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正常血糖性糖尿病酮症酸中毒:它与糖尿病酮症酸中毒有何不同。

Euglycemic Diabetic Ketoacidosis: How Is It Different from Diabetic Ketoacidosis.

作者信息

Ju Hsiao-Hui

机构信息

Department of Undergraduate Studies, The University of Texas at Houston (UTHealth) Cizik School of Nursing, 6901 Bertner Avenue Room #748, Houston, TX 77030, USA.

出版信息

Crit Care Nurs Clin North Am. 2025 Mar;37(1):157-165. doi: 10.1016/j.cnc.2024.08.004. Epub 2024 Sep 23.

DOI:10.1016/j.cnc.2024.08.004
PMID:39890347
Abstract

Diabetic ketoacidosis (DKA) and euglycemic DKA are both diabetes-related emergencies. Individuals with DKA can experience extremely elevated hyperglycemia exceeding 250 mg/dL. Although DKA is more frequently observed in people with type 1 diabetes (T1DM), euglycemic DKA, which is characterized by mildly elevated or nearly normal blood glucose at levels below 200 mg/dL, has recently been linked to the use of SGLT-2 inhibitors generally used for type 2 diabetes mellitus (T2DM). Without the substantial hyperglycemia associated with DKA, euglycemic DKA may be clinically overlooked. The pathophysiology, precipitating factors, clinical presentations, treatments, and evaluations of euglycemic DKA and DKA are reviewed.

摘要

糖尿病酮症酸中毒(DKA)和正常血糖性DKA均为糖尿病相关急症。DKA患者可出现超过250mg/dL的极高血糖水平。尽管DKA在1型糖尿病(T1DM)患者中更常见,但正常血糖性DKA,其特征为血糖轻度升高或接近正常,水平低于200mg/dL,最近已与通常用于2型糖尿病(T2DM)的钠-葡萄糖协同转运蛋白2(SGLT-2)抑制剂的使用相关联。由于缺乏与DKA相关的显著高血糖,正常血糖性DKA在临床上可能被忽视。本文对正常血糖性DKA和DKA的病理生理学、诱发因素、临床表现、治疗及评估进行了综述。

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