Hormones and Labs
These cells in the islets of Langerhans produce insulin
Beta Cells
These are the three classic "P" symptoms of diabetes.
Polyuria, polydipsia, and polyphagia
This long-acting insulin releases evenly throughout the day to control basal glucose levels.
This process breaks down fatty acids and protein to create acidic ketones as backup fuel.
Ketogenesis
HHS glucose levels are typically greater than this extremely high value in mg/dL.
600 mg/dL
This hormone, produced by alpha cells, works in "starvation mode" to raise blood glucose.
Glucagon
This is the priority assessment when a patient on insulin infusion develops an irregular heartbeat with inverted T-waves.
This class of diabetes medications works by stimulating the beta cells of the pancreas to secrete insulin.
Sulfonylureas
This electrolyte medication should be added when treating DKA with normal saline and insulin.
Potassium
HHS is characterized by serum pH greater than this value and very high glucose, unlike DKA.
pH of 7.4
This HbA1c result indicates successful diabetes treatment.
<6.5%
Alcohol consumption in a diabetic patient taking insulin can predispose them to this condition.
Hypoglycemia
This medication decreases the amount of glucose produced by the liver and increases insulin sensitivity.
Metformin (A type of biguanide)
This breathing pattern, characterized by deep rapid breaths, occurs as the body tries to compensate for metabolic acidosis.
Kussmaul respirations
In HHS treatment, this intervention must be completed first before giving insulin to avoid dangerous fluid shifts.
Fluid resuscitation
A random glucose greater than this number with symptoms indicates diabetes.
Greater than or equal to 200
This phenomenon causes alternating periods of nocturnal hypoglycemia and morning hyperglycemia.
Somogyi Phenomenon
This protein slows gastric emptying to delay glucose spikes and is mimicked by drugs like Ozempic
GLP-1
In DKA, the ABG shows this type of acid-base imbalance with low pH and low HCO3.
Metabolic Acidosis
When a patient with HHS becomes alert only to person after being pleasant all day, this is the immediate priority action.
These four hormones, in addition to glucagon, can increase blood glucose
epinephrine, norepinephrine, growth hormone, and cortisol
This action should be taken to determine why a Type 1 diabetic has elevated morning blood glucose levels.
Measuring Blood glucose early morning (Around 0200)
This sodium-glucose co-transport inhibitor tells the kidneys to excrete glucose but is hard on kidneys.
Empagliflozin (or SGLT2 inhibitors)
When a patient on insulin drip has finished DKA treatment, this has occurred with the anion gap and insulin.
Restored anions with insulin which has closed the anion gap
This lab value remains normal in HHS but is decreased in DKA.
Bicarbonate (HCO3)