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Med Clin North Am. 2017 May;101(3):587-606. doi: 10.1016/j.mcna.2016.12.011.

Management of Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State.

Author information

1
Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, 69 Jesse Hill Jr. Drive Southeast, 2nd Floor, Atlanta, GA 30303, USA.
2
Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, 69 Jesse Hill Jr. Drive Southeast, 2nd Floor, Atlanta, GA 30303, USA. Electronic address: Geumpie@emory.edu.

Abstract

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are the most serious and life-threatening hyperglycemic emergencies in diabetes. DKA is more common in young people with type 1 diabetes and HHS in adult and elderly patients with type 2 diabetes. Features of the 2 disorders with ketoacidosis and hyperosmolality may coexist. Both are characterized by insulinopenia and severe hyperglycemia. Early diagnosis and management are paramount. Treatment is aggressive rehydration, insulin therapy, electrolyte replacement, and treatment of underlying precipitating events. This article reviews the epidemiology, pathogenesis, diagnosis, and management of hyperglycemic emergencies.

KEYWORDS:

Diabetes; Diabetic ketoacidosis; Hyperglycemic emergencies; Hyperglycemic hyperosmolar state; Management of hyperglycemic emergencies

PMID:
28372715
PMCID:
PMC6535398
DOI:
10.1016/j.mcna.2016.12.011
[Indexed for MEDLINE]
Free PMC Article

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