OVERVIEW

Diabetic Hyperglycemic Emergencies: A Systematic Approach (Pharmacology CME) is organized by EB Medicine.

Publication Date: Feb 01, 2020
CME Expiration Date: Mar 02, 2023

Description:
Hyperglycemic emergencies – diabetic ketoacidosis (DKA) and the hyperosmolar hyperglycemic state (HHS) – are common presentations in the ED that require swift, specialized management strategies. Uncovering the precipitating event is critical to management, as morbidity and mortality are related more to the trigger than the DKA/HHS itself.
• What are the “five Is” triggers of DKA/HHS?
• What causes abdominal pain in acidosis, and how will the presentation differ between DKA, HHS, and other causes (such as appendicitis)?
• Why should volume resuscitation always be started before giving insulin?
• What does the evidence show regarding aggressive versus nonaggressive dosing of IV fluids?
• Why should you be especially cautious when giving fluids to patients with HHS?
• When should you start adding dextrose to the IV fluid?
• What is the latest evidence on the value of giving an insulin bolus?
• What are the cautions that need to be observed when administering potassium?
• Under what circumstances should sodium bicarbonate be administered?
• Why is euglycemic diabetic ketoacidosis becoming increasingly common?