How to rescue diabetic lactic acidosis and how to prevent diabetic lactic acidosis?

Prevention of diabetic lactic acidosis: actively ** various diseases that induce lactic acidosis. For diabetic patients, those with diabetes mellitus combined with kidney disease, liver and kidney insufficiency, age over 70 years old, and those with poor cardiopulmonary function should avoid biguanides, and even prohibit phenformin.

Eat properly and abstain from alcohol.

If lactic acidosis occurs, patients with mild lactic acidosis should drink water quickly to facilitate the excretion of lactic acid, and at the same time take an appropriate amount of alkaline drugs such as sodium bicarbonate, and the specific dosage should be carefully followed by the doctor. Patients with moderate and severe disease should be sent to the hospital for diagnosis in time to avoid delaying the condition.

Diabetes mellitus with lactic acidosis has a low incidence but a high mortality rate. It is mainly due to the accumulation of lactic acid, a sugar metabolite of anaerobic digestion in the body, resulting in hyperlactic acidemia, and further decreased blood pH, which is lactic acidosis. Most of them occur in patients with hypoxic diseases such as hepatic or renal insufficiency or chronic cardiopulmonary insufficiency, especially those taking phenformin.

1) Clinical manifestations.

Fatigue and weakness, anorexia, nausea or vomiting, deep breathing, drowsiness, etc. Most have a history of taking biguanides.

2) Laboratory tests.

Significant acidosis, but no elevated blood and urine ketones, and elevated blood lactate levels.

c). Rescue should be carried out aggressively. **Includes rehydration, volume expansion, correction of dehydration, and shock. Alkali replacement should be done as early and as sufficient. Dialysis** if necessary to remove precipitating factors.

4) Prevention. Strictly grasp the indications of biguanides, especially phenformin, and contraindicate the use of biguanides in patients with liver and kidney insufficiency, chronic hypoxic cardiopulmonary diseases and poor general condition. The incidence of lactic acidosis due to metformin is much lower than that of phenformin, so metformin is recommended for patients who require biguanides** whenever possible.

1.Timely detection and **, and oxygen inhalation if necessary.

2.Rehydration volume expansion improves tissue perfusion, corrects shock, and diuretic acid excretion. With normal saline, avoid lactic acid-containing preparations.

3.Alkali is supplemented with 5% sodium bicarbonate, and the alkali infusion is stopped when the pH is > to avoid alkalosis.

4.Insulin Insulin is added to glucose solution intravenously to reduce anaerobic digestion of sugars and facilitate the elimination of blood lactate.

5.Hemodialysis is often used in patients with sodium and water retention.

Hello: There are several ways to do this:1

Timely detection and **, and oxygen inhalation if necessary. 2.Rehydration volume expansion improves tissue perfusion, corrects shock, and diuretic acid excretion.

With normal saline, avoid lactic acid-containing preparations. 3.Alkali supplementation:

5% sodium bicarbonate, stop the alkali infusion at pH to avoid alkalosis. 4.Insulin:

Insulin is added to glucose solution intravenously to reduce anaerobic digestion of sugars.