• 作者：Mark Neufang ^{neufanma@kreuznacherdiakonie.de}
• 关键词：Diabetes mellitus ; diabetisches Koma ; endokrinologischer Notfall ; Stoffwechselentgleisung ; hyperosmolares Coma diabeticum ; diabetische Ketoazidose ; ketoazidotisches Coma diabeticum
• 刊名：DoctorConsult - The Journal. Wissen f¨¹r Klinik und Praxis
• 出版年：2011
• 出版时间：2011
• 年：2011
• 卷：2
• 期：4
• 页码：e217-e220
• 全文大小：157 K

Diabetic coma is an endocrinological emergency leading to severe metabolic crisis with electrolyte disturbance, dehydration and disturbance of consciousness up to coma in patients with diabetes mellitus. In many cases it involves the first manifestation of diabetes mellitus.

A distinction is made between hyperosmolar diabetic coma that mainly occurs in type 2 diabetes with relative lack of insulin and results in severe dehydration, and diabetic ketoacidosis on the other hand, which mainly develops in type 1 diabetes with absolute insulin shortage. In the latter case, a shifted acid-base balance and metabolic acidosis are the main pathophysiologic processes. Mixed forms may occur, both relating to pathophysiology or the underlying type of diabetes. Thus, ketoacidotic coma may also occur in progredient type 2 diabetes with complete dysfunction of ¦Â-cells.