Cetoacidosis normoglucémica en una embarazada
Euglycemic ketoacidosis is a condition defined as diabetic ketoacidosis with a bicarbonate level of less than 10 mEq/l, ketonemia or ketonuria, and glucose levels below 200 mg/dl. It accounts for at least 30% of presentations in diabetic ketoacidosis. We report a case of euglycemic ketoacidosis i...
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| Publicado en: | Revista Médica Universitaria |
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| Autores principales: | , , , , , |
| Materias: | |
| Acceso en línea: | https://bdigital.uncu.edu.ar/fichas.php?idobjeto=4574 |
| Sumario: | Euglycemic ketoacidosis is a condition defined as diabetic ketoacidosis with a
bicarbonate level of less than 10 mEq/l, ketonemia or ketonuria, and glucose levels
below 200 mg/dl. It accounts for at least 30% of presentations in diabetic
ketoacidosis. We report a case of euglycemic ketoacidosis in pregnant with the purpose to a point out this unusual type of diabetic acidosis and discuss the
pathogenic mechanism and treatment. Associated factors include excessive
vomiting, inadequate food intake, continued daily insulin dose and in some cases
pregnancy. Relative insulinopenia, accelerated liver glycogen depletion with
consequent reduction in liver glucose storages, together with the action of glucagon
and contrainsular hormones over lipolysis and gluconeogenesis are the key
mechanisms in the development of euglycemic ketoacidosis. The management of
this entity is different because it requires infusion with dextrose and high doses of
insulin to correct acidosis. It is relevant to emphasize that in patients with the
underlying conditions mentioned above, diabetic ketoacidosis should be considered
despite normal glucose levels. |
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