Diabetes Care. Jul;32(7) doi: /dc Hyperglycemic crises in adult patients with diabetes. Kitabchi AE(1), Umpierrez GE, Miles JM. Impact of a hyperglycemic crises protocol. hyperglycemic crises protocol based upon the American Diabetes Association (ADA) consensus statement. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS, also known as hyperosmotic hyperglycemic Typical lab characteristics of DKA and HHS · – ADA DKA HHS water deficit · – DKA rapid overview Hyperglycemic crises in adult patients with diabetes. Diabetes Care ;

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As glucose concentration improves following insulin infusion and administration of the intravenous fluids, serum osmotic gradient previously contributed by hyperglycemia reduces which limits water shifts from the intracellular compartment.

Hormonal interactions in the regulation of blood glucose. DKA can be classified as mild, moderate, or severe based on the severity of metabolic acidosis and the presence of altered mental status Insulin therapy, correction of acidosis, and volume expansion decrease serum potassium concentrations.

Management of hyperglycemic crises in patients with diabetes. Caution needs to be taken with patients who complain of abdominal pain on presentation because the symptoms could be either criises result of the DKA or an indication of a precipitating cause of DKA, particularly in younger patients or in the absence of severe metabolic acidosis 34 Abdominal pain in patients with hyperglycemic crises.


Measurement of serum salicylate and blood methanol level may be helpful. Patients with known diabetes may be given insulin at the dosage they were receiving before the onset of DKA so long as it was controlling glucose properly.

Hyperglycemic Crises in Adult Patients With Diabetes – Semantic Scholar

Nonspecific hyperamylasemia and hyperlipasemia in diabetic cgises However, total body potassium deficit is usually present from urinary potassium losses due to osmotic diuresis and ketone excretion. Prevention of hypophosphatemia by phosphate infusion during treatment of diabetic ketoacidosis and hyperosmolar coma. Kussmaul respiration, acetone breath, nausea, vomiting and abdominal pain may also occur primarily in DKA and are due to ketosis and crisrs.

This notion should particularly apply in the management of HHS in elderly and patients with multiple medical problems in whom it may not be clear how long these subjects experienced severe hyperglycemia prior to the admission to the hospital. Spurious laboratory values in diabetic ketoacidosis and hyperlipidemia. Elvira O GosmanovaM.

Moreover, there is a tendency to hypoglycemia rather than hyperglycemia with isopropyl alcohol injection 96 National Center for Health Statistics National hospital discharge and ambulatory surgery data [article hyperglyce,ic.

Hyperglycemic Crises in Adult Patients With Diabetes

Annu Rev Med ; Intensive Care Med ; Addressing health problems in the African American and other minority communities requires explicit recognition of the fact that these populations are probably quite diverse in their behavioral responses to diabetes If desirable glucose reduction 22009 not achieved in the first hour, an additional insulin bolus at 0.


Am J Clin Pathol ; Mayo Clin Proc ; Therefore, inappropriately high or low levels of PCO2, determined by ABG will suggest the presence of a mixed acid-based disorder. Hosp Pract ; The procoagulant and inflammatory states may be due to nonspecific phenomena of stress and may partially explain the association of hyperglycemic crises with a hypercoagulable state Elegant studies on hepatic glucose production rates have reported rates ranging from normal or near normal 38 to elevated 1215possibly contributing to the wide range of plasma glucose levels in DKA that are independent of the severity of ketoacidosis Diabetes Metab Res Rev ; Insulin resistance in diabetic ketoacidosis.

Until recently, treatment algorithms hyeprglycemic the administration of an initial intravenous dose of regular insulin 0.

This is observed due to several reasons. Diabetes care ; Proinflammatory cytokines in response to insulin-induced hypoglycemic stress in healthy subjects.

Impact of a hyperglycemic crises protocol.

Cell Mol Neurobiol ; Because most cases occur in patients with known diabetes and with previous DKA, resources need to be redirected toward prevention by funding better access to care and educational programs tailored to individual needs, including ethnic and personal health care beliefs.

Diabetes Mellitus Search for additional papers on this topic. Hyperchloremic non—anion gap acidosis, which is seen during the recovery phase of DKA, is self-limited with few clinical consequences