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The major differential diagnosis is diabetic ketoacidosis (DKA). In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL). [6] Metabolic acidosis is absent or mild. [6] A temporary state of confusion (delirium) is also more common in HHS than DKA. HHS also tends to affect older people more.
Diabetic ketoacidosis may be diagnosed when the combination of hyperglycemia (high blood sugars), ketones in the blood or on urinalysis and acidosis are demonstrated. [6] In about 10% of cases the blood sugar is not significantly elevated ("euglycemic diabetic ketoacidosis"). [3] A pH measurement is performed to detect acidosis.
Hyperosmolar syndrome or diabetic hyperosmolar syndrome is a medical emergency caused by a very high blood glucose level. The prefix "hyper-" means high, and "osmolarity" is a measure of the concentration of active particles in a solution, so the name of the syndrome simply refers to the high concentration of glucose in the blood.
Moreover, certain medications prescribed for different conditions have the potential to cause HHS. [13] [15] As with DKA, urgent medical treatment is necessary, commonly beginning with fluid volume replacement. [8] On the whole, HHS is a medical emergency marked with hyperglycemia, hyperosmolarity, dehydration, and mild or no ketosis. [15]
Blood tests for the diagnosis of diabetic ketoacidosis measure glycemia (sugar level), pH (blood acidity), and ketone bodies. As urgent medical treatment is often required when DKA is suspected, the tentative diagnosis can be made based on clinical history and by calculating the anion gap from the basic metabolic panel , which would demonstrate ...
Has Very Low or No Added Sugar: While beverages like 100% fruit juices and milk may have natural sugars, the presence of protein or fat, as found in milk, can help prevent a spike in blood sugar ...
This means that the insulin/glucagon balance is such that diabetic ketoacidosis doesn’t usually develop. Having said that, a complication called hyperosmolar hyperglycemic state (or HHS) is much more common in type 2 diabetes than type 1 diabetes - and it causes increased plasma osmolarity due to extreme dehydration and concentration of the ...
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