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Algorithm for treatment of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS)

#DKA #HHS #Algorithm #Diabetic #Ketoacidosis
Hyperglycemic Hyperosmolar ... Hyperglycemic #Hyperosmolar
Pathophysiology of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS)
Absolute Insulin deficit:
 - Type I DM:
Hyperglycemic Hyperosmolar ... hyperglycemic #hyperosmolar
DKA vs HHS
 - Think of DKA and HHS on a spectrum of hyperglycemic emergencies
 -
#ketoacidosis #hyperosmolar
Guideline for management of adult patients with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)

UCSD Internal
ketoacidosis (DKA) or hyperosmolar
Ketosis Disorders - Comparison Table
 • Starvation Ketosis
 • Alcoholic Ketoacidosis (AKA)
 • Diabetic Ketoacidosis (DKA)
Hyperglycemic Hyperosmolar
Anion Gap Metabolic Acidosis
 • Diabetic Ketoacidosis ± Hyperglycemia ± Hyperosmolar
 • Alcoholic Ketoacidosis ± Hyperglycemia
Hyperglycemia ± Hyperosmolar
Diagnostic Approach to Hyponatremia
Box A:
 • Normo/hyperosmolar Hyponatremia: Glucose, Mannitol, Glycine, Contrast media, Maltose
 • Pseudohyponatremia:
Box A: • Normo/hyperosmolar
Ketosis Disorders
Ketone bodies are a normal metabolic energy source. Excessive unregulated production of ketones, often accompanied
Hyperglycemic hyperosmolar
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Succinylcholine - Hyperosmolar
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Succinylcholine - Hyperosmolar