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  • - - (Diabetic ketoacidosis)
       
     

    - - (Diabetic ketoacidosis)

     - - (Diabetic ketoacidosis)
    . () - () , (acidosis), .

    ' - , , , -; , , -.

    ( DKA) . () - () , (acidosis), . 

    " - (2012-13), -3.6% DKA type 1.

    6% DKA type 1 ( Dhatariya ' -Diabetes Medicine 2015), 8% DKA - DKA.

    DKA , 24 .  , polyuria ( ) -polydipsia ( ), , , , (coma). 

    DKA , , , , ,    (Kussmaul respiration),     - , . 

    -DKA (Kitabachi ' -Diabetes Care 2007) . , DKA  (type 1 -type 2) . 

    DKA (thromboembolism) DKA , - - (cardiac arrest)  -DKA, ( , (Basu ' -Diabetes Medicine  1993).

    DKA?

    -, . , DKA -, -euglycemic ketoacidosis, ( -3 '/) DKA.

    , . ,    198 /", (ADA) 250 /", DKA.

    ( " "), , DKA ( Sacks ' -Clinical Chemistry 2011).

    acetoacetate 3-hydroxybutyrate , -3 '/, DKA ( Sheikh-Ali ' -Diabetes Care 2008, -Aora ' 2011).  

    DKA?

    - .  -, , ( ).

    .  0.9% saline, פּוֹ,  saline -, -.

    .  -ADA 0.45% saline, .

    , saline 0.9%.   (Van Zyl ' -Quarterly Journal of Medicine -Mahler ' -American Journal of Emergency Medicine 2011).

    , - NaCl 0.9%, (Chua ' -Journal of Critical Care 2012).

    :

    -DKA, . saline, .

    :

     (Green ' -Annals of Emergecy Medicine  1998, -Okuda ' -Journal of Clinical Endocrinology & Metabolism 1996).

      (pH -7.0)   , .  (Handy -Sony -British Journal of Anasthesiology 2008).

    ,  (anoxia).

    ?

    " , 0.1 /" /.

    Kitabachi ' -Diabetes Care 2008 (bolus) .

    , .

    , . , -KDA  , -6

    -250 /", 12 -DKA ( Umpierez ' -Diabetes Care 2009). 

    , .

    ?

    DKA, .

    , DKA.

    DKA:   pH -7.1;   -5 '/; 6 '/ -3.5 '/.

    -DKA,  3-5% (Henriksen ' -Diabetes Care & Clinical Practice 2007). .

    - ?

    - DKA. .

    - - , , -.

    30-60 -   . type 1, - (Hsia ' -Journal of Clinical Endocrinology & Metabolism 2012).

    DKA ?

    type 1 -DKA, .

    -70% DKA

      , , (Laftel ' -Diabetes Medicine  2006).

    , -gliflozins sodium-glucose cotransptrter-2 inhibitors , -DKA.     

    , ' - .


    12/12/2015

     
       


    , , " , "
    , " " .

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