Lucero Pablo, Chapela Sebastián
Hospital Británico de Buenos Aires, Intensive Care Services, Argentina.
Universidad de Buenos Aires, Facultad de Medicina, Departamento de Bioquimica Humana, Argentina.
Case Rep Crit Care. 2018 Oct 1;2018:1747850. doi: 10.1155/2018/1747850. eCollection 2018.
Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus, both type I and type II, as well as other types with diabetes such gestacional diabetes mellitus. It is characterized by blood glucose levels greater than 250 mg/dL and metabolic acidosis (pH < 7.3 and serum bicarbonate < 15 mEq/dL) with an increased anion gap and the presence of ketone bodies in the blood or urine. Within this pathology, there is a subgroup of pathologies which are characterized by being present with no signs of hyperglycemia, posing a diagnostic challenge due to the absence of the main sign of the pathology and the diversity of their pathophysiology. In this article, we will present 3 clinical cases with 3 different forms of clinical presentation: a case of DKA in pregnancy, a case of DKA associated with the use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, and a third case related to sepsis, together with a narrative review of the literature on the topic.
糖尿病酮症酸中毒（DKA）是1型和2型糖尿病以及其他类型糖尿病（如妊娠期糖尿病）的一种急性并发症。其特征为血糖水平高于250mg/dL，伴有代谢性酸中毒（pH＜7.3且血清碳酸氢盐＜15mEq/dL），阴离子间隙增加，血液或尿液中存在酮体。在这种病理情况下，有一类亚组病理表现为无高血糖迹象，由于缺乏该病理的主要体征及其病理生理的多样性，给诊断带来挑战。在本文中，我们将呈现3例具有3种不同临床表现形式的临床病例：1例妊娠合并DKA病例、1例与使用钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂相关的DKA病例以及第3例与脓毒症相关的病例，并对该主题的文献进行叙述性综述。
