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A 2004 statement by the European Society for Paediatric Endocrinology and the Lawson Wilkins Pediatric Endocrine Society (for children) uses slightly different cutoffs, where mild DKA is defined by pH 7.20–7.30 (bicarbonate 10–15 mmol/L), moderate DKA by pH 7.1–7.2 (bicarbonate 5–10) and severe DKA by pH<7.1 (bicarbonate below 5). [31]
DKA often has serum glucose level greater than 300 mg/dL (HHS is >600 mg/dL). [6] DKA usually occurs in type 1 diabetics whereas HHS is more common in type 2 diabetics. [6] DKA is characterized by a rapid onset, and HHS occurs gradually over a few days. [6] DKA also is characterized by ketosis due to the breakdown of fat for energy. [6]
Ketotic hypoglycemia classically presents in male young children, typically between the ages of 10 months and 6 years, in the morning after a prolonged overnight fast. Symptoms include those of neuroglycopenia, ketosis, or both. [6] [7] Neuroglycopenic symptoms usually include lethargy and malaise, but may include unresponsiveness or seizures.
[10] lethargy may ultimately progress to a coma which is more common in T2D than T1D. [18] HHS, unlike DKA, does not result in significant ketosis and acidosis, or there may be only a very minimal. This is because the presence of a small quantity of insulin suppresses the release of counterregulatory hormones and limits the production of ...
Polydipsia and polyuria occur when blood glucose levels rise high enough to result in excretion of excess glucose via the kidneys, which leads to the presence of glucose in the urine. This produces an osmotic diuresis. [citation needed] Signs and symptoms of diabetic ketoacidosis may include: [citation needed] Ketoacidosis
The most common causes of high anion gap metabolic acidosis are: ketoacidosis, lactic acidosis, kidney failure, and toxic ingestions. [3] Ketoacidosis can occur as a complication of diabetes mellitus (diabetic ketoacidosis), but can occur due to other disorders, such as chronic alcoholism and malnutrition. In these conditions, excessive free ...
Alcoholic ketoacidosis is treated with intravenous dextrose and supportive care and usually does not require insulin. [2] Starvation ketoacidosis can be resolved with intravenous dextrose with attention to electrolyte changes that can occur with refeeding syndrome. [5]
Alkalemia occurs at a pH over 7.45. Arterial blood gas analysis and other tests are required to separate the main causes. In certain situations the main cause is clear. For instance, a diabetic with ketoacidosis is a recognizable case where the main cause of acidemia is essentially obvious. [citation needed]