• Title/Summary/Keyword: 당뇨병성 케톤산증

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당뇨병 돋보기 II-당뇨병성 급성 합병증-케톤산증

  • Hong, Ji-Yeong
    • The Monthly Diabetes
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    • s.214
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    • pp.35-37
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    • 2007
  • 당뇨병환자에서 발생하는 가장 중요한 급성 합병증인 당뇨병성 케톤산증이나 고삼투성 비케톤성 혼수는 인슐린의 투여를 중단하였거나 감염, 외상 등의 신체적 손상이나 정신적 스트레스에 의하여 인슐린에 대한 길항 호르몬들이 과분비돼 발생한다. 일반적으로 당뇨병성 케톤산증은 인슐린 의존형 당뇨병환자 중 주로 젊은 층에서 자주 나타나며 병의 경과가 빠르게 진행되기 때문에 고삼투압 상태보다는 케톤산혈증이 주요 문제가 된다. 반면에 고삼투압성 비케톤성 혼수는 인슐린 비의존형 당뇨병환자 중 주로 노인층에서 호발하며 병의 경과가 서서히 진행하기 때문에 심한 고혈당 상태로 인한 고삼투압 상태가 주요 문제가 된다. 이와같은 당뇨병의 급성 대사성 합병증들은 치료가 지연되거나 적절한 치료가 행해지지 못했을 때는 예후가 극히 불량하며 사망률 또한 높은 것으로 보고되고 있다. 이에 급성 대사성 합병증 중 당뇨병성 케톤산증의 병인, 진단 및 치료 등을 알아보기로 한다.

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A Patient with Mitochondrial Myopathy who Experienced Diabetic Ketoacidosis with Auto-antibody (사립체 근병증 환자에서 발생한 자가항체 양성의 당뇨병성 케톤산증 1례)

  • Nam, Soon Young;Huh, Rimm;Kwun, Younghee;Lee, Jieun;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.2
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    • pp.191-194
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    • 2014
  • Mitochondrial myopathy results from a primary dysfunction of the respiratory chain and is frequently accompanied with endocrine manifestations. Among the endocrine manifestations of mitochondrial disease, diabetes mellitus is relatively common. Diabetes mellitus in the mitochondrial myopathy is usually insulin dependent due to the defect in insulin secretion resulted from mitochondrial dysfunction. But it is seldom manifested as diabetes ketoacidosis and doesn't usually have an auto-antibody. We report a patient with mitochondrial myopathy who was diagnosed as having diabetes mellitus by presenting as diabetes ketoacidosis and had both of the auto-glutamic acid decarboxylase (GAD) antibody and anti-insulin auto-antibody.

A Case Report of a Patient Diagnosed with Diabetic Ketoacidosis Accompanied by Hyperammonemia from Systemic Inflammation (고암모니아혈증을 동반한 전신성 염증으로 인한 당뇨병성 케톤산증 환자 치험 1례)

  • Jang, Hansol;Chung, U-ryeong;Jung, Seung-hyun
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.283-293
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    • 2022
  • A 42-year-old male patient with prolonged throat pain and discomfort, dry mouth, and general weakness and recently diagnosed with tonsillitis, pulmonary embolism, and venous thrombosis was admitted to the internal Korean medicine department. A sudden onset of diabetic ketoacidosis with hyperammonemia was diagnosed on the second day of treatment. During admission, the patient received insulin therapy, hydration, and traditional Korean medicine treatment, including herbal medicine. Subjective symptom change was evaluated daily and blood glucose level checked five times per day. At discharge, the patient's fasting and postprandial blood sugar levels were adequate. After an additional two weeks of herbal treatment, the symptoms were significantly ameliorated. Thus, having been admitted with dysregulated glucose metabolism leading to a hyperglycemic crisis after a series of inflammatory events, the patient showed symptomatic improvements and decreased blood glucose after 18 days of hospitalization and treatment.

A case of Diabetic Ketoacidosis (당뇨병성 케톤산증 1례)

  • Byun, Sang-Hyuk;Kwon, Young-Gu;Ahn, Young-Min;Ahn, Se-Young;Doo, Ho-Kyung;Choi, Ki-Lim
    • The Journal of Internal Korean Medicine
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    • v.23 no.1
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    • pp.141-145
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    • 2002
  • Diabetic Ketoacidosis(DKA), one of acute complications of diabetes mellitus(DM) occurs mostly in insulin dependent diabetes mellitus (IDDM) patients. Its clinical symptoms are hyperglycemia, ketonemia or ketonuria, metabolic acidosis, etc. The interaction of lack of insulin, excessive secretion of insulin antagonic hormone and dehydration cause body fluid loss and electrolyte, typical symptom of DKA as polyuria, polydipsia, nausea, vomiting, abdominal pain occur. As a result, prompt supply of fluid and insulin by intravenous injection should be conducted for treatment. It is still an emergent disorder whose mortality is still 10 to 15%, though is has decreased compared to the past. We treated a female patient who has DKA, had withdrawn insulin pump therapy. We report a case of DKA with a brief review of related literatures.

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Diabetic ketoacidosis with pulmonary thromboembolism (당뇨병성 케톤산증에서 발생한 폐혈전색전증)

  • Kim, Dong Min;Lee, Jeonghun;Nam, Soo Min;Lee, Yeon Sun;Moon, Hee;Lee, Kang-Woo;Jang, In Wook
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.99-102
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    • 2014
  • Diabetic ketoacidosis (DKA), a fatal acute diabetic complication, is characterized by severe metabolic decompensation and intravascular volume depletion. These conditions may result in hypercoagulability and prothrombic state. Pulmonary thromboembolism (PTE) could be presented as an uncommon and life-threatening complication of DKA. Reported herein is a case involving a 54-year-old male patient who was admitted with DKA due to chronic alcohol consumption and stopping the intake of oral antidiabetic drugs. After low-molecular-weight heparin and warfarin treatment because of PTE during the DKA treatment, the patient's condition improved over the week that he was discharged on insulin and warfarin.