{"title":"A Life-Threatening Finding From Hypercoagulable States in DKA With Controversial Treatment.","authors":"Erika Y Reid","doi":"10.1097/TME.0000000000000581","DOIUrl":null,"url":null,"abstract":"<p><p>Diabetic Ketoacidosis (DKA) is a severe complication typically observed in individuals with type 1 diabetes, but it can also occur with type 2 diabetes under certain circumstances. It is characterized by insulin deficiency leading to hyperglycemia, ketosis, and metabolic acidosis, necessitating immediate medical intervention to prevent severe complications and possible death. This article presents a case report of a 76-year-old man with no prior history of diabetes who presented in DKA with a thrombotic complication at the emergency department. The vascular endothelium serves as a barrier against thrombosis but is also a primary target of hyperglycemia. The presence of high glucose levels triggers adverse intracellular processes, leading to endothelial dysfunction. Hyperglycemia and insulin resistance contribute to increased platelet sensitivity, coagulation factor abnormalities, and impaired fibrinolysis (Li et al., 2021). This article delves into the identification and treatment of DKA complicated by the pro-thrombotic state, presenting a contentious treatment approach.</p>","PeriodicalId":45446,"journal":{"name":"Advanced Emergency Nursing Journal","volume":"47 3","pages":"232-240"},"PeriodicalIF":1.0000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advanced Emergency Nursing Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/TME.0000000000000581","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/31 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Diabetic Ketoacidosis (DKA) is a severe complication typically observed in individuals with type 1 diabetes, but it can also occur with type 2 diabetes under certain circumstances. It is characterized by insulin deficiency leading to hyperglycemia, ketosis, and metabolic acidosis, necessitating immediate medical intervention to prevent severe complications and possible death. This article presents a case report of a 76-year-old man with no prior history of diabetes who presented in DKA with a thrombotic complication at the emergency department. The vascular endothelium serves as a barrier against thrombosis but is also a primary target of hyperglycemia. The presence of high glucose levels triggers adverse intracellular processes, leading to endothelial dysfunction. Hyperglycemia and insulin resistance contribute to increased platelet sensitivity, coagulation factor abnormalities, and impaired fibrinolysis (Li et al., 2021). This article delves into the identification and treatment of DKA complicated by the pro-thrombotic state, presenting a contentious treatment approach.
糖尿病酮症酸中毒(DKA)是一种严重的并发症,通常见于1型糖尿病患者,但在某些情况下也可能发生在2型糖尿病患者中。其特点是胰岛素缺乏导致高血糖、酮症和代谢性酸中毒,需要立即进行医疗干预,以防止严重并发症和可能的死亡。这篇文章提出了一个病例报告,76岁的男子没有糖尿病史谁提出了DKA与血栓性并发症在急诊科。血管内皮是防止血栓形成的屏障,但也是高血糖的主要目标。高血糖水平的存在会触发不良的细胞内过程,导致内皮功能障碍。高血糖和胰岛素抵抗会导致血小板敏感性升高、凝血因子异常和纤维蛋白溶解受损(Li et al., 2021)。本文深入探讨了鉴别和治疗DKA合并血栓形成前状态,提出了一个有争议的治疗方法。
期刊介绍:
Advanced Emergency Nursing Journal is a peer-reviewed journal designed to meet the needs of advanced practice clinicians, clinical nurse specialists, nurse practitioners, healthcare professionals, and clinical and academic educators in emergency nursing. Articles contain evidence-based material that can be applied to daily practice. Continuing Education opportunities are available in each issue. Feature articles focus on in-depth, state of the science content relevant to advanced practice nurses and experienced clinicians in emergency care. Ongoing Departments Include: Cases of Note Radiology Rounds Research to Practice Applied Pharmacology