Dka vs hhs glucose levels Physiology and function of insulin. 9 mmol/L) or a random blood glucose concentration ≥ 200 mg/dL (11. One of the hallmark features of HHS vs. DKA or HHS should be suspected whenever people have significant hyperglycemia, especially if they are ill or highly symptomatic (see above). Mar 10, 2023 · IV fluid administration will restore the extracellular fluid volume and stimulate an increase in GFR, both of which will aid in reducing glucose levels by 30% to 50%. 1, E11. DKA and HHS remain important causes of morbidity and mortality among diabetic patients despite well-developed diagnostic criteria and treatment protocols (1). Nov 19, 2021 · This document discusses diabetic emergencies including hypoglycemia, diabetic ketoacidosis (DKA), and hyperglycemic hyperosmolar state (HHS). 1 units/kg/h) for resolution. Dec 21, 2022 · Hyperosmolar hyperglycemic syndrome (HHS) and diabetic ketoacidosis (DKA) are two serious diabetic complications. The unique distinguishing factor in HHS is the absence of ketones or a low ketone production despite an insulinopenic state. May 23, 2021 · Takeaway clinical pearls include the key diagnostic elements between DKA and HHS. HHS. 3 Anion gap Increased Normal/slightly increased pCO2 20-30 Normal Osmolality 300-320 >320 Study with Quizlet and memorize flashcards containing terms like This complication is found mainly in Type 2 diabetics? A. HHS: Most commonly affects people with Type 2 diabetes. 25-7. It involves very high blood sugar levels and can be life threatening. In addition, to the insulin drip the patient also has 5% Dextrose 0. 1) during the hospitalization, hereby defined as combined HHS-DKA and otherwise as pure HHS. Both conditions cause very high blood sugar levels, but there are essential distinctions between the two. Both conditions will have insulin and fluid management, and HHS patients may require increased fluid resuscitation. Since glucose levels are often checked frequently, skyrocketing glucose may pre-date the development of a widening anion gap by a few hours. 2017-09/Management-of-DKA-241013. 1, E14. 9. HHS diagnostic criteria: serum glucose >600 mg/dL, arterial pH >7. You may not realise you have type 2 diabetes until you’re very unwell with HHS and diagnosed. - Early recognition and treatment are essential to reduce mortality. Both are due Diabetic ketoacidosis treatment in adults includes insulin therapy, fluid replacement, and electrolyte management to prevent complications. 9,7 This increase in mortality is attributable to the older age and comorbidities (including an higher rate of venous An initial blood sugar by POC fingerstickis >600 Case 1. 05 units/Kg/hr OR; Change to rapid acting subcutaneous insulin 0. 24 <7. - Enough insulin is present with HHS to prevent the breakdown of fats for energy, thus preventing ketosis. Aug 6, 2021 · after the insulin infusion is stopped, patients should be monitored for recurrence of DKA: (1) Follow the glucose level. DKA: Develops quickly — often within 24 hours. , glucagon) are released, triggering: • Gluconeogenesis: Production of glucose from non-carbohydrate sources. 2 1600 There is a relative insulin deficiency, inadequate to control blood glucose levels, yet not severe enough to lead to ketosis. Fluid losses in HHS are estimated to be two times more than those in diabetic ketoacidosis (DKA). DKA These are both complications of diabetes with very ⬆️ BLOOD GLUCOSE LEVELS. Curr Diabetes Rev. In general, HHS is associated with type 2 diabetes and thus is relatively rare in pediatrics with most of the literature focused on individual case reports or case series. With DKA clients, the objective is to stabilize the blood sugar. 9 percent NaCl over one hour and draw AGB, CBC with diff, UA, serum glucose, Jul 1, 2009 · Recent epidemiological studies indicate that hospitalizations for DKA in the U. (Total fluid loss~4-6L) maintain BSL 8-12 mmol/L Urinary catheter to monitor urine output Circulatory support : (Total fluid loss~6-10L) half of the estimated water deficits will need to be replace during the An A1c is a blood test reflecting average blood glucose levels over a period of three (3) months; clients with elevated blood glucose levels are at risk for developing long-term complications. Diabetic Council . the patient's labs are the following: pH 7. Despite advances in monitoring technologies, insulin therapeutics, and insulin delivery systems, the rate of hyperglycemic emergencies remains largely unchanged. In contrast to diabetic ketoacidosis (DKA) in which acidemia and ketonemia are key features, these are limited in HHS. 25, glucose 455, potassium 2. 