Treatment of Diabetic Ketoacidosis (DKA)/Hyperglycemic Hyperosmolar State (HHS): Novel Advances in the Management of Hyperglycemic Crises (UK Versus USA).

• Authors: Ketan K. Dhatariya, Norfolk and Norwich University; Priyathama Vellanki, Emory University
• Journal Title: Current Diabetes Reports
• Volume: Volume 17, Number 5
• Publisher: Current Medicine Group | 2017-05-31, Pages 33-33
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1007/s11892-017-0857-4
• Subjects: Health Sciences, Health Care Management; Health Sciences, Public Health
• Keywords: Diabetic ketoacidosis; Hyperglycemic hyperosmolar state; Management; Survey

Abstract

Purpose of Review 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. Recent Findings 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. Summary 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.