What’s Going Wrong?
Which condition typically occurs in Type 1 diabetes due to absolute insulin deficiency?
Diabetic ketoacidosis (DKA).
What classic breathing pattern is associated with DKA?
Kussmaul respirations.
Which has a higher glucose level, typically >33 mmol/L
HHS
What is the first-line intervention for both DKA and HHS?
Iv Fluids
Which complication is a risk if glucose is lowered too quickly?
Cerebral edema.
HHS is driven primarily by what pathophysiologic problem?
Severe hyperglycaemia causing dehydration.
Which condition is more likely to present with abdominal pain and vomiting?
DKA
DKA usually presents with a pH below what value?
pH<7.30
What type of insulin is used for continuous IV infusion?
Actrapid or Novorapid
What life‑threatening electrolyte imbalance can occur in both DKA and HHS during treatment?
Hypokalemia.
Why does DKA cause ketone production?
Lack of insulin → fat breakdown → ketone formation.
What is a common mental status change seen in HHS?
Confusion
What electrolyte must be watched closely because it can drop quickly once insulin is started?
Potassium
At what glucose level do you add dextrose to IV fluids in DKA?
<15mmol/L
What complication can occur from severe dehydration in HHS?
Low blood pressure leading to shock.
Which condition presents with metabolic acidosis: DKA or HHS?
DKA.
Severe dehydration with dry mucous membranes and hypotension is more common in DKA or HHS?
HHS
What lab helps you assess kidney function in DKA/HHS?
Creatinine.
For both conditions, potassium must be replaced based on labs. When should insulin not be started?
If K+ is <4 mmol/L.
What can happen to the kidneys in severe DKA or HHS due to dehydration?
Acute kidney injury.
In HHS, why are ketones often absent or mild?
Because there’s still a little insulin, which stops the body from making ketones.
Fruity breath odor is associated with which condition?
DKA
On a Blood Gas, what shows compensation for metabolic acidosis?
A low CO₂ (the lungs blow off CO₂ to compensate).
Why must fluids be given cautiously in elderly HHS patients?
To avoid fluid overload and heart failure.
What severe metabolic imbalance can lead to cardiac arrhythmias in DKA?
Potassium shifts due to acidosis and treatment.