Infusion therapy in diabetes mellitus

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infusion therapy in diabetes mellituswith diabetes mellitus tactics of infusion therapy is chosen depending on the physical condition of the patient, and it consists of three stages.

the First phase treatment beginning with the introduction of saline intravenously during the first hour injected 1 liter of solution inkjet for 2, 3 and 4 hours 0.5 liters. Gradually, as the signs of dehydration, slow the rate of administration of solution until such time as the indicator of the level of glucose in blood plasma does not decrease to 16.7 mmol/l, and only the solution is to introduce a stop.

If you have the original hypokalemia plasma, the correction of its starting in 2 hours (but not earlier) since the start of infusion therapy: intravenous solution potassium chloride in certain doses.

Normalization KHS begins with the first stage of treatment when carrying out infusion therapy in combination with insulin therapy. Infusion is carried out in the first hour simultaneously with the introduction of saline solution: if pH < 7.0 intravenous 4% sodium bicarbonate solution. If you align the pH level to 7.0 introduction soda stopped and corrected potassium level.

the Second stage of treatment begins only after the decline of plasma glucose to the level of 16.7 mmol/L. the Patient to this point must be in mind. To avoid possible hypoglycemia introduction is carried out intravenously 5% glucose solution with the addition of 4 IU of insulin injected in one gram of glucose. The velocity in the reference should be about 200 ml/hour.

the Third stage is carried out in the specialized office. At this stage are subcutaneous insulin injection every 4-6 hours - time depends on the level of glucose in the blood. Each injection must be accompanied by ingestion of food that contains carbohydrates in an amount of not less than 50 g.

Infusion therapy at the third stage of treatment of diabetes can be reversed, and liquid take by mouth.

In the absence in a medical institution syringes machines use another method - fractional introduction of small doses of insulin. The principle of working doses of insulin same - an inkjet intravenously once per hour.

Almost nowhere is no longer used fractional introduction of high doses - this method of treatment in diabetes is considered obsolete, but in its Universities continue to study for the overall development (from the point of view of the consequences of using the method). In accordance with this method repeatedly injected large doses insulin, not paying proper attention to fluid therapy, and this has led, often enough, to hypoglycemia, hypokalemia, cerebral edema, and lactic acidosis, and as a result - death.