Management of Diabetic Ketoacidosis in Children and Adolescents with Type 1 Diabetes Mellitus

被引：43

作者：

Castellanos, Luz ^{[1
,2
]}

Tuffaha, Marwa ^{[1
,2
]}

Koren, Dorit ^{[1
,2
]}

Levitsky, Lynne L. ^{[1
,2
]}

机构：

[1] Massachusetts Gen Hosp, Div Pediat Endocrinol, 175 Cambridge St,5th Floor, Boston, MA 02114 USA

[2] Massachusetts Gen Hosp, Pediat Diabet Ctr, 175 Cambridge St,5th Floor, Boston, MA 02114 USA

来源：

PEDIATRIC DRUGS | 2020年 / 22卷 / 04期

关键词：

INORGANIC-PHOSPHATE METABOLISM; CEREBRAL EDEMA; RISK-FACTORS; INSULIN DEFICIENCY; PEDIATRIC-PATIENTS; OXIDATIVE STRESS; CELL DYSFUNCTION; GLYCEMIC CONTROL; PULMONARY-EDEMA; CLINICAL-TRIAL;

D O I：

10.1007/s40272-020-00397-0

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Diabetic ketoacidosis (DKA) is the end result of insulin deficiency in type 1 diabetes mellitus (T1D). Loss of insulin production leads to profound catabolism with increased gluconeogenesis, glycogenolysis, lipolysis, and muscle proteolysis causing hyperglycemia and osmotic diuresis. High levels of counter-regulatory hormones lead to enhanced ketogenesis and the release of 'ketone bodies' into the circulation, which dissociate to release hydrogen ions and cause an overwhelming acidosis. Dehydration, hyperglycemia, and ketoacidosis are the hallmarks of this condition. Treatment is effective repletion of insulin, fluids and electrolytes. Newer approaches to early diagnosis, treatment, and prevention may diminish the risk of DKA and its childhood complications including cerebral edema. However, the potential for some technical and pharmacologic advances in the management of T1D to increase DKA events must be recognized.

引用

页码：357 / 367

页数：11

共 139 条

[1] Management of life-threatening acid-base disorders - First of two parts [J].