Postoperative Transition from Euglycemic Diabetic Ketoacidosis to Diabetic Ketoacidosis: A Case Report  

作　　者：Dan Cao Li Shi Piao Chen Wenhao He Dan Cao;Li Shi;Piao Chen;Wenhao He(State Key Laboratory of Oncology in South China, Guangzhou, China;Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China;Department of Breast Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China;Department of Nursing, Sun Yat-sen University Cancer Center, Guangzhou, China)

机构地区：[1]State Key Laboratory of Oncology in South China, Guangzhou, China [2]Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China [3]Department of Breast Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China [4]Department of Nursing, Sun Yat-sen University Cancer Center, Guangzhou, China

出　　处：《Journal of Diabetes Mellitus》2024年第4期183-193,共11页糖尿病（英文）

摘　　要：Objective: This study aims to analyze the causes of postoperative transition from euglycemic diabetic ketoacidosis (EDKA) to diabetic ketoacidosis (DKA), summarize clinical nursing experiences, enhance the recognition and management of such complications, and improve patient prognosis. Methods: A detailed case analysis was conducted on a patient who developed EDKA early after breast cancer surgery, which subsequently transitioned to DKA. A multidisciplinary team (MDT) consultation was employed to formulate a personalized nursing plan. Specific methods included comprehensive clinical data collection, monitoring of blood glucose, urine ketones, and blood ketone levels;implementing dynamic insulin adjustment strategies;providing dietary education and psychological support;and guiding dietary adjustments through nutritional consultations. Results: Through personalized observation, blood glucose management, dietary management, psychological care, and wound care, the patient’s blood and urine ketone levels returned to normal, the flap healed well, and blood glucose was maintained within the normal range. The patient is currently undergoing postoperative adjuvant chemotherapy. Conclusion: For postoperative patients with unexplained nausea, vomiting, and dehydration, regardless of diabetes history, timely testing of blood glucose, blood ketones, blood urea nitrogen, creatinine, electrolytes, and blood gas analysis can facilitate early detection of EDKA. Additionally, personalized management of blood glucose, diet, psychological care, and wound care is crucial for the prevention and treatment of EDKA.Objective: This study aims to analyze the causes of postoperative transition from euglycemic diabetic ketoacidosis (EDKA) to diabetic ketoacidosis (DKA), summarize clinical nursing experiences, enhance the recognition and management of such complications, and improve patient prognosis. Methods: A detailed case analysis was conducted on a patient who developed EDKA early after breast cancer surgery, which subsequently transitioned to DKA. A multidisciplinary team (MDT) consultation was employed to formulate a personalized nursing plan. Specific methods included comprehensive clinical data collection, monitoring of blood glucose, urine ketones, and blood ketone levels;implementing dynamic insulin adjustment strategies;providing dietary education and psychological support;and guiding dietary adjustments through nutritional consultations. Results: Through personalized observation, blood glucose management, dietary management, psychological care, and wound care, the patient’s blood and urine ketone levels returned to normal, the flap healed well, and blood glucose was maintained within the normal range. The patient is currently undergoing postoperative adjuvant chemotherapy. Conclusion: For postoperative patients with unexplained nausea, vomiting, and dehydration, regardless of diabetes history, timely testing of blood glucose, blood ketones, blood urea nitrogen, creatinine, electrolytes, and blood gas analysis can facilitate early detection of EDKA. Additionally, personalized management of blood glucose, diet, psychological care, and wound care is crucial for the prevention and treatment of EDKA.

关 键 词：Breast Cancer Diabetic Ketoacidosis (DKA) Euglycemic Diabetic Ketoacidosis (EDKA) Blood Glucose Nursing Care 

分 类 号：R58[医药卫生—内分泌]