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糖尿病酮症酸中毒与高渗性非酮症性昏迷,两者均可有高血糖症。但对为什么酮症酸中毒的血糖浓度往往要比高渗性非酮症性昏迷低,这个问题仍不能作满意的解释。两者胰高血糖素同样增高,按理在酮症酸中毒时胰岛素最缺乏,血糖应最高。 首先,我们应认识到,老年性糖尿病发生酮症酸中毒,血糖往往很高,有时与高渗性昏迷一样。与Ⅰ型胰岛素依赖性糖尿病迅速发生酮症酸中毒不同,老年患者在发生这两种综合征时,临床过程延长,导致非常严重的脱水。严重脱水本身可引起明显高血糖。其次两者血糖的显著差异,还有两种可能因素起着重要的作用。
Diabetic ketoacidosis and hyperosmolar nonketotic coma, both of which may have hyperglycemia. But why the ketoacidosis blood glucose concentration is often lower than hypertonic non-ketotic coma, this problem can not be satisfactorily explained. The same two glucagon increased, according to the theory of ketoacidosis most insulin deficiency, blood glucose should be the highest. First, we should recognize that ketoacidosis in senile diabetes mellitus, which is often high in blood sugar, is sometimes the same as hypertonic coma. In contrast to the rapid onset of ketoacidosis in type 1 insulin-dependent diabetes mellitus, older patients develop an extended clinical course of both syndromes, leading to very severe dehydration. Severe dehydration itself can cause significant hyperglycemia. Second, the significant difference between the two blood glucose, there are two possible factors play an important role.