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Diabetic emergencies.

K G Alberti

    British Medical Bulletin
    |January 1, 1989
    PubMed
    Summary
    This summary is machine-generated.

    Diabetic emergencies, including hypoglycaemia and ketoacidosis, cause significant premature deaths. Simple, consistent guidelines are crucial for general practitioners to improve diagnosis and treatment, reducing avoidable mortality.

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    Area of Science:

    • Endocrinology
    • Internal Medicine
    • Emergency Medicine

    Background:

    • Diabetic emergencies are a major cause of premature mortality in diabetic patients.
    • These emergencies include various diabetic comas, emergency surgery, and myocardial infarction.
    • Current management often involves avoidable morbidity, mortality, and misdiagnosis.

    Purpose of the Study:

    • To highlight the significance of diabetic emergencies as a cause of premature death.
    • To emphasize the need for simple guidelines for general practitioners and admitting physicians.
    • To improve the management of diabetic emergencies and reduce associated mortality and morbidity.

    Main Methods:

    • Review of common diabetic emergencies and their management.
    • Discussion of treatment protocols for hypoglycaemia, diabetic ketoacidosis, hyperosmolar hyperglycaemic non-ketotic coma, lactic acidosis, emergency surgery, and myocardial infarction.

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  • Emphasis on the importance of timely diagnosis and consistent treatment guidelines.

    • Main Results:

    • Hypoglycaemia is the most common diabetic emergency, easily diagnosed and treated, with delays being detrimental.
    • Diabetic ketoacidosis is common and often preventable; rehydration, insulin infusion, and potassium replacement are key initial treatments.
    • Lactic acidosis is rare and requires alkalinisation; metabolic derangements in surgery/myocardial infarction benefit from glucose, potassium, and insulin infusions.

    Conclusions:

    • Consistent, simple guidelines are essential for effective management of diabetic emergencies.
    • Improved diagnostic accuracy and timely treatment can significantly reduce avoidable morbidity and mortality.
    • Standardized protocols facilitate easier and more successful treatment outcomes across various diabetic emergencies.