5. Bicarbonate therapy may be considered only for extreme acidosis (pH ≤7. 1 mmol/L) and a prior history of diabetes (irrespective of the glucose level) . By the time HHS is diagnosed your blood sugar levels can often be over 40mmol/l. Start studying DKA vs. One reason is that the acute acidosis in DKA causes distressing symptoms (e. Which condition is this? A. Jun 22, 2024 · The key difference between DKA and HHS is the degree of insulin insufficiency. Positive Ketones in the urine. g. . Rapid, deep respirations. 4 9 38 3. HHS - A Comprehensive Comparison Overview - Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS) are critical diabetic emergencies. Both the UK guidelines and the ADA suggest similar glucose levels to diagnose HHS. BMJ Best Practice 2021 . Insulin levels are sufficient to prevent ketogenesis in H Read less The Management of Hyperosmolar Hyperglycaemic State (HHS) in Adults* February 2022 *For 16-18 year olds Use this guideline if the person aged 16 – 18 is being managed by the adult May 1, 2018 · In this article, we focus on five diabetic emergencies: 1) diabetic ketoacidosis (DKA); 2) hyperosmolar hyperglycemic state (HHS); 3) hyperglycemia without obvious acidosis; 4) hypoglycemia; and 5 Aug 1, 2018 · The hyperglycemic hyperosmolar state (HHS) is a life-threatening metabolic decompensation of diabetes which presents with severe hyperglycemia and profound dehydration, typically accompanied by alteration in consciousness ranging from lethargy to coma. The serum osmolality is elevated greater than 320 mOsm/kg H2O. Dec 20, 2024 · 00:00 Introduction 01:14 Type 1 vs Type 2 Diabetes 02:51 DKA Symptoms 04:02 HHS Symptoms 05:12 DKA Treatment 06:43 Insulin Administration 08:15 Potassium Administration 09:48 HHS Treatment 11:30 Rehydration Status 12:40 Conclusion #NCLEX #DKA #DKAvsHHS #Diabetes #Insulin May 9, 2021 · Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are acute metabolic complications of diabetes mellitus that can occur in patients with both type 1 and 2 diabetes mellitus. When should the nurse prepare to give the glucagon? For precipitous drop in blood glucose Diabetic Ketoacidosis (DKA) vs. Diabetic ketoacidosis requires intravenous insulin administration (0. The major precipitating factor for both DKA and HHS is infection. - Both arise from insulin deficiency leading to hyperglycemia. This article will navigate everything you need to know about DKA vs HHS. It provides details on the diagnostic criteria, symptoms, and general approach to managing patients with DKA. are increasing. Serum glucose levels - In DKA the serum glucose is below 800 mg/dl and usually in the 350-500 mg/dl range. A patient who has type 2 diabetes is on the unit after aneurysm repair. May 9, 2021 · Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) represent two extremes in the spectrum of decompensated diabetes. HHS typically presents with normal or small amounts of urine or serum ketones. This has been a known complication with the rise in the usage of SGLT2i (sodium glucose transporter type 2 inhibitors) class of medications. A urinalysis is positive for ketones. 1, E13. Dec 1, 2017 · Hyperosmolar hyperglycemic state (HHS) is a life-threatening endocrine emergency that most commonly affects adults with type 2 diabetes mellitus. Sep 23, 2020 · Remember that the expected ranges for blood glucose are usually between 75-140 mg/dL depending on the type of test. Feb 16, 2023 · 6. 