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| UDK 616.379-008.64-06 | ISSN 0350-2899, 33(2008) br.3-4 p.106-114 | ||||||||||
| Review Acute hyperglycemic complications in diabetes mellitusAleksandar Aleksić (1), Željka Aleksić (2) |
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| Summary: Diabetes mellitus (DM) is a serious public health problem, especially because of rapidly increasing prevailance. According to the International Diabetes Federation (IDF) estimations, there were 194 mililion of diabetic people in the world in 2005. According to the annual report of the World Health Organization (WHO) of 1998, there were 135 million of diabetic people in the world in 1995, and this number is expected to increase to as many as 333 million in 2025. The expected increase of prevalence is due to population aging, incorrect nutrition, obesity and sedentary lifestyle. The increase in developed countries will be about 42% and in developing countries it is expected to be about 70%. Most of diabetic patients belong to DM type 2 (85%-95%). Acute hyperglycemic DM complications are the following: 1) diabetic ketoacidosis (DKA), 2) hyperglycemic hyperosmolar nonketogenic state (HHOS) and 3) lactic acidosis (LA). DKA is a severe metabolic disturbance of extremely nonregulated diabetes followed by absolute or relative insulin deficiency and demands urgent treatment. DKA incidence in developed countries is 1.6% and in poor countries, with worse diabetic care organization, the incidence can be up to 30%. DKA treatment consists of: restoration of fluid volume; insulin administration; electrolyte recovery and correction of acidobasis imbalances; identifying and treating of precipitating factors of DKA. HHOS is characterized by nearly ten times lower incidence than DKA, but with high mortality (30%-60%). It is more frequently found in older persons. By its definition, LA is metabolic acidosis due to increased production of lactic acid and decreased systemic pH. There is not much evidence on LA occurence. It is a rare event or it is rarely identified. During 1976 and 1979, only a hundred cases were reported worldwide. The mortality rate is very high, even up to 70%-80%. In conclusion, by timely made diagnosis and rapid and adequate treatment, along with good laboratory and technical support, treatment efficiency can be substantially improved in these states. Key words: diabetes mellitus, acute hyperglycemic complications, diabetic ketoacidosis, hyperglycemic hyperosmolar nonketogenic state, lactic acidosis Napomena: kompletan tekst rada na srpskom jeziku Note: full text in Serbian |
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Corresponding Address: Aleksandar Aleksić Zdravstveni centar Zaječar Rasadnička bb, 19000 Zaječar e-mail: lukaal@ptt.rs Paper received: 04.09.2008 Paper accepted: 21.12.2008 Published online: 26.01.2009 |
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