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Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. [1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion and occasionally loss of consciousness. [1] A person's breath may develop a specific "fruity" smell. [1]
The major differential diagnosis is diabetic ketoacidosis (DKA). In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL). [6] Metabolic acidosis is absent or mild. [6] A temporary state of confusion (delirium) is also more common in HHS than DKA. HHS also tends to affect older people more.
Emergency treatment can come into effect within hours in case of diabetic hyperosmolar syndrome. Treatment involves intravenous fluids to replenish hydration-reducing plasma, intravenous insulin to lower blood sugar levels, and intravenous potassium and sodium to replace the lost electrolytes which are essential for cell function, as insulin will force some electrolytes into the cell.
High anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap (a medical value based on the concentrations of ions in a patient's serum). Metabolic acidosis occurs when the body produces too much acid , or when the kidneys are not removing enough acid from the body.
While replacing fluid and electrolyte loss, insulin, and acid-placed balance are the aim of this treatment. [8] proper treatment usually results in full recovery, though death can result from inadequate or delayed treatment, or from complications (e.g., brain edema). [12] Preventing DKA is attainable by following some precautions. [16]
Signs and symptoms of diabetic ketoacidosis may include: [citation needed] Ketoacidosis; Kussmaul hyperventilation (deep, rapid breathing) Confusion or a decreased level of consciousness; Dehydration due to glycosuria and osmotic diuresis; Increased thirst 'Fruity' smelling breath odor; Sweet sensation that is felt into the mouth without a reason
People with acute metabolic acidosis may exhibit deep, rapid breathing called Kussmaul respirations which is classically associated with diabetic ketoacidosis. [8] Rapid deep breaths increase the amount of carbon dioxide exhaled, thus lowering the serum carbon dioxide levels, resulting in some degree of compensation. Overcompensation via ...
Untreated central diabetes insipidus patients usually exhibit polyuria, nocturia, and polydipsia as a result of the initial rise of serum sodium and osmolality. [5] Patients may also experience neurologic symptoms associated with the underlying illness, such as headaches and diplopia, depending on the exact origin of the central diabetes insipidus.
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