6 mmol/L). Both DKA and HHS can occur in patients with type 1 and type 2 diabetes; however, DKA is more common in young people with type 1 diabetes (T1D) and HHS is more frequently reported in adult and elderly patients with type 2 diabetes (T2D). Hyperosmolar Hyperglycemic Syndrome (HHS) - The major difference between HHS and DKA is that ketosis and acidosis do not occur with HHS. , sepsis, pancreatitis, myocardial infarction, CVA). It can occur in patients of all ages and can Blood glucose level > 600 mg/dL; A fasting blood glucose concentration ≥ 250 mg/dL (13. Diabetic Ketoacidosis (DKA) vs. The pathogenesis of these two diseases is presented in Fig. 18 Urine and serum ketones may be present, but often Nov 15, 2015 · HHS DKA HHS Glucose 250-600 >600 Sodium 125-135 135-145 Potassium Normal/inc Normal Bicarbonate <15meq/l Normal/slightly reduced Arterial pH <7. Abdominal Pain 10. Begin one liter of 0. May 1, 2005 · A diagnosis of diabetic ketoacidosis requires the patient's plasma glucose concentration to be above 250 mg per dL (although it usually is much higher), the pH level to be less than 7. The treatment of DKA in adults will be reviewed here. This chapter focuses on the medical side of DKA, including its causes, manifestations, complications, and management strategies. Diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycamic state ((HHS), previously referred to as hyperosmolar non-ketotic (HONK) coma) are medical emergencies with significant morbidity and mortality. DKA: Present Precipitating Causes of DKA and HHS The five causes of DKA/HHS can be remembered as the “Five I’s”: (1) infection; (2) in-farction; (3) infant (pregnancy), (4) indiscretion, and (5) [lack of] insulin (Table 3). Urine or blood ketones. glucagon levels ad a patient is admitted with diabetic ketoacidosis. The hyperosmolar state results from osmotic diuresis, leading to profound volume depletion and elevated plasma osmolality. DKA (Diabetic ketoacidosis) happens with TYPE I and you can see a BG >250 HHS (hyperosmolar syndrome) happens with TYPE II and you can see a BG > 600 ⚠️ NCLEX Tip: DKA patients have fruity breath & Kussmaul respirations. 02-0. • Lab test differences : 1. 3 >7. Hyperglycemic hyperosmolar syndrome (HHS) is an acute diabetic emergency that exists in a continuum with Diabetic Ketoacidosis (DKA). 2013 Jan 1; 9(1): 25–53. 05 units DKA typically occurs in individuals with type 1 diabetes and is characterized by high blood sugar levels, ketone production, and metabolic acidosis. DKA is characterised by severe insulin deficiency and a rise in concentrations of counterregulatory hormones (glucagon, cortisol, adrenaline and growth hormones) [1, 3, 7]. It is often accompanied by symptoms such as excessive thirst, frequent urination, nausea, and abdominal pain. Which of the following findings has the greatest effect on fluid loss? 1. Feb 25, 2014 · 3) Glucose levels are usually lower in DKA compared to hyperosmolar hyperglycemic state (HHS) due to greater urinary glucose excretion in DKA patients, who are usually younger with better kidney function. 00 >7. 2 With prompt treatment, most patients with DKA recover, but in rare cases, such as patients who develop cerebral edema or have an underlying illness, DKA can become life A patient experiencing DKA is on an insulin drip & their current glucose level is 300. DKA results from a buildup of acids in the bloodstream called ketones, while HHS is characterized by extreme dehydration and hyperglycemia. The high glucose in HHS leads to hyperosmolarity, pulling water from body tissues and causing profound dehydration. 25. Blood sugar level. (See also Diabetes Mellitus and Complications of Diabetes Mellitus. As the nurse, you must know typical signs and symptoms of DKA and HHNS, patient teaching, and expected medical treatments. Mortality in HHS ranges Jun 29, 2015 · Diabetic ketoacidosis is a state of insulin deficiency, characterised by rapid onset, extreme metabolic acidosis, a generally intact sensorium, and only mild hyperglycaemia. 18 Arterial pH is typically greater than 7. Critical components of the hyperglycemic crises Jul 18, 2024 · A retrospective study by Schaapveld-Davis et al indicated that in patients being treated for DKA or HHS, those with end-stage renal disease (ESRD) have a greater likelihood of suffering adverse glucose events (specifically, hypoglycemia or a reduction in glucose >200 mg/dL/h) than do patients with normal kidney function, with the odds ratio for Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are serious complications of diabetes that occur when the body produces too much glucose and too few insulin levels. Infection is one of the most common precipitating factors in both DKA and HHS. HHS: Higher than 600 mg/dL. Decreased serum potassium level. HHS: Develops more slowly — usually within days to weeks. Plasma glucose values in HHS are typically greater than in DKA and can exceed 1200 mg/dL (66. This problem is most commonly seen in type 2 diabetes. 