RISK FACTORS OF DEVELOPMENT AND WAY OF TIMELY IDENTIFICATION OF KETOACIDOTIC CONDITIONS IN DIABETES MELLITUS
Keywords:diabetes mellitus, ketonemia, ketonuria, facilities of determination
In the clinic of internal diseases, a doctor often has to deal with ketoacidotonic states, whose development in patients requires timely diagnosis and immediate medical interventions. Diabetic ketoacidosis (DKA) can occur with any type and variant of the course of diabetes mellitus (DM), both during manifestation and at different stages of the evolution of the disease. In labile current type 1 diabetes, as well as syndrome of chronic insulin overdose hypoglycemia alternate with hyperglycemia combined with ketosis. Both of these situations are caused by the releasing of contrinsular hormones in response to hypoglycemic stress. In patients with DM during pregnancy the risk of developing DFA increases by 40%. In DM type 2, DKA develops much less frequently, but it is more severe than in DM type 1. In recent years, ketosis-prone diabetes type 2 has been isolated. Being a manifestation of severe decompensation, DKA can cause a number of complications and, in the absence of timely treatment, represents a threat to the patient's life. One of the ways of prevention of DKA is the training of patients with DM self-control means. At present, a wide range of glucometers is available in Ukraine. The device of choice is GAMMA DIAMOND PRIMA, the main advantage of which is the user's ability to get information about raising the level of ketone bodies in the blood. The detection of ketonuria is also available using the Express Test test strips.
Gubs'kyj JuI. Biologichna himija, Kyi'v; Vinnycja, 2011: 656 p.
Luk'janchikov VS. RMZh 2004; 12 (23): 1301-1305.
Georgijanc MA. Medicina Neotlozhnyh Sostojanij 2006; 5(4): 82-84.
Mozhina TL. Ostrye i neotlozhnye sostojanija v praktike vracha 2010; 3: 52-56.
Tihonova TM. Saharnyj Diabet 2014; 1: 15-20.
Duca LM, Wang B, Rewers M, Rewers A. Diabetes Care 2017; 40(9): 1249-1255. https://doi.org/10.2337/dc17-0558.
Thawabi M, Studyvin S. N Am J Med Sci 2015; 7(6): 291-294. https://doi.org/10.4103/1947-2714.157490.
Makarenko MV, Govsєєv DO, Gulam JaM, et al. Zdorov'e Zhenshhiny 2016; 1(107).
Kamalakannan D, Baskar V, Barton DM, Abdu TA. Postgraduate Med J 2003; 79(934): 454-457.
Carroll MA, Yeomans ER. Crit Care Med 2005; 33(10): S347-S353.
Barski L, Nevzorov R, Jotkowitz A, et al. Am J Med Sci 2013; 345(4): 326-330. https://doi.org/10.1097/MAJ.0b013e31827424ab.
Zhu B, Bu L, Zhang M, et al. Sci Rep 2016;6: 39687. https://doi.org/10.1038/srep39687.
Tuomi T, Santoro N, Caprio S, et al. Lancet 2014; 383 (9922): 1084-1094. https://doi.org/10.1016/S0140-6736(13)62219-9.
Colloby M. J Diab Nurs 2014; 18(9): 352-360.
Smiley D, Chandra P, Umpierrez GE. Diabetes Manag (Lond) 2011; 1(6): 589-600.
Smolenski S, George NM. J Am Assoc Nurse Pract 2019. https://doi.org/10.1097/JXX.0000000000000183.
Gosmanov AR, Gosmanova EO, Dillard-Cannon E. Diabetes Metab Syndr Obes 2014;7: 255-264. https://doi.org/10.2147/DMSO.S5051