17 results
DKA vs HHS
 - Think of DKA and HHS on a spectrum of hyperglycemic emergencies
 -
of DKA and HHS ... emergencies - HHS = insulin ... restart any home insulin ... #HHS #comparison ... endocrinology #comparison
Pathophysiology of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS)
Absolute Insulin deficit:
 - Type I DM:
Ketoacidosis (DKA ... HHS) Absolute Insulin ... Type I DM: No insulin ... Polydipsia #dka ... pathophysiology #comparison
SGLT2 Inhibitors and Euglycemic DKA

Risk factors for euglycemic DKA in those on an SGLT2i include:
 •
• Increased insulin ... and surgery) • Insulin ... serum or urine Treatment ... Consideration of insulin ... SGLT2 #Euglycemic #DKA
DKA DIAGNOSTIC CRITERIA:
1. Serum glucose >250 mg/dL
2. Arterial pH <7.3
3. Serum bicarbonate <18 mEq/L
4. At least
Patients with DKA ... Continue insulin ... and subcutaneous insulin ... Treatment with IV ... #DKA #EDKA #Insulin
Hyperkalemia Management
Membrane Stabilizers:
 • Calcium gluconate
Shifters:
 • Insulin + glucose
 • Albuterol
Excreters:
 • Furosemide
 • Sodium
gluconate Shifters: • Insulin ... Hyperkalemia #Management #Treatment ... #Potassium
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... minutes) Decrease potassium ... Fluids Shift potassium ... intracellularly: • Insulin ... Sodium bicarbonate Potassium
Diabetic Ketoacidosis 
Management Priorities
1. Fluids 
2. Insulin 
3. Potassium 
4. Acidosis 
5. Re-establish oral fluids,
Insulin 3. ... Potassium 4. ... subcutaneous insulin ... Identification and treatment ... underlying cause #DKA
REBEL Review 71: Treatment of Thyroid Storm 

Propranolol 
Esmolol 
Propylthiouracil (PTU) 
Methimazole 
Saturated Solution of Potassium
REBEL Review 71: Treatment ... Saturated Solution of Potassium ... table #management #treatment ... #pharmacology #comparison
There are similarities and differences between these 3 conditions which all carry treatment implications. Each mimic
which all carry treatment ... easily outweighs Insulin ... DKA is essentially ... provided the starting potassium ... algorithm #management #treatment
Emergent Hyperkalemia Treatment Algorithm
ECG changes, weakness, K+ >6.5 Or renal insufficiency with K >5.5 with cellular
Emergent Hyperkalemia Treatment ... cells - Combo of insulin ... reduction • Insulin ... units regular insulin ... Remove potassium