最后审阅: 11 四月 2021
最后更新: 18 十一月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 急性认知损害
  • 危险因素

其他诊断因素

  • 多尿
  • 多饮
  • 体重减轻
  • 恶心和呕吐
  • 无力
  • 黏膜干燥
  • 皮肤弹性差
  • 心动过速
  • 低血压
  • 体温过低
  • 少尿
  • 腹痛
  • 局灶性神经系统体征
  • 癫痫发作

危险因素

  • 感染
  • 胰岛素或者口服降糖药治疗不充分
  • 已知糖尿病患者的急性疾病
  • 家庭护理居住者
  • 术后状态
  • 诱发药物
  • 全胃肠外营养 (TPN)
  • 库欣综合征
  • 甲状腺功能亢进症
  • 肢端肥大症

诊断性检查

首要检查

  • 血糖
  • 血清酮体
  • 静脉血气
  • 血清渗透压
  • 尿素、电解质和肌酐
  • 全血细胞计数
  • 心电图(ECG

需考虑的检查

  • 尿液分析
  • 心肌酶
  • 胸部 X 线检查
  • 肝功能检测
  • C 反应蛋白
  • 血液、尿液、痰液培养

治疗流程

撰稿人

Consultant Physician and Head of Service

Diabetes and Endocrine Centre and the Diabetes Research Unit

Ipswich Hospitals NHS Trust

Ipswich

UK

简介

GR is Lead and Innovator of the National Inpatient Diabetes Audit; and Joint Clinical Lead of the Diabetes, Getting It Right First Time programme.

利益声明

GR has been paid for advisory board meetings with the following companies: Sanofi Aventis, Abbott Diabetes UK, Lilly Diabetes, and Bayer. GR has received lecture fees from Sanofi Aventis, Abbott Diabetes UK, Lilly Diabetes, Novo Nordisk, and Napp Pharmaceuticals Ltd.

BMJ Best Practice would like to gratefully acknowledge the previous expert contributors, whose work has been retained in parts of the content:

Natasha Khazai, MD

Endocrinologist

Joslin Diabetes Clinic

Boston

MA

Guillermo Umpierrez, MD

Professor of Medicine

Emory University School of Medicine

Atlanta

GA

利益声明

NK declares that she has no competing interests. GU is supported by research grants from the American Diabetes Association and the National Institutes of Health, and has received research funds from Sanofi-Aventis, Novo Nordisk, Takeda, and GlaxoSmithKline.

同行评议者展开全部内容

Honorary Professor of Medicine

University of Manchester

Consultant Physician/Diabetologist/Endocrinologist

Tameside and Glossop Integrated Care NHS Foundation Trust

Manchester

UK

利益声明

EJ declares that he has no competing interests.

Section Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

Lead Section Editor, BMJ Best Practice

利益声明

RW declares that she has no competing interests.

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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