Page 280 - fourth year book

DIABETES MELLITUS

 (Vomiting can be caused by many illnesses, not just ketoacidosis. If
vomiting continues for more than 2 hours, contact your health care

provider.)
 Difficulty breathing

 Fruity odor on breath
 A hard time paying attention, or confusion

 Treatment of DKA :

 If the patient has any of the above symptoms, contact the health
care provider IMMEDIATELY, or go to the nearest emergency

room of the local hospital.
 But patients can help prevent DKA by teaching them the warning

signs and checking the urine and blood regularly.

3. Hyperglycemic Hyperosmolar Non Ketotic (HHNS).

A precise definition of HHS does not exist and would be

inappropriate, but there are characteristic features that differentiate it
from other hyperglycemic states such as DKA. Defining HHS by
osmolality alone is inappropriate without taking into account other

clinical features :

 High osmolality, often 320 mosmol/kg or more
 High blood glucose, usually 30 mmol/l or more

 Severely dehydrated and unwell.

 Causes :
 Infection.

 Other illness, such as heart attack or stroke.
 Medicines that decrease the effect of insulin in the body.

 Medicines or conditions that increase fluid loss.

 Risk factors include:
 A stressful event such as infection, heart attack, stroke, or recent

surgery
 Congestive heart failure

249