Hyperglycemic Crisis: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State

Abstract

The two most severe metabolic consequences of diabetes mellitus (DM) are diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemia state (HHS). Type 1 and type 2 diabetics are both susceptible to these illnesses. Hyperglycemia, ketone body production, and metabolic acidosis are symptoms of DKA. Hyperosmolality, high blood glucose increase, and little to no ketosis are signs of HHS. Despite significant advancements, it has been difficult to come to a consensus on the diagnostic criteria and course of therapy for both disorders. Another difficulty is that there is a large overlap between these two extremities of the hyperglycemia crisis continuum. A thorough biochemical and clinical patient evaluation, along with prompt diagnosis and therapy, has long been recognized as being essential for symptom relief. Intravenous insulin, fluid replacement, and concurrent management of the triggering causes all form the cornerstones of therapy. Large-scale research that contributes to the definition of how hyperglycemic crises should be handled is lacking globally. A thorough analysis of the pathogenesis, diagnosis, and treatment of DKA and HHS will be provided in this article.