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Hhs Diabetes Guidelines

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Management Of Hyperosmolar Hyperglycaemic State In Adults With Diabetes.

Diabet Med. 2015 Jun;32(6):714-24. doi: 10.1111/dme.12757. Management of hyperosmolar hyperglycaemic state in adults with diabetes. Sheffield Teaching Hospitals NHS Trust, Sheffield, UK. Hyperglycaemic hyperosmolar state (HHS) is a medical emergency, which differs from diabetic ketoacidosis (DKA) and requires a different approach. The present article summarizes the recent guidance on HHS that has been produced by the Joint British Diabetes Societies for Inpatient Care, available in full at HHS has a higher mortality rate than DKA and may be complicated by myocardial infarction, stroke, seizures, cerebral oedema and central pontine myelinolysis and there is some evidence that rapid changes in osmolality during treatment may be the precipitant of central pontine myelinolysis. Whilst DKA presents within hours of onset, HHS comes on over many days, and the dehydration and metabolic disturbances are more extreme. The key points in these HHS guidelines include: (1) monitoring of the response to treatment: (i) measure or calculate the serum osmolality regularly to monitor the response to treatment and (ii) aim to reduce osmolality by 3-8 mOsm/kg/h; (2) fluid and insulin administration: ( Continue reading >>

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Popular Questions

  1. Misskat29

    Hey, so as the title says, I'm Day 9. Haven't had keto flu up to now, but this evening my head is thumping!
    Ate last night at about 8pm, didn't eat again till 1.30pm this afternoon. Which was when I first became hungry.

    Do you think I've just not eaten enough rather than keto flu?

  2. Ceceb

    My guess, like many responses you are going to get, is not enough salt. Eat lots of salt, because your kidneys are flushing sodium out like crazy.

  3. Misskat29

    Would you just take salt on its own to boost or add to food?

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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

Management Of The Hyperosmolar Hyperglycaemic State (hhs) In Adults With Diabetes (aug 2012)

Management of the hyperosmolar hyperglycaemic state (HHS) in adults with diabetes (Aug 2012) Management of the hyperosmolar hyperglycaemic state (HHS) in adults with diabetes (Aug 2012) Unlike the other common diabetes emergency, diabetic ketoacidosis (DKA), guidelines on the management of the hyperglycaemic hyperosmolar state (HHS) in adults are uncommon and often there is little to differentiate them from the management of DKA. However, HHS is different and treatment requires a different approach. The person with HHS is often elderly, frequently with multiple co-morbidities but always very sick. Even when specific hospital guidelines are available, adherence to and use of these is variable amongst the admitting teams. In many hospitals these patients are managed by non-specialist teams, and it is not uncommon for the most junior member, who is least likely to be aware of the hospital guidance, to be given responsibility for the initial management of this complex and challenging condition. Diabetes specialist teams are rarely involved at an early stage and sometimes never at all. To address these issues the Joint British Diabetes Societies (JBDS) for inpatient care, supported by Continue reading >>

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  1. Melissa_Carver

    Hi all! I’m new here and to ketosis, 10 days in and feeling great!
    So I was listening to the 2 Keto Dudes episode on sweeteners and they were talking about how one sweetener or the other would “knock them out of ketosis.” How do you know when you’ve been knocked out of ketosis? Is it a blood sugar thing? Or are you using a ketone tester (blood/breath/urine strip) to verify?
    (Note: I’m T1D, 25 years now, diagnosed as a kid. I just started wearing my CGM again today to try to level off the blood sugars and adjust my basal rate in my insulin pump as needed. If I can tell by blood sugar if I’m knocked out of ketosis that would perfect and so easy for me!)

    Thanks in advance everyone!

  2. Ernest

    Most likely from experimentation to test tolerance.
    I did a protein tolerance experiment and I’d test my ketone readings, using the Precision Xtra, a few times after eating a large amount of protein .
    I bet one could do the same experiment with sweeteners.

  3. Rian

    There are a few sure ways to know if you are in ketosis. In my opinion the most reliable and easiest way is to acquire a blood ketone test meter. Many people here like the Abbott Precision Xtra. The strips to test ketones are a few bucks each but if you try eBay you can usually get them a little cheaper. You will have to do a fair amount of testing in the beginning to see what foods do what to your ketone levels but after awhile you’ll become familiar with the do’s and don’t and will only need to test or occasion.

    Testing for ketones isn’t a requirement but it is nice to know what’s going on without resorting to guessing.

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Visit us (http://www.khanacademy.org/science/he...) for health and medicine content or (http://www.khanacademy.org/test-prep/...) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Matthew McPheeters. Watch the next lesson: https://www.khanacademy.org/test-prep... Missed the previous lesson? https://www.khanacademy.org/test-prep... NCLEX-RN on Khan Academy: A collection of questions from content covered on the NCLEX-RN. These questions are available under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States License (available at http://creativecommons.org/licenses/b...). About Khan Academy: Khan Academy offers practice exercises, instructional videos, and a personalized learning dashboard that empower learners to study at their own pace in a

Hyperosmolar Hyperglycemic State

A serious metabolic complication of diabetes characterized by severe hyperglycemia, hyperosmolality, and volume depletion, in the absence of severe ketoacidosis. Occurs most commonly in older patients with type 2 diabetes. Contributes to less than 1% of all diabetes-related admissions. However, mortality is high (5% to 15%). Presents with polyuria, polydipsia, weakness, weight loss, tachycardia, dry mucus membranes, poor skin turgor, hypotension, and, in severe cases, shock. Altered sensorium (lethargy, disorientation, stupor) is common and correlates best with effective serum osmolality. Coma is rare and, if seen, is usually associated with a serum osmolality >340 mOsm/kg. Treatment includes correction of fluid deficit and electrolyte abnormalities, and IV insulin. Hyperosmolar hyperglycemic syndrome (HHS), also known as non-ketotic hyperglycemic hyperosmolar syndrome (NKHS), is characterized by profound hyperglycemia (glucose >600 mg/dL), hyperosmolality (effective serum osmolality 320 mOsm/kg), and volume depletion in the absence of significant ketoacidosis (pH >7.3 and HCO3 >15 mEq/L), and is a serious complication of diabetes. HHS may be the first presentation of type 2 diabe Continue reading >>

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  1. sharidoto

    HOW MANY DAYS OF STRICK EATING DOES IT NOEMALLY TAKE BEFORE THE STRIPS START TO SHOW YOUR BURNING FAT??
    DREAM,CREATE,INSPIRE AND LOVE YOU HAVE THE PERFECT LIFE !

  2. ljessica0501

    It varies for everyone. For me personally...it took 4 days to register anything and almost 2 weeks to get purple...I have never seen the darkest purple shade. Some people will tell you not to use the sticks, but I like them. My doctor told me to use them 3 times a day for a week to see when my body is the highest. Again...everyone is different. I am highest in the morning, but I hear some people are highest at night.
    Lauren
    Your goals, minus your doubts, equal your reality. - Ralph Marston

  3. PeeFat

    Your body has to burn off all the stored sugar before it goes into ketosis. The shade on the stick should read ' moderate. ' Any higher means you aren't drinking enough water to flush out excess ketones. Too many ketones in your body is unhealthy. So don't think you have to be in the darkest purple range to be eating properly. Also the best time to test is first thing in the morning. Only diabetics need check more than once a day. On atkins we don't even need to use keto sticks. If you follow the rules you will be in ketosis.

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