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Diabetisches Koma und perioperative Diabetestherapie

  • Matthias Berndt
  • Silke Klose
  • Hendrik Lehnert
Living reference work entry
Part of the Springer Reference Medizin book series (SRM)

Zusammenfassung

Das diabetische Koma im engeren Sinne wird in 3 Formen unterteilt, wobei Mischbilder der einzelnen Erkrankungen vorkommen können: diabetische Ketoazidose (DKA), hyperosmolares, nicht ketoazidotisches Koma (HONK; engl. „hyperosmolar hyperglycemic state“, HHS), Laktatazidose. Auch die alkoholtoxische Ketoazidose tritt beim Diabetes mellitus auf, soll aber an dieser Stelle nicht weiter erörtert werden. Die Hypoglykämie zählt nicht unmittelbar zum diabetischen Koma, muss aber als relevante Akutkomplikation hier aufgeführt werden.

Die Blutglukosekontrolle auf der Intensivstation ist in diesem Beitrag thematisiert, und darüber hinaus werden die Spezifika der perioperativen Betreuung diabetischer Patienten dargestellt. Das insgesamt deutlich erhöhte perioperative Risiko resultiert aus begleitenden diabetischen Spätkomplikationen. Durch eine verzögerte Magenentleerung besteht bei der diabetischen Gastroparese ein erhöhtes Aspirationsrisiko.

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Copyright information

© Springer Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Universitätsklinikum Schleswig-Holstein – Campus Lübeck, Medizinische Klinik ILübeckDeutschland
  2. 2.Universitätsklinik für Nieren- und Hochdruckkrankheiten, Diabetologie und Endokrinologie, Zentrum Innere MedizinMagdeburgDeutschland
  3. 3.Universitätsklinikum Schleswig-Holstein, Medizinische Klinik ILübeckDeutschland

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