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Guideline for management of adult patients with diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS)

UCSD Internal
patients with diabetic ... ketoacidosis (DKA ... ) or hyperosmolar ... #ketoacidosis # ... #treatment
Algorithm for treatment of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS)

#DKA #HHS #Algorithm #Diabetic #Ketoacidosis
Algorithm for treatment ... of Diabetic Ketoacidosis ... State (HHS) ... #DKA #HHS #Algorithm ... #Diabetic #Ketoacidosis
Pathophysiology of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS)
Absolute Insulin deficit:
 - Type I DM:
Ketoacidosis (DKA ... Hyperglycemic Hyperosmolar ... Syndrome (HHS) ... Polydipsia #dka #hhs ... #diabetic #ketoacidosis
Ketosis Disorders - Comparison Table
 • Starvation Ketosis
 • Alcoholic Ketoacidosis (AKA)
 • Diabetic Ketoacidosis (DKA)
(AKA) • Diabetic ... Ketoacidosis (DKA ... Hyperglycemic Hyperosmolar ... State (HHS) ... • DKA/HHS Overlap
Pediatric Diabetic Ketoacidosis
#Management #Peds #DKA #DiabeticKetoacidosis #Algorithm #PEMSource
Pediatric Diabetic ... Ketoacidosis #Management ... #Peds #DKA #DiabeticKetoacidosis ... #Algorithm #PEMSource
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
Diabetic Ketoacidosis 
Management Priorities
1. Fluids 
2. Insulin 
3. Potassium 
4. Acidosis 
5. Re-establish oral fluids,
Diabetic Ketoacidosis ... Identification and treatment ... #Ketoacidosis # ... Diabetes #Management ... #Pediatrics #Peds
Ketosis Disorders
Ketone bodies are a normal metabolic energy source. Excessive unregulated production of ketones, often accompanied
• Alcoholic ketoacidosis ... • Diabetic ketoacidosis ... Hyperglycemic hyperosmolar ... • DKA/HHS Overlap ... of both DKA & HHS
DKA DIAGNOSTIC CRITERIA:
1. Serum glucose >250 mg/dL
2. Arterial pH <7.3
3. Serum bicarbonate <18 mEq/L
4. At least
have new-onset diabetes ... are Euglycemic Diabetic ... ketoacidosis (EDKA ... Treatment with IV ... closes and acidosis has
There are similarities and differences between these 3 conditions which all carry treatment implications. Each mimic
which all carry treatment ... conditions, serum BHB has ... In Alcoholic Ketoacidosis ... drips unless also diabetic ... leads to severe ketoacidosis