35, plasma bicarbonate is lower than 15 mEq/L, the blood glucose level is higher than 250 mg/dL, and ketones are present in the blood and urine. Nov 25, 2024 · DKA and HHS often occur together (mixed DKA/HHS). Diabetic ketoacidosis was a fatal disease before the dis-covery of insulin in 1921. Oliguria. 1,2 It is characterized by the presence of metabolic acidosis, ketonemia, and hyperglycemia. What is diabetic ketoacidosis (DKA)? Jan 3, 2023 · 2,718 likes, 13 comments - beautifulnursing on January 3, 2023: " HHS vs. S. In many patients, features of the two disorders with ketoacidosis and hyperosmolality may also co-exist. Hyperglycemia, despite being the common ground for both conditions, is different in magnitude for each emergency, being more severe in HHS. DKA (Diabetic Ketoacidosis) and HHNS (Hyperosmolar Hyperglycemic State) are two severe complications of diabetes causing severely high blood sugar levels. 3: 10–50% • fast heart It is important to differentiate between diabetic ketoacidosis (DKA) and alcoholic ketoacidosis (AKA) in an alcoholic diabetic patient since it has significant management implications. ) hyperglycemic hyperosmolar Jan 10, 2023 · Among all reasons for hospital admission in people with diabetes, hyperglycemic crisis (DKA and HHS) is the strongest indicator (85. A better understanding of the pathophysiology and a timely diagnosis Hyperglycemic crises - Knowledge @ AMBOSS (See also Diabetes Mellitus and Complications of Diabetes Mellitus. • Glycogenolysis: Breakdown of glycogen into glucose. Study with Quizlet and memorize flashcards containing terms like A client is diagnosed with hyperglycemic hyperosmolar nonketotic coma (HHNK) after being admitted with a blood glucose level of 720 mg/dL. 9% normal saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. Blood sugar levels differ significantly between DKA and HHS. 30 Ketones mmol/L 1. Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 and type 2 diabetes resulting from an absolute or relative insulin deficiency. Time to develop. Affects mainly Type 1 diabetics; Ketones and Acidosis present; Hyperglycemia presents >300 mg/dL; Variable osmolality; Happens Suddenly; Causes: no insulin present in the body or illness/infection; Seen in young or undiagnosed diabetics; Main problems are hyperglycemia, ketones, and acidosis (blood pH <7. common causes of HHS Sep 13, 2021 · Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is also known as hyperglycemic hyperosmolar syndrome (HHS). A client with type 1 diabetes mellitus has diabetic ketoacidosis. o B. In the decade from 1996 to 2006, there was a 35% increase in the number of cases, with a total of 136,510 cases with a primary diagnosis of DKA in 2006—a rate of increase perhaps more rapid than the overall increase in the diagnosis of diabetes (). Warm, dry skin. triggers: infection, MI, surgery, omission of normal medications; decreased insulin or resistance -> decreased glucose utilisation in skeletal muscle, increased fat and muscle breakdown It is critical to assess glucose and ketone levels to evaluate for diabetic ketoacidosis. DKA comes up frequently in the CICM SAQs, but usually as an ABG interpretation exercise. pdf; Joint British Nov 2, 2009 · DKA vs HHS Circulatory support : IV NS 1L per hr initially (basic), switch to IV Dextrose saline as glucose level drops (<15mmol/L). 1 mmol/L) Anion gap >10 meq/L; Sodium level >150 mEq/L; Blood urea nitrogen ≥ 20 mg/dL; DKA vs HHS Treatment. Diabetic ketoacidosis (DKA) is associated with hyperglycemia and ketoacidosis, whereas hyperosmolar hyperglycemia state (HHS) mainly has severe hyperglycemia and hyperosmolarity. DKA (Focus is glucose management) HHS (Focus is fluid replacement) Parameter Mild Moderate Severe Mixed picture may occur pH 7. the physician orders intravenous fluids of 0. 30 and serum bicarbonate is routinely greater than 18 mEq/L in persons with HHS. You are providing care to a patient experiencing diabetic ketoacidosis. 