Читать книгу The Diabetes Ready Reference for Health Professionals - Kathryn Mulcahy - Страница 8

HOSPITAL ADMISSION GUIDELINES

I. ACUTE METABOLIC COMPLICATIONS OF DIABETES

A. Diabetic ketoacidosis (DKA)

1. Plasma glucose >250 mg/dl (>13.9 mmol/l) with arterial pH <7.30 and serum bicarbonate level <15 mEq/l and moderate ketonuria and/or ketonemia

B. Hyperosmolar hyperglycemic state (HHS): Impaired mental status and elevated plasma osmolality in a patient with hyperglycemia. Usually includes

1. Severe hyperglycemia (e.g., plasma glucose >600 mg/dl [>33.3 mmol/l]) and

2. Elevated serum osmolality (e.g., >320 mOsm/kg [>320 mmol/kg])

C. Severe hypoglycemia with neuroglycopenia

Blood glucose <50 mg/dl (<2.8 mmol/l) and the treatment of hypoglycemia has not resulted in prompt recovery of sensorium

OR

coma, seizures, or altered behavior (e.g., disorientation, ataxia, unstable motor coordination, dysphasia) due to documented or suspected hypoglycemia

II. UNCONTROLLED DIABETES

A. Admission justified when necessary to determine cause and start corrective action. Documentation should include at least one of the following:

1. Hyperglycemia associated with volume depletion

2.