ABSTRACT
This review summarizes the current therapeutic approach to diabetic ketoacidosis and hyperosmolar coma. The focus is on emergency treatment and intensive care management, particularly with regard to volume substitution, insulin therapy and potassium replacement. The basic concepts of low and very low insulin therapy are presented, with special emphasis on the pathogenesis and avoidance of the disequilibrium syndrome. Furthermore, the indications for bicarbonate therapy as well as phosphate and magnesium replacement in diabetic ketoacidosis are discussed.
