Overlap of diabetic ketoacidosis and hyperosmolar hyperglycemic state
ESRAA HASSAN, Hisham Mushtaq, Esraa Mahmoud, Sherley Chhibber, Shoaib Saleem, Ahmed Issa, Nitesh Jain, Abbas B Jama, Anwar Khedr, Sydney Boike, Mikael Mir, Noura Attallah, Salim Surani, Syed Anjum Khan
Abstract
Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemia state (HHS) are two life-threatening metabolic complications of diabetes that significantly increase mortality and morbidity. Despite major advances, reaching a uniform consensus regarding the diagnostic criteria and treatment of both conditions has been challenging. A significant overlap between these two extremes of the hyperglycemic crisis spectrum poses an additional hurdle. It has well been noted that a complete biochemical and clinical patient evaluation with timely diagnosis and treatment is vital for symptom resolution. Worldwide, there is a lack of large-scale studies that help define how hyperglycemic crises should be managed. This article will provide a comprehensive review of the pathophysiology, diagnosis, and management of DKA-HHS overlap.