5-3 >3 >3 <3 HCO 3 mmol/L 15-18 10-14 <10 >18 Osmolality mmol/L (calculated) Variable >320 Blood glucose level (BGL) mmol/L Glucose >11 Euglycaemic DKA can occur in Blood Sugar Levels. dka hhs Pathophysio & Causes Without insulin, the amount of glucose entering the cells is reduced, and gluconeogenesis (the production and release of glucose by the liver) is increased, leading to hyperglycemia (see Fig. Oct 11, 2022 · Definition: Hyperglycemic Hyperosmolar Syndrome (HHS) is defined as hyperosmolality due to elevated serum glucose without significant ketosis. Renal wasting of glucose does not allow for serum glucose to rise to the levels seen in DKA and HHS. She is given fluids and admitted to the intensive care unit for close monitoring and administration of an insulin drip. FFA=free fatty acids . triggers: infection, MI, surgery, omission of normal medications; decreased insulin or resistance -> decreased glucose utilisation in skeletal muscle, increased fat and muscle breakdown Dec 10, 2021 · Laboratory results show increased serum glucose of 400 mg/dL and hyperkalemia of 4. Learn about fluids, insulin, electrolytes, precipitating factors, and transitioning to subcutaneous insulin. 18. Explore metabolism in fed and fasting states, DKA and HHS diagnosis, differences, and case studies. 0). Ketones This quiz on DKA vs HHNS (Diabetic Ketoacidosis vs Hyperglycemic Hyperosmolar Nonketotic Syndrome) will test you on how to care for the diabetic patient who is experiencing these conditions. The hyperglycaemic complications of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) can be life-threatening and require emergency hospital admission if suspected. which of the following is the most appropriate nursing intervention to perform next? - start the IV fluids . 5%) to warrant admission, likely due to its severe and potentially lethal damage to our body. Ketoacidosis with mild hyperglycemia or even normal blood glucose ("normoglycemic" DKA) has become more common with the increased use of sodium-glucose cotransporter 2 [SGLT2] inhibitors. 1 Apr 30, 2021 · HHS occurs less frequently when compared to diabetic ketoacidosis but once it occurs it has a higher mortality rate of about 15%. DKA is that HHS does not cause an anion gap metabolic Aug 8, 2023 · HHS typically presents with more extreme hyperglycemia and mental status changes compared with DKA. Pathogenesis of diabetic ketoacidosis and hyperosmolar hyperglycaemic syndrome. 00-7. Apr 2, 2024 · Diabetic ketoacidosis (DKA) is an acute complication of diabetes that results from absolute or relative insulin deficiency. 35) Nov 28, 2024 · DKA vs. Timely diagnosis, comprehensive clinical and biochemical evaluation, and effective management is key to the successful resolution of DKA and HHS. 30 7. In DKA, glucose levels usually range from 250 to 600 mg/dL, whereas in HHS, they soar to levels often exceeding 600 mg/dL (Kitabchi et al. HHS carries a high mortality (often quoted ~15%) – but this is largely due to comorbid problems and triggers, rather than the HHS itself. Which of the following is not a sign or symptom of Diabetic Ketoacidosis?* o A. Study with Quizlet and memorize flashcards containing terms like DKA blood glucose level, HHS blood glucose level, DKA ketones and more. Up to 30% of patients with DKA may also have some features of HHS. The precipitating factors, clinical features, evaluation, and diagnosis of DKA and HHS in adults will be reviewed here. Prevention of diabetic ketoacidosis and HHS Sep 1, 2013 · WHY ARE GLUCOSE LEVELS LOWER IN DKA? DKA patients usually have lower blood sugar levels than HHS patients. Jun 21, 2021 · Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two of the most serious acute complications of diabetes with overlapping features. DKA & HHS differences cont’d. May 27, 2022 · Blood sugar levels Arterial pH levels Mortality rate Difference in symptoms; HHS: people with type 2 diabetes: more than 600 milligrams per deciliter (mg/dl) more than 7. Hyperosmolar hyperglycemic state (previously referred to as hyperglycemic hyperosmolar nonketotic coma [HHNK] and nonketotic hyperosmolar syndrome [NKHS]) is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to 20%, which is significantly higher than the mortality for diabetic ketoacidosis 3 5 6 In DKA, the arterial pH is lower than 7. 