The principle of treatment of diabetic ketoacidosis is to replenish fluids as soon as possible in order to restore blood volume, correct the state of water loss, insulin hypoglycemia, correct the electrolyte and acid-base balance imbalance, and at the same time actively search for and eliminate the causative factors, prevention and treatment of complications, and proper nursing care to reduce the morbidity and mortality rate.
1. Rehydration: it is the key link of treatment. Only after the effective tissue perfusion is improved and restored, the biological effect of insulin can be brought into full play. The basic principle is “fast then slow, salt then sugar”.
2. Insulin therapy: Generally, small-dose (short-acting) insulin therapy is adopted. When the blood glucose drops to 13.9mmol/L, 5% glucose solution is input and insulin is added proportionally to stabilize the blood glucose level in a safer range. Transition to regular subcutaneous injection of insulin after stabilization.
3. Correct electrolyte and acid-base balance imbalance: severe acidosis affects cardiovascular, respiratory and neurological functions, and should be treated accordingly, and the indications of alkali supplementation are blood pH＜7.1, HCO3-＜5mmol/L.
4. Treatment of predisposing diseases and prevention of complications: pay attention to the prevention and treatment of important complications, especially cerebral edema and renal failure, and maintain the function of important organs.
5. Nursing care: good nursing care is an important part of rescuing DKA. The mouth and skin should be cleaned on time to prevent pressure sores and secondary infections. Observe the change of condition carefully, and record the state of mind, pupil size and reaction, vital signs, water in and out accurately.
Diabetic ketoacidosis is a serious acute complication of diabetes mellitus, which requires timely hospitalization to prevent life-threatening delays.