Evidence-based management of hyperglycemic emergencies in diabetes mellitus.

Abstract:

:The hyperglycemic emergencies, diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are potentially fatal complications of uncontrolled diabetes mellitus. The incidence of DKA and the economic burden of its treatment continue to rise, but its associated mortality rate which was uniformly high has diminished remarkably over the years. This Improvement in outcome is largely due to better understanding of the pathogenesis of hyperglycemic emergencies and the application of evidence-based guidelines in the treatment of patients. In this article, we present a critical review of the evidence behind the recommendations that have resulted in the improved prognosis of patients with hyperglycemic crises. A succinct discussion of the pathophysiology and important etiological factors in DKA and HHS are provided as a prerequisite for understanding the rationale for the effective therapeutic maneuvers employed in these acute severe metabolic conditions. The evidence for the role of preventive measures in DKA and HHS is also discussed. The unanswered questions and future research needs are also highlighted.

authors

Nyenwe EA,Kitabchi AE

doi

10.1016/j.diabres.2011.09.012

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

340-51

issue

3

eissn

0168-8227

issn

1872-8227

pii

S0168-8227(11)00514-6

journal_volume

94

pub_type

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