46-6). o C. e. 4% Jun 22, 2024 · In recognition of the wider range of glucose levels at presentation with DKA, the criteria for diagnosis of DKA have been changed to encompass a lower glucose value of >200 mg/dL (11. Diabetic ketoacidosis (DKA) - Diabetic ketoacidosis is a life Counterregulatory hormones (e. Hyperosmolar hyperglycemic state (previously referred to as hyperglycemic hyperosmolar nonketotic coma [HHNK] and nonketotic hyperosmolar syndrome [NKHS]) is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to 20%, which is significantly higher than the mortality for diabetic ketoacidosis May 1, 2015 · Plasma glucose levels seen in persons with HHS are usually significantly higher than those seen with DKA and are normally greater than 600 mg/dL when HHS is diagnosed. Development of progressively severe hyperglycemia may be an early sign of recurrent DKA. Mild to moderate acidosis may be due to severe dehydration and associated hypoperfusion and lactic acidosis. I've seen this erroneous detail a few times in this sub-reddit so I feel it is important to share the accurate information: Diabetic Ketoacidosis (also known by its initials DKA) isn't caused by hyperglycemia, it occurs when absolute or relative insulin deficiency inhibits the ability of glucose to enter cells for utilization as metabolic fuel, the result being that the liver rapidly breaks Hyperosmolar hyperglycaemic state (HHS) can happen when people with type 2 diabetes – or undiagnosed type 2 diabetes – have very high blood glucose levels, also called blood sugar levels. 2. • These processes further increase blood glucose levels, as insulin remains insufficient to transport glucose into tissues. , 2009). * After H& P, obtain capillary glucose and serum or urine ketones (nitroprusside method). Cathy covers critical care topics and complications associated with Diabetes, including: hypoglycemia, Diabetic Ketoacidosis (DKA), and Hyperglycemic Hyperos Nov 3, 2020 · higher mortality rate than DKA; part of a continuum with DKA, with insulin resistance predominant over insulin deficiency; PATHOPHYSIOLOGY. DKA is characterized by ketoacidosis and typically hyperglycemia, while HHS usually has more severe hyperglycemia but no ketoacidosis (table 1). Learn vocabulary, terms, and more with flashcards, games, and other study tools. , E10. ) hyperglycemic hyperosmolar nonketotic syndrome, A patient is found to have a blood glucose of 375 mg/dL, positive ketones in the urine, and blood pH of 7. 3, serum bicarbonate >15 mEq/L, and minimal ketonuria and ketonemia. 1U/Kg every 2 hours; HHS 1,2,3 – when serum glucose is 300, maintain plasma glucose 200-300 until patient alert. Jun 3, 2020 · DKA and HHS are two similar yet in many ways different metabolic emergencies of diabetes are encountered in emergency departments. 30, and the UK, the average cost for an episode of diabetic ketoacidosis is estimated to be £2064 ($2682; €2384) per patient. DKA: Usually above 250 mg/dL. Won Frerichs and Dreschfeld first described the disorder around 1880. Both require treatment with insulin, IV fluids, electrolyte and Comparison table between diabetic ketoacidosis and Hyperosmolar hyperglycaemia state Tables > DKA vs HHS. Ketoacidosis in an alcoholic diabetic patient is a diagnostic Study with Quizlet and memorize flashcards containing terms like What are the overlapping features of DKA and HHS?, DKA s/s, HHS s/s and more. 3 Case 1 Chemistry Hyperglycemic Crisis: DKA vs. 14. Hypotension. The client would be experiencing polyuria, and Kussmaul's respirations (deep and rapid breathing pattern) would be present. Similarities - Insulin deficiency is the primary cause. The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with type 1 diabetes at 1600. DKA vs HHS. ). Both conditions result from high blood glucose levels and require insulin to help treat Jan 1, 2002 · Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are two acute complications of diabetes that can result in increased morbidity and mortality if not efficiently and effectively treated. Diabetic ketoacidosis (DKA) - Diabetic ketoacidosis is a life It is rarer than