Treatment of diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults

Jun 16th, 2015
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— Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS, also called nonketotic hyperglycemia) are two of the most serious acute complications of diabetes. They are part of the spectrum of hyperglycemia and each represents an extreme in the spectrum.

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Treatment of diabetic ketoacidosis and hyperosmolar hyperglycemic state in adultsAuthorsAbbas E Kitabchi, PhD, MD, FACP, FACEBurton D Rose, MDSection EditorDavid M Nathan, MDDeputy EditorJean E Mulder, MDDisclosuresAll topics are updated as new evidence becomes available and ourpeer review processis complete.Literature review current through:Dec 2012.|This topic last updated:jun 26, 2012.INTRODUCTION-Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS, also called nonketotic hyperglycemia) are two of the most serious acute complications of diabetes. They are part of the spectrum of hyperglycemia and each represents an extreme in the spectrum.The treatment of DKA and HHS in adults will be reviewed here. The epidemiology, pathogenesis, clinical features, and diagnosis of these disorders are discussed separately. (See"Epidemiology and pathogenesis of diabetic ketoacidosis and hyperosmolar hyperglycemic state"and"Clinical features and diagnosis of diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults".)DEFINITIONS-DKA and HHS differ clinically according to the presence of ketoacidosis and the degree of hyperglycemia [1-3]. The definitions proposed by the American Diabetes Association for DKA and HHS are shown in the table (table 1)[1].In DKA, metabolic acidosis is often the major finding, while the serum glucose concentration is generally below 800 mg/dL (44 mmol/L) [1-3]. However, serum glucose concentrations may excee

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