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Review
. 2022 Nov 16;10(32):11702-11711.
doi: 10.12998/wjcc.v10.i32.11702.

Overlap of diabetic ketoacidosis and hyperosmolar hyperglycemic state

Esraa Mamdouh Hassan  1 , Hisham Mushtaq  2 , Esraa Elaraby Mahmoud  3 , Sherley Chhibber  4 , Shoaib Saleem  5 , Ahmed Issa  6 , Jain Nitesh  1 , Abbas B Jama  1 , Anwar Khedr  7 , Sydney Boike  8 , Mikael Mir  8 , Noura Attallah  1 , Salim Surani  9   10 , Syed A Khan  1
Affiliations
Review

Overlap of diabetic ketoacidosis and hyperosmolar hyperglycemic state

Esraa Mamdouh Hassan et al. World J Clin Cases. .

Abstract

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemia state (HHS) are two life-threatening metabolic complications of diabetes that significantly increase mortality and morbidity. Despite major advances, reaching a uniform consensus regarding the diagnostic criteria and treatment of both conditions has been challenging. A significant overlap between these two extremes of the hyperglycemic crisis spectrum poses an additional hurdle. It has well been noted that a complete biochemical and clinical patient evaluation with timely diagnosis and treatment is vital for symptom resolution. Worldwide, there is a lack of large-scale studies that help define how hyperglycemic crises should be managed. This article will provide a comprehensive review of the pathophysiology, diagnosis, and management of DKA-HHS overlap.

Keywords: Diabetes; Diabetic ketoacidosis; Hypernatremia; Hyperosmolar Coma; Hyperosmolar hyperglycemia state; Metabolic acidosis.

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Conflict of interest statement

Conflict-of-interest statement: There are no conflicts of interest to report.

References

    1. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32:1335–1343. - PMC - PubMed
    1. Nasa P, Chaudhary S, Shrivastava PK, Singh A. Euglycemic diabetic ketoacidosis: A missed diagnosis. World J Diabetes. 2021;12:514–523. - PMC - PubMed
    1. Puttanna A, Padinjakara R. Diabetic ketoacidosis in type 2 diabetes mellitus. Pract Diabetes . 2014;31:155–158.
    1. Islam T, Sherani K, Surani S, Vakil A. Guidelines and controversies in the management of diabetic ketoacidosis - A mini-review. World J Diabetes. 2018;9:226–229. - PMC - PubMed
    1. Gosmanov AR, Gosmanova EO, Kitabchi AE. Hyperglycemic Crises: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, Dungan K, Hershman JM, Hofland J, Kalra S, Kaltsas G, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, Morley JE, New M, Purnell J, Sahay R, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext. South Dartmouth (MA): MDText.com, Inc., 2000. Available from: http://www.ncbi.nlm.nih.gov/books/NBK279052/ - PubMed