I think 005 u/kg/h insulin is the best dose for hhs treatment - nice guidelines actually suggest not even starting insulin until glucose no longer falls with fluid administration alone (or if there is significant ketonaemia (eg 3β-hydroxy butyrate greater than 1 mmol/l or urine ketones greater than 2+. Diabetic ketoacidosis (dka) is a potentially life-threatening complication of diabetes mellitus signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. Hyperosmolar hyperglycemic state (hhs) is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis symptoms include signs of dehydration, weakness, legs cramps, vision problems, and an altered level of consciousness. Diabetic ketoacidosis (dka) and hyperosmolar hyperglycemic state (hhs) are two of the most serious metabolic complications of diabetes while dka is more common, hhs has a higher mortality rate.
Disclaimer: the sole purpose of this website is to help internal medicine residents, medical students, and attendings to learn and teach medicine at its best by doing so, i hope that im residents will enjoy medicine, and medical students will find interest in internal medicine. The hyperosmolar hyperglycemic state (hhs) is a syndrome characterized by severe hyperglycemia, hyperosmolality, and dehydration in the absence of ketoacidosis the exact incidence of hhs is not known, but it is estimated to account for 1% of hospital admissions in patients with diabetes ( 1 . Precipitating factors the most common precipitating factor in the development of dka and hhs is infection [1,4,10]other precipitating factors include discontinuation of or inadequate insulin.
Dka occurs mainly, but not exclusively, in type 1 diabetes because type 1 diabetes is characterized by a lack of insulin production in the pancreas it is much less common in type 2 diabetes because the latter is closely related to cell insensitivity to insulin, not -- at least initially -- to a shortage or absence of insulin. The powerpoint ppt presentation: dka and hyperosmolar hyperglycemic state hhs is the property of its rightful owner do you have powerpoint slides to share if so, share your ppt presentation slides online with powershowcom. When start potassium in dka is a debate() apparently in the east coast and midwest, we give our potassium( po or iv) when giving the insulin the worry is the ivf and insulin will cause hypokalemia to a significant level.
8 executive summary the hyperglycaemic hyperosmolar state (hhs) is a medical emergency hhs is different from diabetic ketoacidosis (dka) and treatment requires a different approach. Hyperosmolar hyperglycemic state (hhs) is one of two serious metabolic derangements that occurs in patients with diabetes mellitus (dm)  it is a life-threatening emergency that, although less common than its counterpart, diabetic ketoacidosis (dka), has a much higher mortality rate, reaching up to 5-10. Diabetic ketoacidosis can occur in persons of all ages, with 14 percent of cases occurring in persons older than 70 years, 23 percent in persons 51 to 70 years of age, 27 percent in persons 30 to. Introduction diabetic ketoacidosis (dka) and the hyperosmolar hyperglycemic state (hhs) are the two most serious acute metabolic complications of diabetes.
Diabetic ketoacidosis (dka) and hyperosmolar hyperglycemic state (hhs) are the most serious acute complications of diabetes these diabetic crises cause thousands of deaths annually in the us dka and hhs differ clinically according to the presence of ketoacidosis and the degree of hyperglycemia. Abstract 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. Diabetic ketoacidosis (dka) is a buildup of acids in your bloodit can happen when your blood sugar is too high for too long it could be life-threatening, but it usually takes many hours to.
Hyperosmolar hyperglycemic state (hhs—previously referred to as hyperglycemic hyperosmolar nonketotic coma [hhnk] and nonketotic hyperosmolar syndrome) is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to20%, which is significantly higher than the mortality for diabetic ketoacidosis (currently 1%) it. Diabetic ketoacidosis: low - dose insulin therapy by various routes n engl j med 1977 297 : 238 - 47 umpierrez ge , latif k , stoever j , et al effi cacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis.
Diabetic ketoacidosis (dka) is a life-threatening problem that affects people with diabetes it occurs when the body starts breaking down fat at a rate that is much too fast it occurs when the body starts breaking down fat at a rate that is much too fast. Diabetic ketoacidosis (dka) and hyperglycemic hyperosmolar state (hhs) are biochemically different conditions that require different approaches to treatment they often occur in different age groups, and there is a need for co-ordinated care from the. 1 dka, hhs, and hypoglycemia diabetes strategies for the 21st century february 8, 2017 katherine lewis, md, mscr disclosures i have no conflicts of interest or other disclosures relevant to this.