Results from a relative insulin deficiency in the undiagnosed or untreated diabetic
Sustained hyperglycemia creates an osmotic diuresis and dehydration:
Extracellular space maintained ...
Progression of signs and symptoms typically occur over days to weeks.
Secure airway in comatose patients.
Cardiac monitor and 18G IV
Naloxone, thiamine, and blood glu...
All but the mildest cases should be admitted to ICU:
Frequent serial labs for the 1st 24 hr
Rapid shifts in fluids and electrolytes and the potential for deteriora...
Failure to look for precipitating event or cause
Too rapid correction of glucose—may lead to hypotension
Continuing isotonic fluids after volume resuscitation—may lead to hypernatrem...
Gaglia JL, Wyckoff J, Abrahamson MJ. Acute hyperglycemic crisis in the elderly. Med Clin North Am. 2004;88:1063–1084.
Kitabchi AE, Nyenwe EA. Hyperglycemic crisis in diabe...
250.20 Diabetes with hyperosmolarity, type II or unspecified type, not stated as uncontrolled
250.21 Diabetes with hyperosmolarity, type I [juvenile type], not stated as uncontrolled
Sign up for a 10-day FREE Trial now and receive full access to all content.