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Последний просмотренный: 6 Aug 2025
Last updated: 10 Jun 2025

Резюме

Определение

Анамнез и осмотр

Другие диагностические факторы

  • polyuria
  • polyphagia
  • polydipsia
  • weight loss
  • weakness
  • nausea or vomiting
  • abdominal pain
  • dry mucous membranes
  • poor skin turgor
  • sunken eyes
  • tachycardia
  • hypotension
  • Kussmaul respiration
  • acetone breath
  • altered mental status
  • hypothermia

Факторы риска

  • type 1 diabetes
  • inadequate or inappropriate insulin therapy
  • infection
  • myocardial infarction
  • previous episode of hyperglycemic or hypoglycemic crisis
  • high hemoglobin A1c (HbA1c)
  • adverse social determinants of health
  • age <45 years
  • presence of other diabetes-related complications
  • presence of other chronic health conditions
  • pancreatitis
  • stroke
  • acromegaly
  • hyperthyroidism
  • use of certain drugs
  • Cushing syndrome
  • Hispanic, Asian or black ancestry
  • bariatric surgery
  • prolonged fasting or carbohydrate restriction
  • pregnancy
  • dementia
  • mental health disorders
  • alcohol and/or substance use

Диагностические исследования

Исследования, которые показаны в первую очередь

  • plasma glucose
  • ABG
  • capillary or serum ketones
  • urinalysis
  • serum BUN
  • serum creatinine
  • serum sodium
  • serum potassium
  • serum chloride
  • serum magnesium
  • serum phosphate
  • anion gap calculation
  • serum lactate
  • LFT
  • serum amylase
  • serum lipase
  • serum osmolality
  • CBC
  • ECG

Исследования, проведение которых нужно рассмотреть

  • serum creatine kinase (CK)
  • CXR
  • high sensitivity cardiac troponin
  • blood, urine, or sputum cultures

Алгоритм лечения

Составители

Авторы

Aidar R. Gosmanov, MD, PhD, FACE

Associate Professor of Medicine

Division of Endocrinology

Albany Medical College

Chief, Endocrinology Section

Albany VAMC

Albany

NY

Раскрытие информации

ARG declares that he has no competing interests.

Laleh Razavi Nematollahi, MD

Assistant Professor of Medicine

Cleveland Clinic Lerner College of Medicine

Case Western Reserve University

Cleveland

OH

Раскрытие информации

LRN declares that she has no competing interests.

Выражение благодарностей

Dr Aidar Gosmanov and Dr Laleh Razavi Nematollahi would like to gratefully acknowledge Professor Abbas E. Kitabchi, the previous contributor to this topic.

Раскрытие информации

AEK is an author of a number of references in this topic.

Рецензенты

David Jenkins, DM, FRCP

Consultant Physician

Worcestershire Royal Hospital

Worcester

UK

Раскрытие информации

DJ declares that he has no competing interests.

Udaya M. Kabadi, MD, FRCP(C), FACP, FACE

Professor of Medicine

University of Iowa

Iowa City

IA

Раскрытие информации

UMK declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Umpierrez GE, Davis GM, ElSayed NA, et al. Hyperglycaemic crises in adults with diabetes: a consensus report. Diabetologia. 2024 Aug;67(8):1455-79.Полный текст  Аннотация

American Diabetes Association. Standards of care in diabetes - 2025. Diabetes Care. 2025 Jan ;48(suppl 1):S1-352.Полный текст

Dhatariya KK, Glaser NS, Codner E, et al. Diabetic ketoacidosis. Nat Rev Dis Primers. 2020 May 14;6(1):40. Аннотация

Umpierrez G, Korytkowski M. Diabetic emergencies - ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol. 2016 Apr;12(4):222-32. Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available here.

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