Diabetes in the critically ill patient: DKA, HHS, and beyond

Affiliations

Advocate Christ Medical Center

Abstract

Hyperglycemia is a common occurrence in critically ill patients, carrying a risk of increased adverse events. It can manifest itself as the primary cause of admission, such as in diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), or as a secondary diagnosis in patients with or without preexisting diabetes. The management of hyperglycemic emergencies such as DKA or HHS can be quite complex, requiring an interplay of fluid, electrolyte, and insulin replacement. The consensus targets for blood glucose control in the critical care setting coalesce on the range between 140 and 180 mg/dL, with insulin as the preferred modality of treatment. Little data is available on the management of hyperglycemia in special populations such as patients with renal failure or congestive heart failure.

Type

Book Chapter

Book Chapter/Book Details

In: Schulman-Rosenbaum RC, ed. Diabetes Management in Hospitalized Patients: A Comprehensive Clinical Guide. Springer International Publishing; 2023.


 

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