Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic Syndrome

نویسندگان

  • Beatrice C. Lupsa
  • Silvio E. Inzucchi
چکیده

(a) History: Most patients with diabetic ketoacidosis (DKA) or with hyperosmolar hyperglycemic state (HHS) will have a history of diabetes, and a history of altered insulin dose, infection, signifi cant medical “stress”. Antecedent symptoms of polyuria and polydipsia, lassitude, blurred vision, and mental status changes may predominate the clinical picture. With DKA, abdominal pain and tachypnea are often present. (b) Physical examination usually reveals an altered sensorium, signs of volume contraction/dehydration (tachycardia, hypotension, dry mucus membranes, “tenting” of the skin); in DKA, the odor of acetone in the breath. (c) Laboratory evaluation. The diagnostic criteria for DKA include blood glucose above 250 mg/dL, arterial pH < 7.30, serum bicarbonate < 15 mEq/l Chapter 2 Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic Syndrome

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تاریخ انتشار 2014