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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Particularly important in this regard is captopril, an angiotensin converting enzyme inhibitor prescribed for the treatment of hypertension and diabetic nephropathy.

Hyperglycemic Crises in Adult Patients With Diabetes

Paramount in this effort hypegglycemic improved education regarding sick day management, which includes the following: Medicine Baltimore ; Differential diagnosis Not all patients with ketoacidosis have DKA. Mechanism of cerebral edema in children with diabetic ketoacidosis.

Induction of hypocalcemia and hypomagnesemia by phosphate therapy. Quantitative displacement of acid-base equilibrium in metabolic acidosis. In ketoacidosis, leukocytosis is attributed to stress and maybe correlated to elevated levels of cortisol and norepinephrine Department of Health and Human Services; Further evaluation is necessary if this complaint does not resolve with resolution of dehydration and metabolic acidosis.


Abbas E KitabchiM. Diabetes care ; During treatment of DKA, hyperglycemia is corrected faster than ketoacidosis. In patients with new onset diabetes, a multi-dose insulin regimen should be started at a dose of 0. View this chapter in Endotext. Diabetic ketoacidosis with intracerebral complications. Excess catecholamines coupled with insulinopenia promote triglyceride breakdown lipolysis to free fatty acids FFA and glycerol.

References Publications referenced by this paper. Patients with known diabetes may be given insulin at the dose they were receiving before the onset of hyperglycemic crises.

Please review our privacy policy. The administration of continuous IV infusion of regular insulin is the preferred route because of its short half-life and easy titration and the delayed onset of action and prolonged half-life of subcutaneous regular insulin.

Endocr Rev ; Drugs such as corticosteroids, thiazide diuretics, sympathomimetic agents e. Ann Intern Med ; Emerg Med Australas ; The key diagnostic feature in DKA is the elevation in circulating total blood ketone concentration. Ketosis-prone type 2 diabetes in hyperglycenic of sub-Saharan African origin: Pediatr Diabetes ; 2: Postgrad Med J ; Cocaine use also is associated with recurrent DKA 45 Diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome.

The hyperosmolar hyperglycemic syndrome.

Ketoacidosis in pancreatectomized man. J Clin Endocrinol Metab ; Pseudonormoglycemia in diabetic ketoacidosis with hyperglyvemic triglycerides. This is followed by altered level of consciousness and lethargy. Rosenbloom The Journal of pediatrics Ethylene glycol antifreeze is suggested by the presence of calcium oxalate and hippurate crystals in the urine. DKA is responsible for more thanhospital days per year 1,2 at an estimated annual direct medical expense and indirect cost of 2.


The hgperglycemic of blood hydrogen ion concentration on the level of consciousness in diabetic ketoacidosis. Acetone metabolism in humans during diabetic ketoacidosis. Immunogenetic analysis suggest different pathogenesis between obese and lean African-Americans with diabetic ketoacidosis.

Impact of a hyperglycemic crises protocol.

Diabetic ketoacidosis during long-term treatment with continuous subcutaneous insulin infusion. Other precipitating factors include discontinuation of or inadequate insulin therapy, pancreatitis, myocardial infarction, cerebrovascular accident, and drugs 1013 Diabetes Care ; 32 Suppl. Insulin therapy cruses diabetic ketoacidosis: Diabet Med ; There is no evidence that phosphate therapy is necessary in treatment hyperglycwmic better outcome of DKA Abdominal pain in patients with hyperglycemic crises.

Role of glucagon and other hormones in development of diabetic ketoacidosis. Glucose and ketone body kinetics in diabetic ketoacidosis.

Plasma acid-base patterns in diabetic ketoacidosis. Therefore, a careful search for a source of infection should be performed even in the absence of fever. Despite total-body potassium depletion, mild-to-moderate hyperkalemia is common in patients with hyperglycemic crises. Diabetic ketoacidosis and hyperosmolar nonketotic state. Annals of internal medicine ;