diabetic ketoacidosis (DKA), and is reported in <1% of hospital admissions for patients with diabetes, 7–9 but has a higher mortality rate of up to 20%, 10 times higher than that of patients with DKA. HHS 138 112 6. )diabetic ketoacidosis B. 3. This OnePager covers the differences between these ketosis disorders & provides a differential to identify the cause (the 5 I’s mnemonic: infection, ischemia, inflammation, intoxications, insulin deficiency). HHS has a higher mortality than DKA. Polydipsia. Diabetic Ketoacidosis (DKA) Hyperglycemic Hyperosmolar Syndrome (HHS) Patho: Common in type 2 DM Result of insulin deficiency Illness and infection are associated with insulin resistance- if insulin levels are not increased during illness and infection, hyperglycemia may progress to DKA Jun 27, 2022 · DKA 1,2,3 – when serum glucose is 200, maintain plasma glucose 150-200 until resolution of ketoacidosis Reduce insulin to 0. 4. o D. Feb 17, 2023 · Most commonly affects people with Type 1 diabetes. In HHS, patients will have higher glucose levels, milder acidosis, mild ketosis, and increased dehydration. Reduce insulin to 0. Jan 30, 2024 · DKA and HHS are two complications of diabetes that have similar symptoms, causes, and treatments. 1. Suspect a diagnosis of DKA in a person with known diabetes or significant hyperglycaemia (blood glucose level greater than 11 mmol/L) and the following: DKA vs HHNS Diabetic Ketoacidosis. ⭐️ - polyuria, polyphagia, polydipsia d/t diuresis and cell starvation - Weight loss: cells unable to use glucose bc of insulin deficiency and the body is placed in a catabolic state - GI effects: increased ketones and acidosis lead to N/V and abdominal pain - blurred vision, headache, weakness, orthostatic hypotension: fluid volume depletion from osmotic diuresis leads to dehydration - metabolic Jan 6, 2025 · Understand normal glucose metabolism, pathophysiology of hyperglycemic syndromes, and effective management strategies. Nearing 100 years of insulin availability, mortality related to diabetic ketoacidosis in the adult population has progressively declined to less Nov 3, 2020 · higher mortality rate than DKA; part of a continuum with DKA, with insulin resistance predominant over insulin deficiency; PATHOPHYSIOLOGY. The patient is on an insulin drip and their current glucose level is 300. , nausea, dyspnea, abdominal pain) that encourage patients to seek attention at an earlier stage. 1, 2 However, the incidence increased by 52. DKA, HHS, AKA, etc are common in the ICU, but can have high morbidity if mismanaged. They described patients with diabetes mellitus with profound hyperglycemia and glycosuria without the classic Kussmaul breathing or acetone in the Jun 1, 2024 · Perhaps the most important aspect of treating DKA or HHS is ensuring that no underlying process is missed (e. Dec 12, 2023 · To separate patients with a combined condition of HHS and DKA (HHS-DKA) and patients with pure HHS, we used the Danish National Patient Register (DNPR) to identify whether the patients had an ICD10 diagnosis code of DKA (i. In DKA, the blood glucose levels will be greater than 300 mg/dL — but under 600 mg/dL, because when blood sugar levels reach 600 mg/dL, we enter into hyperglycemic-hyperosmolar state (HHS) which we’ll cover next. In general, glucose levels in HHS are higher than the ones for DKA. Infection. 45% NS infusing in the right antecubital vein. A normal or mildly elevated blood glucose level does not rule out diabetic ketoacidosis in certain conditions, such as pregnancy or with SGLT2 inhibitor use. 2 Glucose levels must be lowered more slowly for HHS patients than for DKA patients, at a rate of only 50 to 75 mg/dL/h. The admitting orders include: normal saline infusion, insulin infusion, tylenol PRN and glucagon PRN. As outlined in Figure 1, to make the diagnosis and determine the severity of DKA or HHS, the following should be assessed: plasma levels of electrolytes (and anion gap), plasma glucose (PG), creatinine, osmolality and beta-hydroxybutyric acid (beta-OHB Aug 12, 2023 · Hyperosmolar hyperglycemic syndrome (HHS) is a clinical condition that arises from a complication of diabetes mellitus. 9 mmol/L. opul juye vcvifr dnxa muenlwb bhrdgqr ekngbh oahrtk fewyeojp yqdynt