On February 26, a diabetic patient measured his blood sugar at home and found that his blood sugar had soared, and then increased the dose of medication by himself, but he did not want to cause acute kidney failure.
85-year-old Grandma Zhang is a type 2 diabetic patient, although she suffers from chronic diseases, she has a good sense of health, not only takes regular medication every day, but also maintains the habit of monitoring her blood sugar levels. Since a few months ago, Grandma Zhang felt that the effect of blood sugar control was not good, and her fasting blood sugar and postprandial blood sugar were significantly high, and she once had a fasting blood sugar of more than 10mmol L and a blood sugar of more than 20mmol L two hours after a meal.
Thinking that it was because the dosage was not enough, Grandma Zhang changed the hypoglycemic drug metformin, which she took three times a day and one tablet at a time, to three times a day and two tablets at a time. Unexpectedly, on February 18, Grandma Zhang was weak and in a trance, and then began to slurred words and babble nonsense. Subsequently, accompanied by her family, Grandma Zhang came to the Gutian Campus of Wuhan Fourth Hospital for treatment. After coming to the hospital, Grandma Zhang's blood creatinine rose to 3537 (umol l), a sudden and sharp deterioration of kidney function. Based on her symptoms and the results of blood tests, the medical staff judged that she had severe metabolic acidosis and hyperkalemia, and that she was one step away from hemodialysis.
In the outpatient clinic of nephrology in the Gutian branch of the hospital, the attending doctor Du Xingguo inquired about Grandma Zhang's medical history in detail and completed the relevant examinations for her. It is understood that Grandma Zhang has a history of chronic renal insufficiency, coupled with drug overdose, which led to her acute renal failure and severe metabolic acidosis. Combined with the results of the examination, Du Xingguo changed the hypoglycemic drugs for Grandma Zhang, and treated the symptoms**. After a week, the old man's blood creatinine gradually decreased, and his consciousness gradually became clear.
Wei Honglan, head of the nephrology ward of the Gutian branch of the hospital, said that the causes of acute renal failure are pre-renal, renal and post-renal, and Grandma Zhang may be due to acute renal interstitial injury caused by drug overdose, causing acute renal failure. Wei Honglan reminded that for patients with type 2 diabetes, especially those with kidney disease, oral hypoglycemic drugs need to be cautious, and the dosage of drugs must be carefully adjusted under the guidance of professional physicians, and do not use drugs at home to avoid life-threatening drugs. (Yangtze River ** reporter Wang Kaining, correspondent Ren Weirong, Hong Zhixuan).
Editor: Yu Lina].
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