How Do I Deal With Diabetes Nausea?

Diabetic lactic acidosis is a clinical syndrome caused by abnormal biochemical changes in blood lactate and pH decrease (<7.35) caused by different causes, with severe consequences and high mortality.

Basic Information

English name: diabetic lactic acidosis
Visiting department: Endocrinology

Multiple groups: Diabetics
Common symptoms: Weakness, nausea, vomiting, headache, dizziness, etc. In severe cases, even deep coma or shock

Causes of diabetic lactic acidosis

1. Diabetic patients often have pyruvate oxidation disorders and lactic acid metabolism defects, so there is usually hyperlactic acidemia.

2. Acute complications of diabetes, such as infection, ketoacidosis, hyperglycemia and hypertonic state, can cause lactic acid accumulation. Induced lactic acidosis. Lactic acidosis can coexist with ketoacidosis.

3. The combined heart, liver and kidney diseases of diabetic patients cause poor perfusion of tissues and organs, and hypoxemia; patients with increased levels of glycated hemoglobin and decreased hemoglobin oxygen carrying capacity are more likely to cause local hypoxia and increase lactic acid production; in addition, liver and kidney dysfunction Affects the metabolism, transformation and excretion of lactic acid, which leads to lactic acidosis.

Clinical manifestations of diabetic lactic acidosis

Diabetic lactic acidosis is acute, but the symptoms and signs are not specific.

Mild: Only fatigue, nausea, decreased appetite, dizziness, drowsiness, and slightly deeper breathing.

Moderate to severe: nausea, vomiting, headache, dizziness, tenderness of the whole body, cyanosis of lips, deep breathing, but no ketone, decreased blood pressure, weak pulse, fast heart rate, dehydration, disturbance of consciousness, weakened limb reflex, Decreased muscle tone, dilated pupils, deep coma, or shock.

Diabetic lactic acidosis test

1. History and symptoms

It is common in diabetic patients who take a lot of biguanide drugs, who are complicated by infection, sepsis, and chronic heart, lung, liver, and kidney diseases. They also easily cause increased lactic acid production and metabolic disorders; the main symptoms are nausea, vomiting, diarrhea .

2. Medical examination

Low body temperature, deep and large breathing, flushed skin, decreased blood pressure, shock, and disturbance of consciousness.

3. Auxiliary inspection

Increased blood lactic acid (> 5mmol / L), blood pH <7.35, anion gap> 18mmol / L, NaHCO ₃ <20mmol / L.

Diagnosis of diabetic lactic acidosis

Diagnosis can be made based on the cause, clinical manifestations, and laboratory tests.

Treatment of diabetic lactic acidosis

1. Find and treat in time, and inhale oxygen if necessary.

2. Rehydration and expansion can improve tissue perfusion, correct shock, diuretic and acid discharge. Use physiological saline and avoid preparations containing lactic acid.

3. Supplement alkali 5% sodium bicarbonate, stop the alkali infusion when PH> 7.25, so as to avoid alkali poisoning.

4. Insulin Insulin is added to glucose intravenously to reduce the anaerobic fermentation of sugars, which is beneficial to the elimination of blood lactic acid.

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