Portal de Periódicos da CAPES

Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic Nonketotic Coma

1988; Elsevier BV; Volume: 72; Issue: 6 Linguagem: Inglês

10.1016/s0025-7125(16)30721-0

1557-9859

Abbas E. Kitabchi, Mary Beth Murphy,

Diet and metabolism studies

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) are life-threatening acute metabolic complications of diabetes mellitus. Although there are some important differences, the pathophysiology, the presenting clinical challenge, and the treatment of these metabolic derangements are similar. Insulin deficiency, either relative or absolute, and elevated levels of stress-responding, counterregulatory hormones (e.g., glucagon, catecholamines, growth hormone, and cortisol) are the hallmarks of these conditions. Each of these complications can be seen in type 1 and type 2 diabetes, although DKA is usually seen in patients with type 1 diabetes and HHNS in patients with type 2 disease. The clinical management of these syndromes involves careful evaluation and correction of the metabolic and volume status of the patient, identification and treatment of precipitating and comorbid conditions, a smooth transition to a long-term treatment regimen, and a plan to prevent recurrence.