Author/Editor		Urbančič, Vilma; Vrtovec, Matjaž
Title		Urgentna stanja pri bolnikih s sladkorno boleznijo
Translated title		Medical emergencies in patients with diabetes mellitus
Type		članek
Source		In: Bručan A, Gričar M, Fink A, et al, editors. Urgentna medicina: izbrana poglavja 7. Zbornik 8. mednarodni simpozij o urgentni medicini; 2001 jun 13-16; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2001
Volume		str. 155-63
Language		slo
Abstract		In addition to chronic cardiovascular complications, acute metabolic derangements contribute to excess morbidity and mortality of patients with diabetes mellitus. Acute hyperglycaemia which can progress to diabetic ketoacidosis (DKA) or diabetic aketotic hyperosmolar syndrome (DAHS) can be seen in newly developed diabetes mel litus, by infections or other acute ilnesses and after mistakes in treatment. Hypoglycaemia is a complication of treatment with insulin or oral hypoglycaemic agents. The prognosis depends on timely diagnosis and immediate treatment. In spite of this, the mortality rates in acute complications of diabetes remain high. The cause of metabolic derangement must be saught at the very beginning on the basis of medical history, physical examination and laboratory tests. Test strips for rapid determination of blood glucose and glucose and ketones in the urine serve as a useful tool for quick orientation. The treatment of hyperglycaemia is started with 500 ml of normal saline plus 4-,8 IU of regular insulin. Hypoglycaemia in an unconscious patient is treated by hypertonic glucose solution intravenously or glucagon intramuscularly. Admission to hospital is mandatory in patients with DKA, DAHS or hypoglycaemia after oral antidiabetic agents. In a patient with diabetes and altered consciousness, other differential diagnostic possibilities like trauma, intoxications, uremia, hepatic coma, septic or cardiogenic shock and cerebrovascular accident must be considered.
Descriptors		DIABETES MELLITUS EMERGENCIES DIABETIC KETOACIDOSIS HYPERGLYCEMIC HYPEROSMOLAR NONKETOTIC COMA HYPOGLYCEMIA