How is DKA and HHS treated?

How is DKA and HHS treated?

In DKA, we recommend using intravenous (IV) bolus of regular insulin (0.1 u/kg body weight) followed by a continuous infusion of regular insulin at the dose of 0.1u/kg/hr. The insulin infusion rate in HHS should be lower as major pathophysiological process in these patients is severe dehydration.

What is the pathophysiology of DKA?

DKA is a state of absolute or relative insulin deficiency aggravated by ensuing hyperglycemia, dehydration, and acidosis-producing derangements in intermediary metabolism. The most common causes are underlying infection, disruption of insulin treatment, and new onset of diabetes. (See Etiology.)

What is the pathophysiology of HHS?

HHS occurs when the blood sugar of a person with diabetes becomes too high (hyperglycemia) for a long time. The extra sugar is passed into the urine, which causes the person to urinate frequently. As a result, he or she loses a lot of fluid, which can lead to severe dehydration (extreme thirst).

What is the treatment for HHS?

Treatment of HHS Treatment is 0.9% (isotonic) saline solution at a rate of 15 to 20 mL/kg/hour, for the first few hours. After that, the corrected sodium should be calculated. If the corrected sodium is < 135 mEq/L (< 135 mmol/L), then isotonic saline should be continued at a rate of 250 to 500 mL/hour.

What is the difference between HHS and diabetic ketoacidosis?

DKA is characterized by ketoacidosis and hyperglycemia, while HHS usually has more severe hyperglycemia but no ketoacidosis (table 1). Each represents an extreme in the spectrum of hyperglycemia. The precipitating factors, clinical features, evaluation, and diagnosis of DKA and HHS in adults will be reviewed here.

What causes Kussmaul breathing?

Causes: Kussmaul breathing is usually caused by high acidity levels in the blood. Cheyne-Stokes breathing is usually related to heart failure, stroke, head injuries, or brain conditions. Pattern: Kussmaul breathing doesn’t alternate between periods of fast and slow breathing.

What is HHS vs DKA?

DKA is characterized by ketoacidosis and hyperglycemia, while HHS usually has more severe hyperglycemia but no ketoacidosis (table 1). Each represents an extreme in the spectrum of hyperglycemia.

What is HHS medical?

Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes. It involves extremely high blood sugar (glucose) level without the presence of ketones.

What is the difference between DKA and HHS?

Does HHS cause hyperkalemia?

Hypokalemia or hyperkalemia may be present. Commonly, at time of presentation of HHS, serum potassium may be elevated due to an extracellular shift caused by insulin deficiency. However, total body potassium is likely low regardless of its serum value. The average potassium deficit in normally about 300-600 mEq.

What happens in HHNS?

When HHNS affects a person with diabetes, blood sugar levels rise and the body passes excess sugar into the urine. This causes regular bathroom trips, and over time this affects the colour of the liquid.

What is diabetic HHS?

Diabetic hyperosmolar (hi-pur-oz-MOE-lur) syndrome is a serious condition caused by extremely high blood sugar levels. The condition most commonly occurs in people with type 2 diabetes. It’s often triggered by illness or infection.

What lab values indicate diabetic ketoacidosis?

Diabetic ketoacidosis is typically characterized by hyperglycemia over 250 mg/dL, a bicarbonate level less than 18 mEq/L, and a pH less than 7.30, with ketonemia and ketonuria.

What does ketoacidosis smell like?

Ketoacidosis can be smelled on a person’s breath. This smell is often described as smelling like nail polish remover or alcohol. Diabetics can also have this condition but their breath tends to smell fruity.

What is the pathophysiology of diabetic ketoacidosis?

Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. DKA occurs mostly in type 1 diabetes mellitus (DM).

How to treat HHS?

HHS can be treated and controlled most of the time, but early treatment is very important. You may need to stay in the hospital for treatment. Healthcare providers will first treat dehydration by giving you fluids and electrolytes, such as potassium, through an IV.