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What Is The Key Differentiating Factor Between Dka And Hhs

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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".) Continue reading >>

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Popular Questions

  1. mindhunter88

    Just received a blood glucose meter! What are the proper protocols for testing fasted blood sugar and what range is considered to be healthy? Additonally, what is the best method for using this meter to test my reaction to artificial sweeteners, which may be the culprits of my current 7 week stall?

  2. richard

    In general a fasting value of 3.9 - 5.5 mmol/l (70-100 mg/dl) is a normal result.
    Officially the ADA recommends for someone with diabetes: 4.5–7.2 mmol/L (80–130 mg/dl )
    2 hours after a meal a normal result is less than 7.8 mmol/L (140 mg/dl).
    For a diabetic managed with drugs by the ADA the expected values are less than 10.0 mmol/L (180 mg/dl).
    I vehemently disagree with the ADA on both the fasting and the pp numbers. We have a right to normal glucose and on a keto diet we can have just that.
    So glucose jumps around like a cat on a hot tin roof and is affected by a lot of things. But there are specific times to test that are less subject to external influence.
    You can test first thing in the morning. That will not be affected by food, and that value day to day will tell you how your overall glucose control is going. If you do that and then try an intervention and your numbers start going a little lower, then the intervention is improving your glucose control. However it's worth noting that that morning fasted test is still subject to influence - for example @tdseest found that whenever he had a nightmare that his glucose was significantly elevated ... so you really need to smooth other the day to day changes and look at the long term trend.
    Another common place to test is 2 hours AFTER eating. That post-prandial (after digesting) measurement should return to normal ranges 90-100 mg/dl in normal people within 2 hours of eating a meal, in a type 2 diabetic it could stay high for 4-5 hours.
    I wrote an article on my blog on how to chart a glucose curve to test foods
    easylocarb.com
    571
    Charting a glucose curve - Easy Lo-Carb
    How to use a diabetic glucose meter to test how your body will respond to specific foods by plotting a Glucose Curve in response to a food challenge.

  3. mindhunter88

    Exactly and succinctly what I was searching for. Thank you!

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