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Emergency DKA (Diabetic ketoacidosis) is an acute complication seen in people with diabetes. It was found to be more common in insulin-dependent diabetics (Type 1 diabetes), but is now more common in people with type 2 diabetes. This is especially true for new SGLT-2 inhibitors (diabetic drugs) such as Jardiance Forxiga Xigduo and Luxefi.
Causes of DKA
DKA is caused by 3 factors which are
Insufficient insulin Insulin deficiency In type 1 diabetes, the body does not produce insulin. When a patient stops injecting insulin, they are at risk of developing DKA.
Insulin resistance Together with insufficient insulin secretion It is found in people with type 2 diabetes, especially people with long-term diabetes. Have regular insulin injections Stress conditions such as infection, surgery, accident
Acute peripheral artery disease Lack of food, carbohydrate groups (starches, sugars) are risk factors. Especially in patients receiving SGLT-2 inhibitor drugs
Mechanism of occurrence of DKA
For the mechanism of DKA occurrence, the body secretes a group of substances known as Counter-regulatory hormones, including adrenaline, cortisol, and glucagon, are released to fight acute illness. Has resulted in higher blood sugar levels By metabolic fat as สมัคร slotxo energy This mechanism has a positive effect on giving the body more energy. But there is a free gift, ketones, which make the blood acidic. When large amounts of ketones are formed The body expels ketones through breathing. Causing symptoms of asthenia
Symptoms that indicate DKA is developing
Nausea and vomiting
Loss of appetite or no water, no food in preparation for surgery
Have frequent urination symptoms More quantity
Dry throat, thirst (especially cold, sweet water)
Exhaustion, lack of strength
The breath smells fruity.
Detects blood sugar levels higher than 250 milligrams per deciliter.
Prevention of DKA for Diabetics (Sick-day rules)
Focus on eating carbohydrates.
Drink more water
Do not stop taking insulin injections.
It is recommended to eat soft, easily digested foods such as boiled rice, porridge, rice with a little salt, crackers or bread
If unable to eat soft food It is advisable to eat liquid food. With at least 50 grams of carbohydrates every 3-4 hours, such as juice or yogurt puree
Drink enough water at least 1 glass every hour (for people with heart problems or kidney disease. Should consult a doctor about the appropriate amount of water).
Do not stop an insulin injection medication, especially basal or long-acting insulin.
Checking blood sugar more often is to check blood sugar levels regularly, for example in patients with type 1 diabetes should be checked every 4 hours and in patients with type 2 diabetes. Should be examined at least 4 times a day (3 times before meals and before bedtime).
Come to the hospital immediately when symptoms do not improve, such as serious illnesses, such as angina, crooked mouth, weak limbs, symptoms of illness or fever for more than 2 days, and have not resolved nausea, vomiting or diarrhea, unable to eat for more than 6 hours. Pre-meal blood sugar levels greater than 240 milligrams per deciliter. Have symptoms of dehydration Chapped lips, parched throat, thirst or worsening symptoms, weakness, shortness of breath, chest tightness, fruity breath odor.
When there is no water, no food in preparation for surgery or any procedure We recommend discontinuing SGLT-2 inhibitors 3-7 days prior to the procedure. Up to the discretion of the doctor
Should consult a doctor to adjust insulin injections. Including a list of all medications, supplements and vitamins With doctors and dentists before each procedure To prevent complications that may occur.
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