Hyperglycemic Crises in Adult Patients With Diabetes
By A. Kitabchi, G. Umpierrez, J. Miles, J. Fisher. Diabetes Care, 2009
2,108 citations recorded by the source corpus.
Diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS) are the two most serious acute metabolic complications of diabetes. DKA is responsible for more than 500,000 hospital days per year (1,2) at an estimated annual direct medical expense and indirect cost of 2.4 billion USD (2,3). Table 1 outlines the diagnostic criteria for DKA and HHS. The triad of uncontrolled hyperglycemia, metabolic acidosis, and increased total body ketone concentration characterizes DKA. HHS is characterized by severe hyperglycemia, hyperosmolality, and dehydration in the absence of significant ketoacidosis. These metabolic derangements result from the combination of absolute or relative insulin deficiency and an increase in counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone). Most patients with DKA have autoimmune type 1 diabetes; however, patients with type 2 diabetes are also at risk during the catabolic stress of acute illness such as trauma, surgery, or infections. This consensus statement will outline precipitating factors and recommendations for the diagnosis, treatment, and prevention of DKA and HHS in adult subjects. It is based on a previous technical review (4) and more recently published peer-reviewed articles since 2001, which should be consulted for further information. View this table: Table 1 Diagnostic criteria for DKA and HHS Recent epidemiological studies indicate that hospitalizations for DKA in the U.S. are increasing. In the decade from 1996 to 2006, there was a 35% increase in the number of cases, with a total of 136,510 cases with a primary diagnosis of DKA in 2006—a rate of increase perhaps more rapid than the overall increase in the diagnosis of diabetes (1). Most patients with DKA were between the ages of 18 and 44 years (56%) and 45 and 65 years (24%), with only 18% of patients <20 years of age. Two-thirds of DKA patients were considered to have type 1 diabetes and …
Subfields: Endocrinology, Diabetes and Metabolism, Genetics
View Paper: https://www.semanticscholar.org/paper/61e8966e00f35377f52c6860103492c5552f0ceb
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Citations in the corpus
- Standards of Medical Care in Diabetes—2012 (2011, background): “For further information on management of DKA or nonketotic hyperosmolar state, refer to the ADA consensus statement on hyperglycemic crises (198).”
- 6. Glycemic Targets: Standards of Medical Care in Diabetes-2021. (2021, methodology): “For further information on themanagement ofdiabetic ketoacidosis and thenonketotic hyperglycemic hyperosmolar state, please refer to the ADA consensus report “Hyperglycemic Crises in Adult Patients With Diabetes” (119).”
- Standards of Medical Care in Diabetes—2013 (2012, background): “For further information on management of DKA or hyperglycemic nonketotic hyperosmolar state, refer to the ADA statement on hyperglycemic crises (222).”
- 6. Glycemic Targets: Standards of Medical Care in Diabetes—2019 (2018, background): “For further information on the management of diabetic ketoacidosis and the nonketotic hyperglycemic hyperosmolar state, please refer to the ADA consensus report “Hyperglycemic Crises in Adult Patients With Diabetes” (60).”
- Euglycemic Diabetic Ketoacidosis: A Potential Complication of Treatment With Sodium–Glucose Cotransporter 2 Inhibition (2015, background): “9 mmol/L]), anion-gap acidosis, and increased plasma ketones (10).”
- 6. Glycemic Targets: Standards of Medical Care in Diabetes—2020 (2019, methodology): “For further information on the management of diabetic ketoacidosis and the nonketotic hyperglycemic hyperosmolar state, please refer to the ADA consensus report “Hyperglycemic Crises in Adult Patients With Diabetes” (105).”
- Standards of Medical Care in Diabetes—2014 (2013, background): “For further information on management of DKA or hyperglycemic nonketotic hyperosmolar state, refer to the ADA statement on hyperglycemic crises (288).”