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[Treatment of acute diabetic metabolic crises in adults (Update 2019) : Hyperglycemic hyperosmolar state and ketoacidotic metabolic disorders].
Wien Klin Wochenschr 2019; 131(Suppl 1):196-199WK

Abstract

Diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state (HHS) represent potentially life-threatening situations in adults. Therefore, rapid comprehensive diagnostic and therapeutic measures with close monitoring of vital and laboratory parameters are required. The treatment of DKA and HHS is essentially the same and replacement of the mostly substantial fluid deficit with several liters of a physiological crystalloid solution is the first and most important step. Serum potassium concentrations need to be carefully monitored to guide its substitution. Regular insulin or rapid acting insulin analogues can be initially administered as an i.v. bolus followed by continuous infusion. Insulin should be switched to subcutaneous injections only after correction of the acidosis and stable glucose concentrations within an acceptable range.

Authors+Show Affiliations

Department für Innere Medizin 1, Medizinische Universität Innsbruck, Innsbruck, Österreich. Christian Doppler Labor für Insulinresistenz, Medizinische Universität Innsbruck, Innsbruck, Österreich.Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich.Abteilung für Innere Medizin, Krankenhaus Barmherzige Brüder Linz, Linz, Österreich.Abteilung für Innere Medizin, Landeskrankenhaus Kirchdorf, Kirchdorf, Österreich.Universitätsklinik für Notfallmedizin, Medizinische Universität Wien, Wien, Österreich.Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich. anton.luger@meduniwien.ac.at.

Pub Type(s)

Journal Article
Review

Language

ger

PubMed ID

30980160

Citation

Kaser, Susanne, et al. "[Treatment of Acute Diabetic Metabolic Crises in Adults (Update 2019) : Hyperglycemic Hyperosmolar State and Ketoacidotic Metabolic Disorders]." Wiener Klinische Wochenschrift, vol. 131, no. Suppl 1, 2019, pp. 196-199.
Kaser S, Sourij H, Clodi M, et al. [Treatment of acute diabetic metabolic crises in adults (Update 2019) : Hyperglycemic hyperosmolar state and ketoacidotic metabolic disorders]. Wien Klin Wochenschr. 2019;131(Suppl 1):196-199.
Kaser, S., Sourij, H., Clodi, M., Schneeweiβ, B., Laggner, A. N., & Luger, A. (2019). [Treatment of acute diabetic metabolic crises in adults (Update 2019) : Hyperglycemic hyperosmolar state and ketoacidotic metabolic disorders]. Wiener Klinische Wochenschrift, 131(Suppl 1), pp. 196-199. doi:10.1007/s00508-018-1423-z.
Kaser S, et al. [Treatment of Acute Diabetic Metabolic Crises in Adults (Update 2019) : Hyperglycemic Hyperosmolar State and Ketoacidotic Metabolic Disorders]. Wien Klin Wochenschr. 2019;131(Suppl 1):196-199. PubMed PMID: 30980160.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Treatment of acute diabetic metabolic crises in adults (Update 2019) : Hyperglycemic hyperosmolar state and ketoacidotic metabolic disorders]. AU - Kaser,Susanne, AU - Sourij,Harald, AU - Clodi,Martin, AU - Schneeweiβ,Bruno, AU - Laggner,Anton N, AU - Luger,Anton, PY - 2019/4/14/pubmed PY - 2019/9/17/medline PY - 2019/4/14/entrez KW - Anion gap KW - Diabetic ketoacidosis KW - Hyperglycemic hyperosmolar state KW - Pseudohyponatremia KW - Serum osmolality SP - 196 EP - 199 JF - Wiener klinische Wochenschrift JO - Wien. Klin. Wochenschr. VL - 131 IS - Suppl 1 N2 - Diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state (HHS) represent potentially life-threatening situations in adults. Therefore, rapid comprehensive diagnostic and therapeutic measures with close monitoring of vital and laboratory parameters are required. The treatment of DKA and HHS is essentially the same and replacement of the mostly substantial fluid deficit with several liters of a physiological crystalloid solution is the first and most important step. Serum potassium concentrations need to be carefully monitored to guide its substitution. Regular insulin or rapid acting insulin analogues can be initially administered as an i.v. bolus followed by continuous infusion. Insulin should be switched to subcutaneous injections only after correction of the acidosis and stable glucose concentrations within an acceptable range. SN - 1613-7671 UR - https://www.unboundmedicine.com/medline/citation/30980160/[Treatment_of_acute_diabetic_metabolic_crises_in_adults_(Update_2019)_:_Hyperglycemic_hyperosmolar_state_and_ketoacidotic_metabolic_disorders] L2 - https://dx.doi.org/10.1007/s00508-018-1423-z DB - PRIME DP - Unbound Medicine ER -