Hyperglycemic Crises: Diabetic Ketoacidosis (DKA), And Hyperglycemic Hyperosmolar State (HHS)

Jun 17th, 2015
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Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) represent two extremes in the spectrum of marked decompensated diabetes.

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AdvertisementChapter 24 Hyperglycemic Crises: Diabetic Ketoacidosis (DKA), And Hyperglycemic Hyperosmolar State (HHS)Abbas E. Kitabchi, M.D., Ph.D.akitabchi@utmem.edu, Professor of Medicine and Molecular Sciences, University of Tennessee, Memphis, TNLaleh Razavi, M.D., University of Tennessee Health Science Center, Memphis, TN 38163Updated 1 July 2012TO OBTAIN A COMPLETE DOWNLOAD OF THIS CHAPTER IN PDF FORMAT,CLICK HEREIntroductionDiabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) represent two extremes in the spectrum of marked decompensated diabetes. DKA and HHS are still important causes of morbidity and mortality among patients with diabetes even with major agreements about their diagnostic criteria and treatment protocols [1][2]. The annual incidence of DKA from population-based studies is estimated to range from 4 to 8 episodes per 1,000 patient admissions with diabetes [3]. The incidence of DKA continues to increase with DKA accounting for about 136,510 hospitalizations in the US in 2006 (figure 1 a)[4]. The rate of hospital admissions for HHS is lower than DKA and is less than 1% of all diabetic-related admissions [5][6][7][8]. Decompensated diabetes imposes a heavy burden in terms of economics and patient outcomes. DKA is responsible for more than 500,000 hospital days per year at an estimated annual direct medical expense and indirect cost of 2.4 billion USD. [9]. The mortality rate for DKA has been falling over the years. Age

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