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撒哈拉以南非洲儿童和青少年糖尿病酮症酸中毒的管理:综述

Management of diabetic ketoacidosis in children and adolescents in sub-Saharan Africa: a review.

作者信息

Majaliwa E S, Mohn A, Chiavaroli V, Ramaiya K, Swai A B M, Chiarelli F

机构信息

Department of Paediatrics and Child Health, Muhimbili National Hospital, P.O. Box 65000, Dares Salaam, Tanzania.

出版信息

East Afr Med J. 2010 Apr;87(4):167-73. doi: 10.4314/eamj.v87i4.62207.

Abstract

BACKGROUND

Diabetic ketoacidosis (DKA) is a complex metabolic state of hyperglycaemia, ketosis, and acidosis. Diabetes in sub-Saharan Africa is, in many patients a serious disease with a poor prognosis. Most deaths, however, are due to preventable causes.

OBJECTIVE

To improve knowledge on the management of DKA in sub-Saharan Africa.

DATA SOURCES

Literature review from different published sources.

DATA SYNTHESIS

Health systems in sub-Saharan Africa are currently organised for the treatment of episodes of illness and not long-term conditions like diabetes. Therefore the high rates of DKA is essentially due to lack of training of health professionals, lack of facilities in most hospitals, lack of public awareness as well as lack of health education to individual patients/families. In addition erratic insulin supply coupling with infections, low parental education, poor insulin storage and lack of facilities for self monitoring of blood glucose.

CONCLUSION

A complex unfavourable social and economic environment is the basis of the high prevalence of DKA in sub-Saharan Africa. Several episodes of DKA can be prevented by effective public awareness programmes and education to healthcare providers.

摘要

背景

糖尿病酮症酸中毒(DKA)是一种伴有高血糖、酮症和酸中毒的复杂代谢状态。在撒哈拉以南非洲地区,糖尿病对许多患者来说是一种严重疾病,预后较差。然而,大多数死亡是由可预防的原因导致的。

目的

提高撒哈拉以南非洲地区对DKA管理的认识。

数据来源

来自不同已发表来源的文献综述。

数据综合

撒哈拉以南非洲地区的卫生系统目前是为治疗疾病发作而组织的,而非针对糖尿病等长期病症。因此,DKA的高发病率主要是由于卫生专业人员缺乏培训、大多数医院缺乏设施、公众意识淡薄以及对个体患者/家庭缺乏健康教育。此外,胰岛素供应不稳定,加上感染、父母教育程度低、胰岛素储存不当以及缺乏血糖自我监测设施。

结论

复杂不利的社会和经济环境是撒哈拉以南非洲地区DKA高患病率的基础。通过有效的公众意识项目和对医疗服务提供者的教育,可以预防多次DKA发作。

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