
Diabetic ketoacidosis DKA and hyperglycemic hyperosmolar state HHS are the most serious acute metabolic complications of diabetes. Although DKA and HHS are often discussed as separate entities, they represent points along a spectrum of hyperglycemic emergencies due to poorly controlled diabetes. Clinically, they differ only by the degree of dehydration and the severity of metabolic acidosis. DKA has long been considered a key clinical feature of type 1 diabetes T1D, but in contrast to popular belief, DKA is more common in patients with type 2 diabetes T2D. T2D now accounts for up to one half of all newly diagnosed diabetes in children ages years. In the U. In addition, in recent years an increasing number of unprovoked ketoacidosis cases without precipitating cause have been reported in children, adolescents and adult subjects with T2D.
Relapse of Umpierrez may occur after sudden interruption of IV diet therapy or in patients without concomitant use of SC insulin administration or lack of frequent umiperrez. GE Umpierrez, W. A recent study in adolescents reported that an keto home-based multidisciplinary intervention resulted in guillermo significant decrease in DKA admissions over 2 years.
Perspective: SGLT2 inhibitors may predispose to ketoacidosis. Cerebral edema typically occurs hours after treatment is activated, but it can be present before treatment has begun or may develop any time during treatment for DKA. Diabetic Ke to acidosis and Hyperglycemic Hyperosmolar. Hypoglycemic events most commonly occur after several hours of insulin infusion between 8 and 16 hours or during the transition phase. Kitabchi AE. Freire, GE. Umpierrez, D.
Theoretic advantages of phosphate therapy include prevention of respiratory depression and generation of erythrocyte 2,3-diphosphoglycerate. More magazines by this user. Hyperglycemia results from increased hepatic and renal glucose production and impaired glucose utilization in peripheral tissues. J Pediatr Endocrinol Metab. Alcoholism, ketoacidosis, and lactic acidosis. Both insulin therapy and correction of acidosis decrease serum potassium levels by stimulating cellular potassium uptake in peripheral tissues and may lead to hypokalemia. Program of 83 rd Annual Meeting of Endocrine Society. Description of the Condition Incidence Diabetic ketoacidosis DKA and hyperglycemic hyperosmolar state HHS are the most serious acute metabolic complications of diabetes. Management of type 2 diabetes: evolving strategies for treatment.
