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3.12.1 - Diabetic Emergencies
from Section 3.12 - Endocrine Disorders
- By Sridhar Nallapareddy, Jon Griffiths
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 377-380
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Summary

Key Learning Points
1. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) have a high mortality rate and require prompt identification and management.
2. Fluid resuscitation is often the most important therapeutic intervention in both groups, and patients with HHS often need no exogenous insulin at all.
3. The high mortality rate often results from electrolyte disturbances, particularly hypokalaemia in DKA. It should be very closely monitored, particularly in the early phase of treatment.
4. Thromboembolism is a life-threatening complication in both groups of patients, so always consider thromboprophylaxis early.
5. Look for common precipitating factors in all patients, but be aware that the white cell count and amylase, sodium and creatinine levels can all be abnormal in otherwise uncomplicated diabetic emergencies.