increased presence of circulating ketones, and the development of ketoacidosis in the presence of hyperglycemia. This ...Diabetic ketoacidosis(DKA) is defined as an acute metabolic disorder, which is characterized by an increased presence of circulating ketones, and the development of ketoacidosis in the presence of hyperglycemia. This syndrome occurs as a result of insulin deficiency. Patients can be dramatically ill, however, with aggressive treatment, most patients recover rapidly. Despite being a low-risk condition, the development of acidosis, is one of the admission criteria to the intensive care unit(ICU) for these patients, in order to provide close monitoring, and recognize complications that could result from the use of aggressive therapy, such as continuous infusions if insulin. In some institutions, DKA is treated in the emergency department and general medical/surgical wards to avoid ICU overcrowding.展开更多
目的:探讨临床中上消化道出血合并高渗性非酮症糖尿昏迷患者的临床护理方法.方法:采取回顾性方法对2012-01/2014-12南华大学附属第一医院内分泌科20例上消化道出血合并高渗性非酮症糖尿昏迷患者的临床护理方法进行总结与分析.结果:患者...目的:探讨临床中上消化道出血合并高渗性非酮症糖尿昏迷患者的临床护理方法.方法:采取回顾性方法对2012-01/2014-12南华大学附属第一医院内分泌科20例上消化道出血合并高渗性非酮症糖尿昏迷患者的临床护理方法进行总结与分析.结果:患者均在2-24 h之后度过危险期,且病情均稳定,之后经过严格的治疗与细心的护理出院,无相关并发症的发生.护理前vs护理后患者的格拉斯哥昏迷指数(Glasgow coma scale,GCS)评分(9.2分±2.2分vs 13.5分±1.8分),差异有统计学意义(P<0.05).结论:临床中应依据上消化道出血合并高渗性非酮症糖尿昏迷患者的病情状况进行及时的诊断与合理的护理,从而改善患者的预后,降低死亡.展开更多
文摘Diabetic ketoacidosis(DKA)and hyperosmolar hyperglycemia state(HHS)are two life-threatening metabolic complications of diabetes that significantly increase mortality and morbidity.Despite major advances,reaching a uniform consensus regarding the diagnostic criteria and treatment of both conditions has been challenging.A significant overlap between these two extremes of the hyperglycemic crisis spectrum poses an additional hurdle.It has well been noted that a complete biochemical and clinical patient evaluation with timely diagnosis and treatment is vital for symptom resolution.Worldwide,there is a lack of large-scale studies that help define how hyperglycemic crises should be managed.This article will provide a comprehensive review of the pathophysiology,diagnosis,and management of DKA-HHS overlap.
文摘Diabetic ketoacidosis(DKA) is defined as an acute metabolic disorder, which is characterized by an increased presence of circulating ketones, and the development of ketoacidosis in the presence of hyperglycemia. This syndrome occurs as a result of insulin deficiency. Patients can be dramatically ill, however, with aggressive treatment, most patients recover rapidly. Despite being a low-risk condition, the development of acidosis, is one of the admission criteria to the intensive care unit(ICU) for these patients, in order to provide close monitoring, and recognize complications that could result from the use of aggressive therapy, such as continuous infusions if insulin. In some institutions, DKA is treated in the emergency department and general medical/surgical wards to avoid ICU overcrowding.
文摘目的:探讨临床中上消化道出血合并高渗性非酮症糖尿昏迷患者的临床护理方法.方法:采取回顾性方法对2012-01/2014-12南华大学附属第一医院内分泌科20例上消化道出血合并高渗性非酮症糖尿昏迷患者的临床护理方法进行总结与分析.结果:患者均在2-24 h之后度过危险期,且病情均稳定,之后经过严格的治疗与细心的护理出院,无相关并发症的发生.护理前vs护理后患者的格拉斯哥昏迷指数(Glasgow coma scale,GCS)评分(9.2分±2.2分vs 13.5分±1.8分),差异有统计学意义(P<0.05).结论:临床中应依据上消化道出血合并高渗性非酮症糖尿昏迷患者的病情状况进行及时的诊断与合理的护理,从而改善患者的预后,降低死亡.
