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Differential diagnosis of a ketoatsidotichesky and hypoglycemic coma at children

Ketoatsidotichesky coma

Hypoglycemic coma

Reasons

Late diagnosis of a diabetes mellitus

Insulin overdose

Insufficient dose of insulin;

Disturbance of a diet (hyponutrient, admission of meal)

Disturbance of a diet (abuse of fats, carbohydrates)

Labile course of a disease

Intercurrent disease

Big exercise stress
Associated diseases with vomiting and a diarrhea

Development

Prodrome phase — a prekomatozny state

Fast development

 

Gradual loss of consciousness

Fast loss of consciousness

Symptoms

Dryness and cyanosis of skin and mucous  membranes

Pallor and perspiration

Language dry

Language is wet

Hypotonia of muscles

Muscle tension, lockjaw of masseters

The tone of eyeglobes is lowered.

Tone of eyeglobes normal.

There are no spasms

Spasms

Kussmaul's breath

 Normal respiration

Pulse is frequent, weak filling

Tachycardia, sometimes bradycardia

Lack of appetite, nausea, vomiting

At the beginning of development of a hypoglycemia appetite increase is noted

Sometimes abdominal syndrome

The abdominal syndrome does not happen

Acetone smell in expired air

There is no acetone smell in expired air

Hyperglycemia

Hypoglycemia (but there can be a norm and even, a hyperglycemia)

Giperketonemiya

Giperketonemiya is absent

Falling of reserve alkalinity of blood

Reserve alkalinity of blood normal

Acetonuria and glycosuria

Acetonuria and a glycosuria is not present

 
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