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Desarrollo de un protocolo para el tratamiento de la cetoacidosis diabética euglicémica

Zulma Cardona¹, Jared G Friedman¹, Nevin Kamal¹

¹Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 530, Chicago, IL, 60611, USA.

Current diabetes reports

|September 3, 2025

Resumen

La cetoacidosis diabética euglicémica (euDKA), a menudo relacionada con los inhibidores de SGLT2, requiere tratamiento especializado. Un nuevo protocolo que utiliza la titulación fija de insulina y dextrosa mejora el manejo de la euDKA, abordando las limitaciones de los protocolos tradicionales de DKA.

Área de la Ciencia:

Endocrinología
Farmacología
Médico interno

Sus antecedentes:

La incidencia de cetoacidosis diabética euglicémica (euDKA) está aumentando con el uso de inhibidores del cotransportador de sodio-glucosa 2 (SGLT2i).
Los protocolos tradicionales de cetoacidosis diabética (DKA) son ineficaces para el euDKA debido a los niveles normales de glucosa.
Las directrices existentes no abordan específicamente la gestión de euDKA.

Objetivo del estudio:

Revisar los datos actuales sobre el euDKA.
Introducir un nuevo protocolo de gestión para euDKA.
Abordar los desafíos en el tratamiento de euDKA con medicamentos SGLT2i.

Principales métodos:

Revisión de la literatura de casos y resultados de euDKA.
Desarrollo e implementación de un protocolo de tratamiento estandarizado de euDKA en una unidad de cuidados intensivos.
El protocolo incluye la perfusión fija de insulina y la titulación del líquido que contiene dextrosa.

Principales resultados:

Los pacientes con euDKA experimentan estancias hospitalarias más largas y un cierre más lento de la brecha anional en comparación con los pacientes con DKA hiperglucémico.
El aumento de la prescripción de SGLT2i se correlaciona con un mayor riesgo de euDKA.
El nuevo protocolo ha sido aprobado y actualmente está en uso.

Conclusiones:

Un protocolo estandarizado para euDKA es necesario debido a los desafíos del tratamiento.
El protocolo desarrollado ofrece un enfoque específico para la gestión de euDKA.
Se necesita más investigación para evaluar la seguridad y la eficacia del protocolo en diferentes entornos.

Palabras clave:

DKA y sus derivados Cetoacidosis diabética y euglicémica El protocolo del hospital Infusión de insulina Inhibidor de la SGLT2

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