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

#DKA #HHS #Algorithm #Diabetic #Ketoacidosis
Hyperglycemic Hyperosmolar ... State (HHS) ... #DKA #HHS #Algorithm ... Hyperglycemic #Hyperosmolar
Guideline for management of adult patients with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)

UCSD Internal
ketoacidosis (DKA) or hyperosmolar ... hyperglycemic state (HHS ... @ucsdim #DKA #HHS
DKA vs HHS
 - Think of DKA and HHS on a spectrum of hyperglycemic emergencies
 -
DKA vs HHS - Think ... of DKA and HHS ... emergencies - HHS ... if HHS + poor PO ... #ketoacidosis #hyperosmolar
Ketosis Disorders - Comparison Table
 • Starvation Ketosis
 • Alcoholic Ketoacidosis (AKA)
 • Diabetic Ketoacidosis (DKA)
Hyperglycemic Hyperosmolar ... State (HHS) ... • DKA/HHS Overlap
Pathophysiology of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS)
Absolute Insulin deficit:
 - Type I DM:
Hyperglycemic Hyperosmolar ... Syndrome (HHS) ... Polydipsia #dka #hhs ... hyperglycemic #hyperosmolar
Ketosis Disorders
Ketone bodies are a normal metabolic energy source. Excessive unregulated production of ketones, often accompanied
Hyperglycemic hyperosmolar ... state (HHS) - partial ... • DKA/HHS Overlap ... of both DKA & HHS
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
H’s and T’s Mnemonic - Causes of Cardiac Arrest
H's - Hypovolemia, Hypoxia, Hydrogen Ions (acidosis), Hyperkalemia
H’s and T’s Mnemonic ... Cardiac Arrest H's ... Pulmonary), Trauma #Hs
Thrombotic Microangiopathy - TTP VS HUS

Big picture points : Often hard to differentiate the two entities,
Microangiopathy - TTP VS HUS ... entities, but has ... this distinction has ... implications : TTP has ... HemolyticUremicSyndrome #HUS