title: Management of Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State.
abstract: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are the most serious and life-threatening hyperglycemic emergencies in diabetes. DKA is more common in young people with type 1 diabetes and HHS in adult and elderly patients with type 2 diabetes. Features of the 2 disorders with ketoacidosis and hyperosmolality may coexist. Both are characterized by insulinopenia and severe hyperglycemia. Early diagnosis and management are paramount. Treatment is aggressive rehydration, insulin therapy, electrolyte replacement, and treatment of underlying precipitating events. This article reviews the epidemiology, pathogenesis, diagnosis, and management of hyperglycemic emergencies.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, 69 Jesse Hill Jr. Drive Southeast, 2nd Floor, Atlanta, GA 30303, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Fayfman
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, 69 Jesse Hill Jr. Drive Southeast, 2nd Floor, Atlanta, GA 30303, USA.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Pasquel
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, 69 Jesse Hill Jr. Drive Southeast, 2nd Floor, Atlanta, GA 30303, USA. Electronic address: Geumpie@emory.edu.
authors.forename: Guillermo E
authors.initials: GE
authors.lastname: Umpierrez
mesh_terms: D001639:Bicarbonates / Q000627:therapeutic use; D048909:Diabetes Complications / Q000175:diagnosis / Q000503:physiopathology; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D004630:Emergencies; D005440:Fluid Therapy; D017052:Hospital Mortality; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007249:Inflammation / Q000503:physiopathology; D007328:Insulin / Q000627:therapeutic use; D018384:Oxidative Stress / Q000502:physiology; D000077203:Sodium-Glucose Transporter 2 Inhibitors
chemical_list: D001639:Bicarbonates; D007004:Hypoglycemic Agents; D007328:Insulin; D000077203:Sodium-Glucose Transporter 2 Inhibitors
keywords: Diabetes; Diabetic ketoacidosis; Hyperglycemic emergencies; Hyperglycemic hyperosmolar state; Management of hyperglycemic emergencies