Differentiating Between Dka And Hhs.
Authors: Christy McDonald Lenahan, MSN, RN, FNP-BC, and Brenda Holloway, DNSc, MSN, RN, FNP-BC, Lafayette, LA, Mobile, AL wo of the most common metabolic emergencies associated with diabetes mellitus are diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS). 1 Although each disorder results in severe hyperglycemia, the underlying pathophysiology, clinical presentation, and treatment are vastly different. 2 It is imperative that clinicians be keenly aware of these differences, considering the variation in clinical pathways associated with each hyperglycemic emergency. 3 This article will compare and contrast the epidemiology, associated risk factors, differential diagnoses, clinical presentation, diagnosis, and medical management of DKA and HHS. Persons of African American ethnicity and older persons are at an increased risk for the development of HHS. 8 Rates of hospital admissions associated with HHS are signicantly lower than those associated with DKA and account for less than 1% of all diabetic-related admissions. 3 It should be noted, however, that between the years of 1997 and 2009 there was a 52.4% increase in the HHS hospitalization rate among children and Continue reading >>