Mixed presentation of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) has been reported in up to 27% of hyperglycemic emergencies. This 15-year retrospective chart review describes clinical features, risk factors, and outcomes among children presenting with hyperglycemic emergencies at our center. Out of 322 patients, 92% were Afro-Caribbean or Black with a mean age of 13.6 years, comprising 266 (83%) with DKA, 52 (16%) mixed DKA-HHS, and rarely with HHS (1%, = 4). Most (98%) of DKA and DKA-HHS groups had type 1 diabetes mellitus (T1DM). All 4 patients with HHS had type 2 diabetes mellitus (T2DM). Compared with the DKA group, the mixed DKA-HHS group had higher IV fluid rates ( < .0001), 4.3-fold greater odds of acute kidney injury (AKI), and 3.3-fold greater odds of altered mental status (AMS). In the HHS group, 50% presented had AMS and AKI and required higher IV fluids rates (≥2× maintenance). Clinicians should recognize mixed cases of DKA-HHS to minimize complications.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/00099228251321899 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hyperglycemic Emergencies in Minority Children and Adolescents With Diabetes.
Clin Pediatr (Phila)
March 2025
Pediatric Endocrinology, Kings County, NYC Health + Hospitals, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
Mixed presentation of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) has been reported in up to 27% of hyperglycemic emergencies. This 15-year retrospective chart review describes clinical features, risk factors, and outcomes among children presenting with hyperglycemic emergencies at our center. Out of 322 patients, 92% were Afro-Caribbean or Black with a mean age of 13.
View Article and Find Full Text PDFAdipose stromal cells increase insulin sensitivity and decrease liver gluconeogenesis in a mouse model of type 1 diabetes mellitus.
Stem Cell Res Ther
March 2025
Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Background: Diabetic ketoacidosis (DKA) is a serious complication of hyperglycemic emergency caused by insulin deficiency through accelerated liver gluconeogenesis and glycogenolysis. DKA is most common in type 1 diabetes (T1D). Transplantation of islet cells and pancreas is an alternative to insulin injection for treating T1D.
View Article and Find Full Text PDFNonketotic hyperglycemic hemichorea - A rare presentation of elevated blood sugar.
Am J Emerg Med
March 2025
Guam Memorial Hospital Authority (GMHA), 850 Gov Carlos G Camacho Rd, Oka 96913, Guam. Electronic address:
Nonketotic hyperglycemic hemichorea, also known as diabetic striatopathy or hyperglycemia basal ganglia syndrome, is a rare presentation of hyperglycemia that can be the initial manifestation of diabetes or present in patients with long-standing poorly controlled diabetes. Patients will demonstrate ballismus or choreiform movements which are usually unilateral. On evaluation, patients' labs will show hyperglycemia without evidence of diabetic ketoacidosis.
View Article and Find Full Text PDFHeterogeneity in the management of diabetic ketoacidosis in Australia: a national survey.
Intern Med J
March 2025
Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Background: Diabetic ketoacidosis (DKA) is a hyperglycaemic emergency, and insulin administration is highly protocolised with either variable- or fixed-rate intravenous infusions. There are limited data supporting superiority of one regimen over another; however, international guidelines recommend fixed-rate infusions.
Aim: To characterise DKA management protocols used in Australian hospitals.
The Incidence and Risk Factors of Stress Hyperglycaemia in Patients Who Received Enteral Nutrition in Intensive Care Units: A Retrospective Cohort Study.
J Clin Nurs
March 2025
Xiangya School of Nursing, Central South University, Changsha, China.
Aim And Objectives: This study aimed to investigate the incidence and identify risk factors of stress hyperglycaemia among patients who received enteral nutrition (EN) in the intensive care unit (ICU).
Background: Stress hyperglycaemia is common among ICU patients receiving EN and is related to worse outcomes. However, the factors associated with stress hyperglycaemia during EN remain unclear, especially among patients who are not diagnosed with diabetes.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!