以严重糖尿病酮症酸中毒为初发表现的年轻超重/肥胖2型糖尿病4例报道及文献复习

来源 :中国糖尿病杂志 | 被引量 : 0次 | 上传用户:guoyafeigood
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目的提高对DKA为初发表现的年轻、超重/肥胖T2DM患者的认识,并探讨减少此种急症的措施。方法回顾性分析4例以DKA为首发表现的年轻、超重/肥胖T2DM患者的临床特点并复习相关文献。结果 4例患者均为年轻男性(年龄14~31岁),有糖尿病家族史、长期大量饮用碳酸饮料的不良饮食史,长期超重/肥胖,均为急性起病(病程8~14 d),以DKA(pH 7.00~7.16)为首发表现,入院时胰岛功能差(FC-P 269.2~469.6 pmol/L),经治疗后胰岛功能迅速恢复,此后以生活方式干预联合二甲双胍治疗,血糖控制良好(HbA_1 c 5.5%~6.3%)。结论在超重/肥胖的青少年人群中(特别是有糖尿病家族史)应积极筛查糖尿病,以减少DKA及其他糖尿病慢性并发症发生。 Objective To raise awareness of young, overweight / obese T2DM patients with DKA as a first manifestation and to explore ways to reduce such emergencies. Methods The clinical features of 4 cases of young, overweight / obese T2DM with DKA as the first manifestation were reviewed retrospectively. Results All the 4 patients were young men (aged 14-31) with a family history of diabetes, a long history of poor dietary intake of carbonated drinks, and long-term overweight / obesity. All were acute onset (duration 8 to 14 days) DKA (pH 7.00 ~ 7.16) was the first manifestation. The function of islets was poor at admission (FC-P 269.2 ~ 469.6 pmol / L), and the islet function recovered quickly after treatment. After that, lifestyle interventions with metformin and good glycemic control c 5.5% ~ 6.3%). Conclusion In overweight / obese adolescents (especially family history of diabetes), diabetes should be actively screened to reduce the incidence of DKA and other chronic complications of diabetes.
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