Akademik Veri Yönetim Sistemi
SENDROM, cilt.18, sa.2, ss.39-45, 2006 (Scopus)
Diabetic ketoacidosis (DKA) is the most common endocrinologic emergency in the emergency medicine practice. DKA is a insulin deficiency state and excess of counterregulatory hormones results in hyperglicemia, dehydration, metabolic acidosis with wide anion gap, ketonemia and keto nuria. The symptoms are due to dehydration, hyperosmolarity, electrolyte losses, ketosis, and acidosis. Differential diagnosis includes other causes of metabolic acidosis with wide anion gap, diseases which can cause decreased level of consicousness, sepsis and acute abdominal pain. The current treatment of ketoacidosis should aim at correcting dehydration, reversing acidosis and ketosis, normalising plasma glucose concentration and osmolarity, replacement of electrolyte losses, identification and treatment of the underlying cause and, avoidance of iatrogenic complications Controlled volume resuscitation, intravenous continuous infusion of regular insulin, early potassium replacement are the mainstays of the therapy. Attention must be paid to correct metabolic abnormalities gradually in order to avoid iatrogenic complications of the treatment.