References

zabmedvestnik

Забайкальский медицинский вестник

Transbaikalian Medical Bulletin

1998-6173

Читинская государственная медицинская академия

10.52485/19986173_2021_2_85

zabmedvestnik-73

Research Article

НАУЧНЫЕ ОБЗОРЫ

SCIENTIFIC REVIEWS

ДИАБЕТИЧЕСКИЙ КЕТОАЦИДОЗ У ДЕТЕЙ И ПОДРОСТКОВ: ОТ ПАТОФИЗИОЛОГИИ ДО ПРОФИЛАКТИКИ

DIABETIC KETOACIDOSIS IN CHILDREN AND ADOLESCENTS: FROM PATHOPHYSIOLOGY TO PREVENTION

Быков

Ю. В.

Bykov

Yu. V.

355017, г. Ставрополь, ул. Мира, 310

355017, Stavropol, Mira str., 310

Федеральное государственное бюджетное образовательное учреждение высшего образования «Ставропольский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияStavropol State Medical UniversityRussian Federation

2021

31072024

028595

2024

Быков Ю.В.

Bykov Y.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.zabmedvestnik.ru/jour/article/view/73

Заболеваемость сахарным диабетом 1 типа у детей растет по всему миру. Диабетический кетоацидоз – одно из самых распространенных осложнений данного заболевания, с высоким процентом госпитализаций и смертностью. Половина детей с впервые выявленным сахарным диабетом 1 типа имеет клинические проявления этого осложнения. К факторам риска, которые приводят к диабетическому кетоацидозу на фоне сахарного диабета относят социальные и экономические факторы, нарушение режима инсулинотерапии, инфекционные заболевания. Метаболический ацидоз на фоне гипергликемии, глюкозурии и гипогликемии, с образованием большого количества кетоновых тел, лежит в основе патофизиологического механизма данного состояния. Диагностика диабетического кетоацидоза осуществляется на основании четких клинических и диагностических критериев. Терапевтическая тактика при данном осложнении должна основываться на четком лечебном алгоритме, который имеет свои особенности в педиатрической практике и включает: инфузионную терапию, внутривенную инсулинотерапию, профилактику и лечение отека головного мозга, коррекцию гипокалиемии. Профилактические мероприятия при диабетическом кетоацидозе имеют важное терапевтическое значение, которые могут снижать процент возникновения данного осложнения у детей и подростков.

The incidence of type 1 diabetes in children is on the rise worldwide. Diabetic ketoacidosis is one of the most common complications of this disease, with a high hospital admission rate and high mortality. Half of children with newly-diagnosed type 1 diabetes mellitus have clinical signs of this complication. The list of risk factors linked to the development of diabetic ketoacidosis in patients with diabetes mellitus comprises social and economic factors, violation of the insulin treatment regimen, and infectious disease. The pathophysiological mechanism of this condition is rooted in the development of metabolic acidosis in the setting of hyperglycemia, glucosuria and hypoglycemia, coupled with the generation of a large number of ketone bodies. Diagnosis of diabetic ketoacidosis is based on clear clinical and diagnostic criteria. In case of this complication, the therapeutic tactics must be based on a clear treatment algorithm, which has its own distinctive aspects in pediatric practices, and includes infusion therapy, intravenous insulin therapy, prevention and treatment of cerebral edema, and correction of hypokalemia. Of great therapeutic importance are measures aimed at prevention of diabetic ketoacidosis, which may reduce the incidence of this complication in children and adolescents.

сахарный диабетдиабетический кетоацидоздетипатогенезлечениепрофилактика

diabetes mellitusdiabetic ketoacidosischildrenpathogenesistreatmentprevention

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The authors declare that there are no conflicts of interest present.