Hyperglycemic Crisis - Algorithm for DKA/HHS



Diagnostic criteria for DKA:

 • pH < 7.3

 • Anion gap > 10 mEq/L

 • Bicarb < 18 mEq/L

 • Urine/serum ketones +++

 • Serum BHB elevated

 • Glucose usually > 250 mg/dL



Diagnostic criteria for HHS:

 • pH > 7.3

 • Anion gap normal < 10 mEq/L

 • Bicarb> 18 mEq/L

 • Urine/serum ketones (neg/+)

 • Serum BHB normal

 • Glucose usually > 600 mg/dL

 • Serum osm > 320 mOsm/kg



Matthew Ho, MD PhD @MatthewHoMD



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