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

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

UCSD Internal
patients with diabetic ... ketoacidosis (DKA ... ) or hyperosmolar ... Medicine @ucsdim #DKA ... #HHS #ketoacidosis
Ketosis Disorders - Comparison Table
 • Starvation Ketosis
 • Alcoholic Ketoacidosis (AKA)
 • Diabetic Ketoacidosis (DKA)
(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:
Ketoacidosis (DKA ... Hyperglycemic Hyperosmolar ... Syndrome (HHS) ... Polydipsia #dka ... #diabetic #ketoacidosis
Anion Gap Metabolic Acidosis
 • Diabetic Ketoacidosis ± Hyperglycemia ± Hyperosmolar
 • Alcoholic Ketoacidosis ± Hyperglycemia
Gap Metabolic Acidosis ... • Diabetic Ketoacidosis ... Hyperglycemia ± Hyperosmolar ... • Alcoholic Ketoacidosis ... amzn.to/3rEtbK8 #AnionGap
Diabetic Ketoacidosis 
Management Priorities
1. Fluids 
2. Insulin 
3. Potassium 
4. Acidosis 
5. Re-establish oral fluids,
Diabetic Ketoacidosis ... Acidosis 5. ... underlying cause #DKA ... #Diabetic #Ketoacidosis ... #Pediatrics #Peds
DKA vs HHS
 - Think of DKA and HHS on a spectrum of hyperglycemic emergencies
 -
DKA vs HHS - Think ... of DKA and HHS ... endocrinology #comparison #diabetic ... #ketoacidosis # ... hyperosmolar #hyperglycemic
DKA Resuscitation Checklist
 - Diagnostic evaluation 
 - Crystalloid 
 - Electrolyte repletion 
 - High-flow
DKA Resuscitation ... cannula if patient has ... #Management #Diabetic ... #Ketoacidosis # ... DKA #Checklist
DKA DIAGNOSTIC CRITERIA:
1. Serum glucose >250 mg/dL
2. Arterial pH <7.3
3. Serum bicarbonate <18 mEq/L
4. At least
ketoacidosis (EDKA ... gap metabolic acidosis ... gap closes and acidosis ... has resolved. ... diabeticketoacidosis #aniongap
Ketosis Disorders
Ketone bodies are a normal metabolic energy source. Excessive unregulated production of ketones, often accompanied
by an anion gap acidosis ... • Diabetic ketoacidosis ... marked anion gap acidosis ... Hyperglycemic hyperosmolar ... • DKA/HHS Overlap