Garg Sunil K, Garg Pragya
Department of Critical Care, NMC Healthcare, Dubai, United Arab Emirates.
Indian J Crit Care Med. 2021 Oct;25(10):1203-1204. doi: 10.5005/jp-journals-10071-23988.
It is important to differentiate between diabetic ketoacidosis (DKA) and alcoholic ketoacidosis (AKA) in an alcoholic diabetic patient since it has significant management implications. Ketoacidosis in an alcoholic diabetic patient is a diagnostic challenge as both these clinical entities have metabolic acidosis with high anion gap. Most patients with DKA have hyperglycemia. The majority of AKA patients present with normal or low glucose levels; however, AKA may also present with high glucose levels, more so in diabetics. The situation becomes quite perplexing when an alcoholic diabetic patient presents with hyperglycemia since it can be attributed to DKA or AKA. Garg SK, Garg P Differential Diagnosis of Ketoacidosis in Hyperglycemic Alcoholic Diabetic Patient: Role of Insulin. Indian J Crit Care Med 2021; 25(10):1203-1204.
对于患有糖尿病的酗酒患者,区分糖尿病酮症酸中毒(DKA)和酒精性酮症酸中毒(AKA)很重要,因为这对治疗有重大影响。糖尿病酗酒患者的酮症酸中毒是一个诊断难题,因为这两种临床情况都存在高阴离子间隙代谢性酸中毒。大多数DKA患者有高血糖。大多数AKA患者血糖水平正常或偏低;然而,AKA患者也可能血糖水平偏高,糖尿病患者中更是如此。当糖尿病酗酒患者出现高血糖时,情况就会变得相当棘手,因为这可能是由DKA或AKA引起的。加尔格·S·K,加尔格·P《高血糖酒精性糖尿病患者酮症酸中毒的鉴别诊断:胰岛素的作用》。《印度危重症医学杂志》2021年;25(10):1203 - 1204。