Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Feb 9:2:820728.
doi: 10.3389/fcdhc.2021.820728. eCollection 2021.

Updates in the Management of Hyperglycemic Crisis

Mohammed Aldhaeefi  1   2   3 , Namareq F Aldardeer  4 , Nada Alkhani  5 , Shatha Mohammed Alqarni  6 , Abdullah M Alhammad  7   8 , Abdulrahman I Alshaya  1   2   3
Affiliations
Review

Updates in the Management of Hyperglycemic Crisis

Mohammed Aldhaeefi et al. Front Clin Diabetes Healthc. .

Abstract

Diabetes mellitus (DM) affects the metabolism of primary macronutrients such as proteins, fats, and carbohydrates. Due to the high prevalence of DM, emergency admissions for hyperglycemic crisis, diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are fairly common and represent very challenging clinical management in practice. DKA and HHS are associated with high mortality rates if left not treated. The mortality rate for patients with DKA is < 1% and ~ 15% for HHS. DKA and HHS have similar pathophysiology with some few differences. HHS pathophysiology is not fully understood. However, an absolute or relative effective insulin concentration reduction and increased in catecholamines, cortisol, glucagon, and growth hormones represent the mainstay behind DKA pathophysiology. Reviewing the patient's history to identify and modify any modifiable precipitating factors is crucial to prevent future events. The aim of this review article is to provide a review of the DKA, and HHS management based on the most recently published evidence and to provide suggested management pathway of DKA of HHS management in practice.

Keywords: diabetes mellitus; diabetic ketoacidosis; hyperglycemia crisis; hyperglycemic emergencies; hyperosmolar hyperglycemic syndrome.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Pathway displays the management of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS).
See this image and copyright information in PMC

References

    1. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic Crises in Adult Patients With Diabetes. Diabetes Care (2009) 32(7):1335–43. doi: 10.2337/dc09-9032 - DOI - PMC - PubMed
    1. Goyal A, Mathew UE, Golla KK, Mannar V, Kubihal S, Gupta Y, et al. . A Practical Guidance on the Use of Intravenous Insulin Infusion for Management of Inpatient Hyperglycemia. Diabetes Metab Syndrome: Clin Res Rev (2021) 15(5):102244. doi: 10.1016/j.dsx.2021.102244 - DOI - PubMed
    1. Saeedi P. Global and Regional Diabetes Prevalence Estimates for 2019 and Projections for 2030 and 2045: Results From the International Diabetes Federation Diabetes Atlas, 9th Edition. Diabetes Res Clin Pract (2019) 10:157. doi: 10.1016/j.diabres.2019.107843 - DOI - PubMed
    1. Pasquel FJ, Umpierrez GE. Hyperosmolar Hyperglycemic State: A Historic Review of the Clinical Presentation, Diagnosis, and Treatment. Dia Care (2014) 37(11):3124–31. doi: 10.2337/dc14-0984 - DOI - PMC - PubMed
    1. Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ, Kreisberg RA, Malone JI, et al. . Management of Hyperglycemic Crises in Patients With Diabetes. Diabetes Care (2001) 24(1):131–53. doi: 10.2337/diacare.24.1.131 - DOI - PubMed

LinkOut - more resources