diabetic%20ketoacidosis%20-and-%20hyperosmolar%20hyperglycemic%20state
DIABETIC KETOACIDOSIS & HYPEROSMOLAR HYPERGLYCEMIC STATE
Diabetic ketoacidosis is characterized by having blood glucose >13.9 mmol/L, arterial pH <7.3 in adults or venous pH <7.3 in pediatrics, bicarbonate <15 mEg/L, moderate ketonuria or ketonemia and anion gap >14.
Hyperosmolar hyperglycemic state in adults is described as having blood glucose >33.3 mmol/L, arterial pH >7.3, bicarbonate >15 mEq/L, mild ketonuria or ketonemia, effective serum osmolality >320 mOsm/kg and variable anion gap.
Hyperosmolar hyperglycemic state in pediatric patients has blood glucose >33.3 mmol/L, venous pH >7.3, bicarbonate >15 mEq/L and altered mental status or severe dehydration.

Patient Education

  • Proper education, access to medical care & effective communication between patient & healthcare provider during illness
  • Sick-day management
    • Patient should be instructed when to contact healthcare professional
    • Education on supplemental short-acting insulin to meet proper blood glucose goals
    • Fever control & infection treatment
    • Easily digestible liquid diet which has carbohydrates & salts
  • Never discontinue insulin unless instructed by healthcare professional
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