How Does A Diabetic Ketoacidosis State Differ From A Hyperosmolar Hyperglycemic State?
A difficult question to answer, but try to put it in a simple way. Both are same but slightly differ. The root cause of DKA and HHS is lack of insulin effect, so the first key aim of treatment is insulin. While subcutaneous insulin may suffice in less severe cases, intravenous administration is to be preferred in more severe cases because severe dehydration and hypovolemia may interfere with the absorption of subcutaneous insulin. Use of insulin pumps must be carefully monitored by trained staff. Untreated, this can lead to two distinct yet overlapping life-threatening emergencies. Hyperglycaemia is the dominant feature of the hyperglycaemic hyperosmolar state, causing severe polyuria and fluid loss and leading to cellular dehydration. Progression from uncontrolled diabetes to a metabolic emergency may result from unrecognised diabetes, sometimes aggravated by glucose containing drinks, or metabolic stress due to infection or intercurrent illness and associated with increased levels of counter-regulatory hormones. Since diabetic ketoacidosis and the hyperglycaemic hyperosmolar state have a similar underlying pathophysiology the principles of treatment are similar (but not identical Continue reading >>