title: Treatment of Diabetic Ketoacidosis (DKA)/Hyperglycemic Hyperosmolar State (HHS): Novel Advances in the Management of Hyperglycemic Crises (UK Versus USA).
abstract: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are diabetic emergencies that cause high morbidity and mortality. Their treatment differs in the UK and USA. This review delineates the differences in diagnosis and treatment between the two countries.
  
  
  
  Large-scale studies to determine optimal management of DKA and HHS are lacking. The diagnosis of DKA is based on disease severity in the USA, which differs from the UK. The diagnosis of HHS in the USA is based on total rather than effective osmolality. Unlike the USA, the UK has separate guidelines for DKA and HHS. Treatment of DKA and HHS also differs with respect to timing of fluid and insulin initiation. There is considerable overlap but important differences between the UK and USA guidelines for the management of DKA and HHS. Further research needs to be done to delineate a unifying diagnostic and treatment protocol.
authors.affiliation: Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, Norfolk, NR4 7UY, UK. ketan.dhatariya@nnuh.nhs.uk.|University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK. ketan.dhatariya@nnuh.nhs.uk.
authors.forename: Ketan K
authors.initials: KK
authors.lastname: Dhatariya
authors.affiliation: Division of Endo, Metabolism & Lipids, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Priyathama
authors.initials: P
authors.lastname: Vellanki
mesh_terms: D016883:Diabetic Ketoacidosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006113:United Kingdom; D014481:United States
keywords: Diabetic ketoacidosis; Hyperglycemic hyperosmolar state; Management; Survey