Kaser Susanne, Sourij Harald, Clodi Martin, Schneeweiß Bruno, Laggner Anton N, Luger Anton
Department für Innere Medizin 1, Medizinische Universität Innsbruck, Innsbruck, Österreich.
Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich.
Wien Klin Wochenschr. 2023 Jan;135(Suppl 1):237-241. doi: 10.1007/s00508-023-02174-8. Epub 2023 Apr 20.
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.
糖尿病酮症酸中毒（DKA）和高血糖高渗状态（HHS）是成人潜在的危及生命的情况。因此，需要采取快速全面的诊断和治疗措施，并密切监测生命体征和实验室参数。DKA和HHS的治疗基本相同，用几升生理晶体溶液补充大部分严重的液体不足是首要也是最重要的一步。需要仔细监测血清钾浓度以指导其补充。常规胰岛素或速效胰岛素类似物可先静脉推注，然后持续输注。只有在酸中毒纠正且血糖浓度稳定在可接受范围内后，胰岛素才应改为皮下注射。
