The document discusses diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS), two life-threatening complications of diabetes that result from low insulin levels. DKA is characterized by high blood glucose levels, ketonemia and acidosis, while HHS involves extremely high blood glucose with hyperosmolarity but minimal ketosis or acidosis. The document provides information on symptoms, diagnostic criteria, treatment approaches and management considerations for DKA and HHS.

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References – DKA and HHS
Canadian Diabetes Association Clinical Practice Guidelines Expert Committee.
Canadian Diabetes Association 2008. Clinical Practice Guidelines for
the Prevention and Management of Diabetes in Canada. Canadian Journal of
Diabetes 2008; 32 suppl 1.
Davidson MB. Hyperglycemia. In: Franz MJ, ed. A Core Curriculum for
Diabetes Education: Diabetes and Complications. 4th ed. Chicago: American
Association of Diabetes Educators 2001:23.
Kalra S, Kalra B, Sharma A, Nanda G. Pre diabetes and ketosis:
treatment with aspart insulin. Diabetes Vasc Dis Res 2007; 4: S100.
Kalra S, Kalra B, Nanda G. OPD management of ketosis in pregnancy:
aspart vs. regular insulin. Diabetic Medicine 2006; 23 Suppl 4: 504.
Kitabchi AE, Guillermo E, Umpierrez GE, Fisher JN. Management of
hyperglycemic crises in patients with diabetes. Diabetes Care 2009; 32: 1335-
1343.
Module 4 - 2 Diabetic ketoacidosis and HHS 44

45. IDF Education Modules 2011
Canadian Diabetes Association. Beyond the Basics. Toronto, ON: Canadian
Diabetes Association; 2006.
Hanas R.Type 1 diabetes in children, adolescents and young adults. 2nd
edition. London: Publ Class Publishing; 2004.
Meltzer, S. Yale, J.F. et al. Practical Diabetes Management: Clinical Support
for Primary Care Physicians. Toronto, ON: Canadian Diabetes Association;
2007.
Module 4 - 2 Diabetic ketoacidosis and HHS 45