What is the difference between DKA and HHNS?
DKA typically evolves within a few hours, whereas HHNS is much slower and occurs over days to weeks, according to 2021 research . The two conditions look similar because of the hyperglycemia component of each condition. Knowing the symptoms of each can help you seek medical care as soon as possible.
How are HHS and DKA treated differently?
In DKA, we recommend using intravenous (IV) bolus of regular insulin (0.1 u/kg body weight) followed by a continuous infusion of regular insulin at the dose of 0.1u/kg/hr. The insulin infusion rate in HHS should be lower as major pathophysiological process in these patients is severe dehydration.
What are the main diagnostic differences between HHS and DKA?
DKA is characterized by ketoacidosis and hyperglycemia, while HHS usually has more severe hyperglycemia but no ketoacidosis (table 1). Each represents an extreme in the spectrum of hyperglycemia.
Why is fluid replacement important in DKA?
Fluid resuscitation is a critical part of treating patients with DKA. Intravenous solutions replace extravascular and intravascular fluids and electrolyte losses. They also dilute both the glucose level and the levels of circulating counterregulatory hormones.
How is HHNS diagnosed?
Diagnosis. HHNS is diagnosed based on symptoms and by measuring blood glucose levels, which can be performed with a finger stick. A blood glucose level of 600 mg/dL and low ketone levels are the main factors for diagnosis of HHNS.
What is HHNS?
Hyperglycaemic hyperosmolar non-ketotic syndrome (HHNS) is a life-threatening complication of uncontrolled diabetes mellitus. This syndrome is characterised by severe hyperglycaemia, a marked increase in serum osmolality, and clinical evidence of dehydration without significant accumulation of ketoacids.
What is HHNS diabetes?
Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), also known as Hyperosmolar Hyperglycaemic State (HHS) is a dangerous condition resulting from very high blood glucose levels. HHNS can affect both types of diabetics, yet it usually occurs amongst people with type 2 diabetes.
What IV fluids are given for DKA?
Normal saline (0.9% sodium chloride) is the most commonly used intravenous fluid in treating DKA, but it has a very high concentration of chloride and can lead to additional acid production when given in large volumes.
Why do we give fluids before insulin in DKA?
When the blood glucose concentration is approximately 250 mg per dL (13.9 mmol per L), glucose should be added to the hydration fluid (i.e., 5 percent dextrose in hypotonic saline solution). This allows continued insulin administration until ketonemia is controlled and also helps to avoid iatrogenic hypoglycemia.
What is the treatment for HHNS?
Treatment. Treatment typically involves starting intravenous (IV) fluids (saline solution delivered through a needle into a vein) to rehydrate the body quickly. It also may require IV insulin to bring down blood sugar levels. If you are hospitalized due to HHNS, you may be kept overnight for observation.
What does DKA HHNS stand for?
What happens in HHNS?
When HHNS affects a person with diabetes, blood sugar levels rise and the body passes excess sugar into the urine. This causes regular bathroom trips, and over time this affects the colour of the liquid.
Hyperglycemic hyperosmolar nonketotic syndrome (HHNS): a metabolic disorder of type 2 diabetes resulting from a relative insulin deficiency initiated by an intercurrent illness that raises the demand for insulin; associated with polyuria and severe dehydration. DKA is caused by an absence or markedly inadequate amount of insulin.
Who is at risk for diabetic ketoacidosis ( DKA )?
Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are acute metabolic complications of diabetes mellitus that can occur in patients with both type 1 and 2 diabetes mellitus.
What’s the best way to treat DKA and HHS?
Timely diagnosis, comprehensive clinical and biochemical evaluation, and effective management is key to the successful resolution of DKA and HHS.
When to use NS bolus in severe DKA?
Like the STRS approach, there is no routine use of an intravenous NS fluid bolus in severe DKA. Last, like the STRS approach the estimated fluid deficit is repaired over 48 hours by adding the hourly volume to maintenance requirement calculated using reduced volume rules.
