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Hyperglykämische Krise bei Patienten mit Diabetes mellitus

Hyperglycemic crisis in patients with diabetes mellitus

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Zusammenfassung

Die diabetische Ketoazidose (DKA) und der hyperosmolare hyperglykämische Status (HHS) sind lebensbedrohliche akute Komplikationen eines Diabetes mellitus. Die Behandlung sollte außer bei milden Fällen auf einer internistischen Intensivstation erfolgen. Klinisch unterscheidet sich die DKA vom HHS durch das Vorliegen einer metabolischen Azidose. Trotz dieses Unterschieds ist die Therapie der DKA und des HHS prinzipiell gleich. Sie besteht aus der intravenösen Gabe von Insulin und der Korrektur der Hypovolämie, sowie der Elektrolytveränderungen. Durch die Anwendung eines standardisierten Behandlungsprotokolls kann eine niedrige Sterblichkeit erreicht werden.

Abstract

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the two most acute life-threatening complications of diabetes mellitus and in most cases treatment should be administered in an intensive care unit. Clinically, DKA and HHS differ according to the presence of metabolic acidosis; however, the treatment of DKA and HHS is similar. The main principles are intravenous administration of insulin and correction of fluid and electrolyte abnormalities which are typically present. By the application of a standardized treatment algorithm a low mortality rate can be achieved.

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Schneider, S. Hyperglykämische Krise bei Patienten mit Diabetes mellitus. Med Klin Intensivmed Notfmed 107, 435–439 (2012). https://doi.org/10.1007/s00063-012-0114-1

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