Diabetes ketone acid poisoning: risk of diabetes

Among the many complications of diabetes mellitus, DKA is like a hidden bomb that can pose a serious risk to the life and health of patients at any time. Insulin is severely under-insulin in the body, due to some of the triggers, and there is an inappropriate rise in lactose hormones, with patients showing clinical syndromes of high blood sugar, hyperketoneemia and metabolic acid poisoning. The mechanism for the occurrence of acid poisoning with diabetes is complex. As a rule, the human body uses glucose as the main source of energy, and glucose is metabolized into the cell as a result of insulin. However, when diabetes patients lack insulin, the situation changes dramatically. Insulin is insufficient and the intake and utilization of sugar in the outer-week tissue has declined, while the body has begun to decompose fat in order to acquire energy. Fatty acid derived from fat decomposition follows a series of oxidizing metabolisms in the liver and produces ketone bodies, including acethylacid, beta-hydroxybutyric acid and acethyl. The ketone is an acidic substance that increases with the formation of the ketone, and causes ketoneemia and metabolic acid poisoning (polymicacid) when its blood concentrations exceed the metabolic capacity of the body. A combination of factors can induce diabetes mellitus. Among these is one of the most common causes, such as respiratory infections, urinary system infections, gastrointestinal infections, etc., and respiratory infections. The infection has led to a state of stress in the organism, the insulin incubation of insulin, epinephrine, and the weakening of the role of insulin, which has contributed to an increase in blood sugar and to the formation of ketone, as well as irregular treatment of insulin, which is an important contributing factor. Some patients may reduce their own doses of insulin, suddenly interrupt insulin treatment, or use obsolete insulin, which causes a sharp decrease in insulin levels in the body, thus breaking the metabolic balance in the body and leading to diabetes ketoneic acid poisoning. In addition, acute diseases such as acute myocardial infarction, cerebrovascular accidents, and eating disorders such as severe consumption, excessive drinking of alcohol or excessive restrictions on carbohydrate intake may induce the disease. For a diabetic patient, insulin injections during a cold are reduced due to physical discomfort, and a few days later there were symptoms of nausea, vomiting and inactivity, which were diagnosed as diabetes ketone acid poisoning after a medical examination. Clinical performance has certain characteristics, and early patients have visible signs of overdrinking and urination, mainly as a result of increased blood sugar levels, leading to increased permeability. The gastrointestinal symptoms, such as reduced appetite, nausea, vomiting and abdominal pain, are then gradually emerging. These gastrointestinal symptoms can be misdiagnosed as gastrointestinal diseases, but are in fact the result of gastrointestinal disorders caused by ketone irritation of gastrointestinal mucous membranes and metabolic acid poisoning. The patient also suffers from a lack of strength and extreme thirst, and as the illness progresses, the mental state changes, evolving from irritation to infirmity, sleep addiction and even coma. Some patients can smell rotten apples because acetone is volatile and can be excreted through the respiratory tract, which is one of the typical signs of diabetes ketone acid poisoning. Patients may show signs of dehydration in terms of physical signs, including dry skin, reduced elasticity and eye dents. Respiration frequency increases as acid poisoning causes respiratory central irritation, with greater respiratory depth, the so-called KUSSMAUL breathing, helping to extricate excess carbon dioxide from the body. Severe patients may also experience circulatory failure, such as low blood pressure and increased heart rate, as a result of massive water loss, insufficient blood capacity and the inhibition of cardiovascular systems by acid poisoning. Diabetes ketone acidism is diagnosed mainly on the basis of patient clinical performance, test results, etc. Blood sugar increases significantly, generally between 16.7 and 33.3mmol/L, and even higher. Blood ketone is generally measured at 3.0mmol/L. The urine test is also positive. Arterial haematological analysis is metabolic acid poisoning, PH values are down, usually < 7.35, CO2 combined power is down and residual alkali negative values are up, in addition to electrolyte disorders, such as that of potassium, which may be normal or high at an early stage, but, as treatment takes place, potassium ion enters the cell in large quantities and levels of potassium blood may decline rapidly, and therefore the concentration of potassium blood will need to be closely monitored during the treatment to replenish the potassium blood in a timely manner. Regular blood tests may indicate an increase in white cell count, which may be related to infection or stress, but there may also be an increase in white cell count in the absence of infection, which needs to be carefully identified. The treatment of diabetic ketone acid poisoning is a race for “combat” with the principle of rehydration as soon as possible to restore blood capacity, correct water loss, reduce blood sugar, correct electrolyte and acid alkali balance disorders, and actively seek out and eliminate incentives to prevent complications. Rehydration is the first part of the treatment. The rapid dripping of physico-saline water after diagnosis and the rapid expansion of blood capacity correct dehydration and shock. Within the initial 1 to 2 hours, 1,000 to 2000 ml of liquid can be entered, and the speed and volume of rehydration can then be adjusted to the patient ' s dehydration, blood pressure, heart rate and urine. When the blood sugar drops to about 13.9mmol/L, it can be replaced by 5% glucose injection with insulin to continue intravenous dripping, to avoid low blood sugar, and to avoid brain oedema caused by too fast a decline in blood sugar. Insulin treatment is critical, usually using small doses of insulin to sustain intravenous drips, which can both effectively reduce blood sugar and avoid adverse effects due to overdoses of insulin, such as low sugar and low potassium. Short-acting insulin is usually dissolved into the physicosal water, with intravenous dripping at a rate of 0.1 U/kg per hour, and the dose of insulin adjusted to the rate of blood sugar decline. It is recommended that blood sugar drop to between 3.9 and 6.1 mmol/L per hour. Blood sugar needs to be closely monitored during treatment to prevent low blood sugar. The correction of electrolyte disorders is critical, especially for potassium supplementation. Since the patient may have a normal or high supposition of potassium blood prior to treatment, while potassium blood drops rapidly during insulin treatment and rehydration, potassium recharge should begin when potassium blood is below 5.5 mmol/L, and when the patient has urine, the potassium element should start to be replenished. Potassium supplementation is generally based on oral and intravenous combinations, and the rate of recharge and the amount of potassium recharge can be adjusted to the level of potassium blood. Light acid poisoning is generally self-corrected after rehydration, insulin treatment, and can be corrected without alkaline use. However, when pH is less than 7.1 or CO2 is less than 5mmol/L, sodium bicarbonate must be replenished with vein drops. In addition, there is a need to actively seek and treat incentives such as anti-infection treatment. In cases of complications, such as shock, heart disorder, cerebral oedema, etc., targeted treatment and monitoring are needed to improve the survival and quality of rehabilitation. The prognosis of diabetes ketone acid poisoning is closely related to the age of the patient, his or her basic state of health, the timeliness of treatment and the availability of complications. Early diagnosis and timely and effective treatment have resulted in a significant reduction in the rate of disease and death. However, if treatment is not timely or regular, the patient may die as a result of serious metabolic disorders, shock, cardiac disorders, cerebral oedema and other complications, or after-effects of the neurological system. Diabetes patients are treated with insulin in order to avoid the occurrence of diabetes ketone acidic poisoning, not to add, reduce, stop, but to be treated in strict accordance with medical instructions. The regular monitoring of indicators such as blood sugar, urea ketone and, in particular, infection, surgery, trauma and other stress, requires greater monitoring, vigilance, maintenance of good living habits, proper diet, adequate exercise, and active prevention of infection, in order to maintain the stability of blood sugar, avoid the “alert” of the danger of diabetes ketone acid poisoning and ensure the health of life.