Hyperglycemic crises: Hyperglycemic hyperosmolar nonketotic coma (HHNK) versus DKA. See DKA video here: https://youtu.be/r2tXTjb7EqU This video and similar images/videos are available for instant download licensing here https://www.alilamedicalmedia.com/-/g... Voice by: Penelope Hammet Alila Medical Media. All rights reserved. All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Support us on Patreon and get FREE downloads and other great rewards: patreon.com/AlilaMedicalMedia Hyperosmolar hyperglycemic state, or HHS, is another ACUTE and life-threatening complication of diabetes mellitus. It develops slower than DKA, typically in the course of several days, but has a much higher mortality rate. Like DKA, HHS is triggered when diabetic patients suffer from ADDITIONAL physiologic stress such as infections, other illness, INadequate diabetic treatment or certain drugs. Similar to DKA, the RISE in COUNTER-regulatory hormones is the major culprit. These hormones stimulate FURTHER production and release of glucose into the blood, causing it to overflow into urine, resulting in excessive LOSS of water and electrolytes. The major DIFFERENCE between HHS and DKA is the ABSENCE of acidosis in HHS. This is because, unlike DKA, the level of insulin in HHS patients is HIGH enough to SUPPRESS lipolysis and hence ketogenesis. This explains why HHS occurs more often in type 2 diabetics, who have more or less normal level of circulating insulin. Reminder: type 2 diabetics DO produce insulin but their cells do NOT respond to insulin and therefore cannot use glucose. Because symptoms of acidosis are NOT present, development of HHS may go UNnoticed until blood glucose levels become EXTREMELY high. Severe dehydration results in INcreased concentrations of solutes in the blood, raising its osmolarity. HyPERosmotic blood plasma drives water OUT of bodys tissues causing cellular dysfunction. Primary symptom of HHS is ALTERED consciousness due to excessive dehydration of brain tissues. This can range from confusion to coma. Emergency treatment consists of intravenous fluid, insulin and potassium similar to those used in DKA.
Diabetic Ketoacidosis And Hyperosmolar Hyperglycemic State In Adults: Clinical Features, Evaluation, And Diagnosis
INTRODUCTION Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS, also known as hyperosmotic hyperglycemic nonketotic state [HHNK]) are two of the most serious acute complications of diabetes. DKA is characterized by ketoacidosis and hyperglycemia, while HHS usually has more severe hyperglycemia but no ketoacidosis (table 1). Each represents an extreme in the spectrum of hyperglycemia. The precipitating factors, clinical features, evaluation, and diagnosis of DKA and HHS in adults will be reviewed here. The epidemiology, pathogenesis, and treatment of these disorders are discussed separately. DKA in children is also reviewed separately. (See "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis".)
DKA (Diabetic Ketoacidosis) Vs HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome) Tables From Step Up to Medicine (3rd Edition, Agabegi) Here is the link for the Quick Hits =) http://imgur.com/TnJPBmu
Diabetic Hyperglycemic Hyperosmolar Syndrome
HHS is a condition of: Extremely high blood sugar (glucose) level Decreased alertness or consciousness (in many cases) Buildup of ketones in the body (ketoacidosis) may also occur. But it is unusual and is often mild compared with diabetic ketoacidosis. HHS is more often seen in people with type 2 diabetes who don't have their diabetes under control. It may also occur in those who have not been diagnosed with diabetes. The condition may be brought on by: Infection Other illness, such as heart attack or stroke Medicines that decrease the effect of insulin in the body Medicines or conditions that increase fluid loss Normally, the kidneys try to make up for a high glucose level in the blood by allowing the extra glucose to leave the body in the urine. But this also causes the body to lose water. If you do not drink enough water, or you drink fluids that contain sugar and keep eating foods with carbohydrates, the kidneys may become overwhelmed. When this occurs, they are no longer able to get rid of the extra glucose. As a result, the glucose level in your blood can become very high. The loss of water also makes the blood more concentrated than normal. This is called hyperosmolarity. I
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W3l Para204 Dka, Hhs, Aka
Poorly managed/undiagnosed diabetes (Type I Diabetes is first presentation of SKA fast or slow how can a DKA patient technically be hypoglycaemic A decrease in the circulating insulin level forces the body to source glucose from the break down of fat/protein at an how does a DKA patient become dehydrated and hypovolaemic (A decrease in the circulating insulin level forces the body to source glucose from the break down of fat/protein at an increased rate to fuel the body > Lysis (break down) of protein and lipids produces ketones as a by product ) The increased ketone production and hyperglycaemia produces osmotic diuresis and as a result a concentration gradient occurs. Fluid moves out of cells into the blood resulting in cellular how does a DKA patient become hyperkalaemic Metabolic acidosis occurs due to the increase in acid The hyperosmolality and acidic state cause potassium to what does hyperkalaemic patient present as on ECG what is the risk of moving a DKA patient which has been lying down for an extended period of time and how should this be managed If a Pt has been lying down for an extended period, K will have been accumulating in blood stream. Once you stand them up the
Med Klin (Munich). 2006 Mar 22;101 Suppl 1:100-5. Diabetic ketoacidosis and hyperosmolar hyperglycemic state. Clinic II and Polyclinic for Internal Medicine, University of Cologne, Germany. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the two most serious metabolic complications of diabetes mellitus (DM). These disorders can occur in both type 1 and type 2 DM. DKA is characterized by hyperglycemia, ketone body forma ...
Diabetic ketoacidosis vs hyperglycemic hyperosmolar nonketotic syndrome (HHNS or HHS): What are the differences between these two complications of diabetes mellitus? This NCLEX review will simplify the differences between DKA and HHNS and give you a video lecture that easily explains their differences. Many students get these two complications confused due to their similarities, but there are major differences between these two complications. Aft ...
In this episode I’ll discuss diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). Subscribe on iTunes, Android, or Stitcher Definition 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 hyperglycem ...
In Brief Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are two acute complications of diabetes that can result in increased morbidity and mortality if not efficiently and effectively treated. Mortality rates are 2–5% for DKA and 15% for HHS, and mortality is usually a consequence of the underlying precipitating cause(s) rather than a result of the metabolic changes of hyperglycemia. Effective standardized treatment p ...
Hyperosmolar Non Ketotic Hypergycaemic Coma (HONK) Though a distinction is being made between diabetic ketoacidosis and HONK, the two really form a part of the same disease spectrum. Some ketoacidosis is present in HONK, and some hyperosmolarity is present in DKA. However, different mechanisms are at play. HONK is distinct form DKA, and the distinction is not entirely arbitrary, at least from the management point of view. For instance, even thou ...
You arrive in the emergency department of a small hospital where your patient is waiting. Mr Smith is a 64 year old of Portuguese descent with type 2 diabetes, chronic hepatitis B, CVA 2 years ago, CAD, and hypertension. His home medications include metoprolol, aspirin, atorvastatin, lisinopril, furosemide and metformin. His daughter is at the bedside and reports he had been doing well until last week when he appeared depressed and had not been t ...