Hyperglycemic emergencies in adults canadian journal of diabetes. The mortality rate in patients with diabetic ketoacidosis dka. Hyperosmolar hyperglycemic state is a lifethreatening emergency manifested by marked eleva tion of blood glucose, hyperosmolarity, and little or no ketosis. Dka is more common in young people with type 1 diabetes and hhs in adult and elderly patients with type 2 diabetes. Dkais responsibleformorethan500,000hospital days per year 1,2 at an estimated annual. Dka is responsible for more than 500,000 hospital days per year 1, 2 at an estimated annual direct medical expense and indirect cost of 2. Diabetic ketoacidosis dka and hyperglycemic hyperosmolar state hhs are. They are part of the spectrum of hyperglycemia, and each represents an extreme in the spectrum.
Risk factors for dka in patients with known diabetes include. Hyperglycemic crises in diabetes american diabetes association k etoacidosis and hyperosmolar hyperglycemia are the two most serious acute metabolic complications of diabetes, even if managed properly. Hyperglycemic crises in adult patients with diabetes a consensus. Diabetic ketoacidosis dka and hyperglycemic hyperosmolar state hhs are the most serious and lifethreatening hyperglycemic emergencies in diabetes. A lecture on the recognition, pathogenesis, and treatment of diabetic ketoacidosis and the hyperosmolar hyperglycemic state. Diabetic ketoacidosis and hyperglycemic hyperosmolar state.
Dka episodes between 2014 and 2017 at the internal diseases and. These disorders can occur in both type 1 and type 2 diabetes. Diabetic ketoacidosis dka and hyperosmolar hyperglycemic state hhs are diabetes emergencies with overlapping features. Treatment of diabetic ketoacidosis dkahyperglycemic.
Standards of medical care in diabetes 2017 american diabetes. In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis. Pdf hyperglycemic crises in adult patients with diabetes. Hyperglycemic crises in adult patients with diabetes. Initial fluid therapy is directed toward expansion of the intravascular, interstitial, and intracellular volume, all of which are reduced in hyperglycemic crises and restoration. A lecture on the recognition, pathogenesis, and management of diabetic ketoacidosis and the hyperosmolar hyperglycemic state. The mortality rate in patients with diabetic ketoacidosis dka is hyperosmolar hyperglycemic state hhs, also known as hyperosmotic hyperglycemic nonketotic state hhnk are two of the most serious acute complications of diabetes. Diabetic ketoacidosis dka and the hyperosmolar hyperglycemic state hhs are the two most serious acute. Diabetic ketoacidosis dka and hyperglycemic hyperosmolar state hhs are acute metabolic complications of diabetes mellitus that can occur in patients with both type 1 and 2 diabetes mellitus.
Kreisberg, md 3 d iabetic ketoacidosis dka and hyperosmolar hyperglycemic state hhs are the two most serious acute metabolic complications of diabe. The proposed ada criteria for dka resolution include serum glucose level. Dka is responsible for more than 500,000 hospital days per year 1,2 at an estimated annual direct medical expense and indirect cost of 2. Diabetic ketoacidosis dka and the hyperosmolar hyperglycemic state hhs are the two most serious acute metabolic complications of diabetes. Ketoacidosis and hyperosmolar hyperglycemia are the two most serious acute metabolic complications of diabetes, even if managed properly. The criteria of the american diabetes association ada were used for the definition of dka as follows. Hyperglycemic crises in adult patients with diabetes diabetes care. Fisher, md 1 d iabetic ketoacidosis dka and the hyperosmolar hyperglycemic state hhsarethetwomostseriousacute metaboliccomplicationsofdiabetes. Request pdf hyperglycemic crises in adult patients with diabetes. Keep up with the latest information for diabetes care and other ada titles via. Timely diagnosis, comprehensive clinical and biochemical evaluation, and effective management is key to the successful resolution of dka and hhs. Critical components of the hyperglycemic crises management include. Hyperglycemic crises in adult patients with diabetes abbas e.