Hyperglycemic crises in diabetes mellitus: diabetic ketoacidosis and hyperglycemic hyperosmolar state

Endocrinol Metab Clin North Am. 2006 Dec;35(4):725-51, viii. doi: 10.1016/j.ecl.2006.09.006.


Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) potentially are fatal but largely preventable acute metabolic conditions of uncontrolled diabetes, the incidence of which continues to increase. Mortality from DKA has declined remarkably over the years because of better understanding of its pathophysiology and treatment. The mortality rate of HHS remains alarmingly high, however, owing to older age and mode of presentation of patients and associated comorbid conditions. DKA and HHS also are economically burdensome; therefore, any resources invested in their prevention would be rewarding.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Bicarbonates / therapeutic use
  • Diabetic Ketoacidosis* / diagnosis
  • Diabetic Ketoacidosis* / prevention & control
  • Diabetic Ketoacidosis* / therapy
  • Fluid Therapy
  • Humans
  • Hyperglycemic Hyperosmolar Nonketotic Coma* / diagnosis
  • Hyperglycemic Hyperosmolar Nonketotic Coma* / prevention & control
  • Hyperglycemic Hyperosmolar Nonketotic Coma* / therapy
  • Insulin / administration & dosage
  • Patient Education as Topic
  • Phosphates / therapeutic use
  • Potassium / therapeutic use
  • Potassium Compounds / therapeutic use


  • Bicarbonates
  • Insulin
  • Phosphates
  • Potassium Compounds
  • potassium phosphate
  • Potassium