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Diabetologische Notfälle

Hypoglykämie, ketoazidotisches und hyperglykämisches Koma

Diabetic emergencies

Hypoglycemia, ketoacidotic and hyperglycemic hyperosmolar nonketotic coma

  • Schwerpunkt: Notfälle in der Endokrinologie/Diabetologie
  • Published:
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Zusammenfassung

Die diabetologischen Notfälle Hypoglykämie, diabetische Ketoazidose (DKA) und hyperglykämische, hyperosmolare Entgleisung (HHE) sind potenziell lebensbedrohliche Komplikationen eines Diabetes mellitus und seiner Behandlung. Entsprechend erfordern sie eine rasche diagnostische und therapeutische Intervention. DKA und HHE zeichnen sich durch einen absoluten bzw. relativen Insulinmangel sowie durch eine schwere Dehydratation aus. Sie unterscheiden sich im Vorhandensein von Ketonkörpern und dem Schweregrad der Azidose, ähneln sich jedoch in der Behandlung. Die Hypoglykämie ist dagegen der limitierende Faktor beim Erreichen ehrgeiziger Glukoseziele. Der vorliegende Beitrag beschreibt Klinik, Diagnostik und Notfallmanagement dieser Stoffwechselentgleisungen.

Abstract

The diabetic emergencies diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS) and hypoglycemia represent severe and potentially life-threatening complications of diabetes mellitus that require prompt diagnostics and treatment. Absolute or relative insulin insufficiency is characteristic of DKA und HHS along with severe dehydration. They differ by the prevalence of ketone bodies and the severity of acidosis; however, the treatment regimens are similar. In contrast, hypoglycemia is the limiting factor for achieving ambitious glucose targets. This article decribes the clinical presentation, diagnostics and emergency management of these metabolic derangements

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Authors and Affiliations

  1. Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland

    H. Kalscheuer, G. Serfling & S. Schmid

  2. Präsidium der Universität zu Lübeck, Universität zu Lübeck, Lübeck, Deutschland

    H. Lehnert

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  1. H. Kalscheuer
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  2. G. Serfling
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  3. S. Schmid
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  4. H. Lehnert
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Correspondence to H. Kalscheuer.

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H. Kalscheuer, G. Serfling, S. Schmid und H. Lehnert geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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H. Lehnert, Lübeck

M. Reincke, München

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Kalscheuer, H., Serfling, G., Schmid, S. et al. Diabetologische Notfälle. Internist 58, 1020–1028 (2017). https://doi.org/10.1007/s00108-017-0317-x

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  • DOI: https://doi.org/10.1007/s00108-017-0317-x

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