Abstract:
:Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome (HHS) are life threatening complications that occur in patients with diabetes. In addition to timely identification of the precipitating cause, the first step in acute management of these disorders includes aggressive administration of intravenous fluids with appropriate replacement of electrolytes (primarily potassium). In patients with diabetic ketoacidosis, this is always followed by administration of insulin, usually via an intravenous insulin infusion that is continued until resolution of ketonemia, but potentially via the subcutaneous route in mild cases. Careful monitoring by experienced physicians is needed during treatment for diabetic ketoacidosis and HHS. Common pitfalls in management include premature termination of intravenous insulin therapy and insufficient timing or dosing of subcutaneous insulin before discontinuation of intravenous insulin. This review covers recommendations for acute management of diabetic ketoacidosis and HHS, the complications associated with these disorders, and methods for preventing recurrence. It also discusses why many patients who present with these disorders are at high risk for hospital readmissions, early morbidity, and mortality well beyond the acute presentation.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Karslioglu French E,Donihi AC,Korytkowski MTdoi
10.1136/bmj.l1114subject
Has Abstractpub_date
2019-05-29 00:00:00pages
l1114eissn
0959-8138issn
1756-1833journal_volume
365pub_type
杂志文章,评审abstract:OBJECTIVE:To identify the factors associated with diabetic ketoacidosis at diagnosis of type 1 diabetes in children and young adults. DESIGN:Systematic review. DATA SOURCES:PubMed, EMBASE, Web of Science, Scopus, and Cinahl and article reference lists. STUDY SELECTION:Cohort studies including unselected groups of ch...
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