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ISSN 0123-2576 (Print)
Medicina & Laboratorio

2007, Number 09-10

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Medicina & Laboratorio 2007; 13 (09-10)

Cetoacidosis diabética y estado hiperglicémico hiperosmolar

Ramírez BJD

Language: Spanish
References: 46
Page: 437-450
PDF size: 1842.43 Kb.


ABSTRACT

Diabetic ketoacidosis and hyperosmolar hyperglycemic state are the two most serious acute metabolic complications of diabetes. These disorders can occur in both type 1 and type 2 diabetes and happen during catabolic stress of severe acute illness. The mortality rate in patients with diabetic ketoacidosis is about 5%, whereas the mortality rate of patients with hyperosmolar hyperglycemic state still remains high at 11%. As priority for all patients in the emergency ward, one should keep in mind the ABC in the initial evaluation with support measures, basic monitoring and venous access. Therapeutic goals in the diabetic ketoacidosis go toward the correction of the dehydration improving the circulating volume, the appropriate administration of insulin and the potassium substitution. Bicarbonate administration, phosphate, magnesium or other therapies can be advantageous in selected patients but they should not be considered as the first line of treatment. After stabilization is achieved, it is very important to educate the patient to recognize metabolic complications and to avoid future events.


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