Urgences medicales en diabetologie: l'acidocetose et le coma hyperosmolaire

Diabetic ketoacidosis and hyperglycaemic hyperosmolar state are relatively frequent metabolic emergencies. Such entities complicate type 1 and type 2 diabetes mellitus, respectively. Diagnosis is ultimately provided by blood and urine analysis. The pathophysiology is mainly based on insulin privation regarding ketoacidosis and resistance to insulin in hyperglycaemic crisis, with an additional deleterious role of counterregulatory hormones. Prognosis of such complications remains generally severe. Management is based on insulin infusion, fluid resuscitation as well as concomitant compensation for electrolytes losses.