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Emerg Med Clin North Am. 2014 May;32(2):437-52. doi: 10.1016/j.emc.2014.01.004. Epub 2014 Feb 19.

Current diagnosis and treatment of hyperglycemic emergencies.

Author information

  • 1CAQ Sports Medicine, Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA. Electronic address: bcorwell@som.umaryland.edu.
  • 2Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.

Abstract

Diabetic ketoacidosis and hyperosmolar hyperglycemic state are the most feared complications of uncontrolled diabetes seen in emergency medicine. The treatment of both conditions must be tailored to individual patients and relies on aggressive fluid resuscitation, insulin replacement, and electrolyte management. Emergency medicine providers must address the underlying causes and monitor for complications of therapy. Improved understanding of the underlying pathophysiology and application of evidence-based guidelines have significantly improved prognosis and decreased mortality. The purpose of this article is to review the diagnosis, presentation, and emergency department management of diabetic ketoacidosis and hyperosmolar hyperglycemic state with an emphasis on current management and treatment guidelines.

Copyright © 2014 Elsevier Inc. All rights reserved.

KEYWORDS:

Diabetic ketoacidosis (DKA); Electrolyte management; Hyperglycemic crisis; Hyperosmolar hyperglycemic state (HHS); Insulin therapy

PMID:
24766942
[PubMed - indexed for MEDLINE]
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