University of Colorado Denver-Anschutz Medical Campus, Aurora, CO, USA.
Diabetes Technol Ther. 2012 Dec;14(12):1149-54. doi: 10.1089/dia.2012.0161. Epub 2012 Sep 25.
Diabetic ketoacidosis (DKA) is one of the most common, costly, and dangerous acute complications in people with type 1 diabetes (T1D). Although DKA has been reported to occur with less frequency than severe hypoglycemia, it is associated with a higher mortality rate and is the leading cause of diabetes-related deaths in children and adolescents. The most common risk factor for DKA is lack of adherence to insulin treatment. Other factors include underinsurance, psychiatric disorders, occlusion of insulin pump infusion sets, and illness. It has been suggested that use of continuous subcutaneous insulin infusion therapy may increase the risk for DKA, although clinical trials have not supported this claim. Expert care within a T1D specialty clinic may help reduce the risk of DKA mortality. Further advances are needed in developing new technologies and methods to improve glycemic control in intensively treated patients without increasing the risk of acute complications. The purpose of this review is to discuss DKA morbidity and mortality in youth with T1D, particularly in relation to insulin pump use.
糖尿病酮症酸中毒（DKA）是 1 型糖尿病（T1D）患者最常见、最昂贵和最危险的急性并发症之一。尽管 DKA 的报告发病率低于严重低血糖，但它与更高的死亡率相关，是儿童和青少年糖尿病相关死亡的主要原因。DKA 的最常见危险因素是不遵守胰岛素治疗。其他因素包括保险不足、精神障碍、胰岛素泵输注装置阻塞和疾病。有人认为，使用持续皮下胰岛素输注治疗可能会增加 DKA 的风险，尽管临床试验并未支持这一说法。在 T1D 专科诊所接受专业护理可能有助于降低 DKA 死亡率的风险。需要进一步开发新技术和方法，在不增加急性并发症风险的情况下，改善强化治疗患者的血糖控制。本综述的目的是讨论 T1D 青少年的 DKA 发病率和死亡率，特别是与胰岛素泵使用的关系。
