PDF(Pubmed)
Abstract：
Diabetic ketoacidosis (DKA) is a life-threatening condition affecting individuals with diabetes characterised by hyperglycaemia, metabolic acidosis and ketonemia. The incidence and financial burden of DKA is still high. Thiamine deficiency is well documented in patients with DKA and could be associated with cardiac dysfunction in those patients. Thiamine deficiency leads to cardiac dysfunction, neuronal death and worsens the prognosis of DKA. There is an existing metabolic relationship between thiamine deficiency in diabetes, obesity and bariatric surgery. Careful monitoring of thiamine, along with other vitamins, is essential for diabetic patients, obese individuals and postbariatric surgery. Further research and clinical studies are urgently needed to assess the following: (1) Whether diabetes, obesity and bariatric surgery make individuals more prone to have DKA related to thiamine deficiency and (2) Whether supplementation of thiamine can protect diabetic patients, obese subjects and individuals undergoing bariatric surgery from DKA. This review summarises the biochemistry of thiamine and the existing metabolic relationships between thiamine deficiency in DKA, diabetes, obesity and bariatric surgery. Primary and family physicians have an important role in ensuring adequate replacement of thiamine in individuals with diabetes, obesity and bariatric surgery.
摘要：
糖尿病酮症酸中毒（DKA）是一种危及生命的疾病，影响以高血糖为特征的糖尿病患者，代谢性酸中毒和酮症。DKA的发病率和经济负担仍然很高。硫胺素缺乏症在DKA患者中有很好的记录，并且可能与这些患者的心脏功能障碍有关。硫胺素缺乏导致心脏功能障碍,神经元死亡并恶化DKA的预后。糖尿病中硫胺素缺乏之间存在代谢关系，肥胖和减肥手术。仔细监测硫胺素，以及其他维生素，对糖尿病患者至关重要，肥胖者和减肥后手术。迫切需要进一步的研究和临床研究来评估以下内容：(1)是否糖尿病，肥胖和减肥手术使个体更容易发生与硫胺素缺乏相关的DKA；（2）补充硫胺素是否可以保护糖尿病患者，肥胖受试者和接受DKA减肥手术的个体。这篇综述总结了硫胺素的生物化学以及DKA中硫胺素缺乏之间的现有代谢关系。糖尿病,肥胖和减肥手术。初级和家庭医生在确保糖尿病患者充分替代硫胺素方面发挥着重要作用。肥胖和减肥手术。
