Therapeutic target
Blood glucose normalization
Therapy recommendations
- Slow blood glucose normalization using insulin therapy.
- Fluid replacement and compensation of electrolyte losses (blood salts).
- See also under “Further therapy“.
Fluid replacement
The most important measure of treatment of hyperglycemia is the compensation of the usually considerable fluid deficit. It should be used initially 0.9% sodium chloride solution, later if necessary hypotonic solutions.
Electrolytes
Hyperglycemia results in hypokalemia (potassium deficiency), but this may be masked (covered) by acidosis (hyperacidity). Hypokalemia (potassium deficiency) also occurs during therapy due to volume administration, insulin, and bicarbonate; this should be compensated for with 20-80 mmol/h.
In diabetic ketoacidosis, phosphate loss must also be compensated (potassium phosphate).
Insulin
Slow blood glucose normalization at circa 50 mg/dl/h with a target of 200-250 mg/dl must be given.
