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DKA And HHS - Compare And Contrast
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🚩ACLS Lecture: tinyurl.com/emnoteacls
DKA vs. HHS - A Comprehensive Comparison
Overview
- Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS) are critical diabetic emergencies.
- Both arise from insulin deficiency leading to hyperglycemia.
- Early recognition and treatment are essential to reduce mortality.
Similarities
- Insulin deficiency is the primary cause.
- Common triggers include infections, medication issues, and non-compliance.
- Fluid resuscitation and insulin therapy are key to treatment.
DKA: Key Features
- Typically occurs in Type 1 Diabetes.
- Rapid onset, often within 24 hours.
DKA: Lab Findings:
- Blood glucose above 250 mg/dL.
- Low pH (below 7.3) and bicarbonate (below 18 mmol/L).
- Ketones present in blood and urine.
- Elevated anion gap.
DKA: Clinical Signs:
- Nausea, vomiting, abdominal pain.
- Fruity breath (ketones).
- Kussmaul respirations (deep, labored breaths).
HHS: Key Features
- Typically occurs in Type 2 Diabetes.
- Gradual onset.
HHS: Lab Findings:
- Blood glucose above 600 mg/dL.
- Normal pH and bicarbonate.
- No significant ketones.
- Marked hyperosmolality.
HHS: Clinical Signs:
- Severe dehydration.
- Neurological symptoms: confusion, seizures, coma.
Comparison of Mortality
- DKA mortality rate: Up to 8%.
- HHS mortality rate: As high as 20%.
- HHS affects older individuals with comorbidities, increasing vulnerability.
Management - Initial Steps for Both:
- Rapid fluid resuscitation (1,000-1,500 mL of 0.9% saline in the first hour).
- Insulin therapy with frequent blood glucose monitoring.
- Monitor and correct potassium levels based on initial lab findings.
Management - Key Differences in Focus:
- DKA: Treat acidosis and ketone production.
- HHS: Manage severe dehydration and hyperosmolality.
Addressing Underlying Causes
- Common triggers: infections, medication non-adherence, health conditions.
- Treating root causes prevents recurrence.
- Encourage a proactive and preventive approach in diabetes management.
Prevention and Long-Term Care
- Importance of access to affordable diabetes care.
- Develop culturally sensitive education programs.
- Promote health equity to address disparities in diabetes care.
- Invest in research and technology, e.g., CGM, insulin pumps.
Conclusion
- DKA and HHS are life-threatening but manageable with proper care.
- Early recognition and tailored management save lives.
- Empower patients with knowledge, tools, and support for better outcomes.
- Together, we can improve the future of diabetes care.
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КОМЕНТАРІ

  • @EreniaArias-n7i
    @EreniaArias-n7i 12 годин тому

    Thank you.

  • @kingcravit-sl9od
    @kingcravit-sl9od 21 годину тому

    Thanks 🙏🙏 very informative.

    • @jackcfchong
      @jackcfchong 18 годин тому

      My pleasure. Please share.

  • @jackcfchong
    @jackcfchong 21 годину тому

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  • @aaronschiff7335
    @aaronschiff7335 День тому

    Great, informative, lecture! Regarding status epilepticus Isn’t the length of time greater than 5 min? You reference 30 min. I was always taught it was a seizure that lasts longer than 5 min. The AAP also references five minutes.

    • @jackcfchong
      @jackcfchong 22 години тому

      Febrile status epilepticus (FSE) is a prolonged seizure lasting 30 minutes or more (or a series of seizures without full recovery between them) that occurs in association with a febrile illness in a child aged 6 months to 5 years who does not have an underlying neurological condition, metabolic disorder, or history of afebrile seizures. However, status epilepticus requires immediate treatment to prevent complications such as neuronal injury, systemic damage, or death. The traditional definition of status epilepticus (30 minutes) has been revised for practical clinical management to initiate treatment after 5 minutes. The new definition of status epilepticus is a seizure lasting 5 minutes or longer, or recurrent seizures without a return to baseline consciousness between episodes. In short, both definitions, 30 minutes (traditional definition) and 5 minutes (practical definition), are correct.

    • @aaronschiff7335
      @aaronschiff7335 19 годин тому

      @ thanks for the clarification! Keep up these amazing lectures!

  • @jackcfchong
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  • @kingcravit-sl9od
    @kingcravit-sl9od День тому

    IO access is so awesome. Thanks 👍👍

  • @kingcravit-sl9od
    @kingcravit-sl9od 2 дні тому

    Nice lecture. Thanks 👍👍

  • @MikeChong333
    @MikeChong333 2 дні тому

    Very good, thanks.

  • @elyaekaputri7766
    @elyaekaputri7766 3 дні тому

    will take my ATLS training course soon, thank you for your help🙏

  • @KingGeorge-mf2nn
    @KingGeorge-mf2nn 3 дні тому

    very nice lecture. febrile seizures are very common. thanks.

    • @jackcfchong
      @jackcfchong 3 дні тому

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  • @jackcfchong
    @jackcfchong 3 дні тому

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  • @AllenZhang-g3d
    @AllenZhang-g3d 4 дні тому

    Thank you sir. Very helpful.

  • @jackcfchong
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  • @kingcravit-sl9od
    @kingcravit-sl9od 5 днів тому

    Thanks for the nice mnemonic.

  • @KingGeorge-mf2nn
    @KingGeorge-mf2nn 5 днів тому

    very useful mnemonic. thank you very much.

  • @KingGeorge-mf2nn
    @KingGeorge-mf2nn 5 днів тому

    thank you sir, very helpful lecture

  • @jackcfchong
    @jackcfchong 5 днів тому

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  • @kingcravit-sl9od
    @kingcravit-sl9od 5 днів тому

    👍👍 very informative. Thanks

  • @jackcfchong
    @jackcfchong 6 днів тому

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  • @jackcfchong
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  • @moradzayed
    @moradzayed 7 днів тому

    thank you

    • @jackcfchong
      @jackcfchong 7 днів тому

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  • @jackcfchong
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  • @MikeChong333
    @MikeChong333 9 днів тому

    Thanks. Love watching your teaching videos, clear and concise.

  • @moradzayed
    @moradzayed 9 днів тому

    thank you

    • @jackcfchong
      @jackcfchong 9 днів тому

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    • @jackcfchong
      @jackcfchong 9 днів тому

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  • @Preksha_1616
    @Preksha_1616 10 днів тому

    Excellence explanation 👍

    • @jackcfchong
      @jackcfchong 10 днів тому

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  • @jackcfchong
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  • @AllenZhang-g3d
    @AllenZhang-g3d 11 днів тому

    Thanks. Very nice lecture.

    • @jackcfchong
      @jackcfchong 10 днів тому

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  • @jackcfchong
    @jackcfchong 11 днів тому

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  • @AllenZhang-g3d
    @AllenZhang-g3d 12 днів тому

    Thank you sir.

    • @jackcfchong
      @jackcfchong 12 днів тому

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  • @peruvianamerican2075
    @peruvianamerican2075 14 днів тому

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