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What are the key differences between DKA and HHS in terms of occurrence, plasma glucose, blood ketones, pH, and hydration status?

DKA mainly occurs in type 1 diabetes (though possible in type 2 and secondary diabetes), while HHS occurs in type 2 and secondary diabetes. In DKA, plasma glucose is usually above 11 mmol/L, blood ketones above 3, and pH below 7.3; in HHS, plasma glucose is above 40 mmol/L, blood ketones below 1.5, and pH above 7.3. Hydration status is variable in DKA, ranging from mild to severe dehydration, whereas HHS involves severe dehydration.

Key points

  • DKA: type 1 diabetes, but also possible in type 2 and secondary diabetes.
  • HHS: type 2 and secondary diabetes.
  • DKA plasma glucose >11 mmol/L; HHS >40 mmol/L.
  • DKA blood ketones >3; HHS <1.5.
  • DKA pH <7.3; HHS pH >7.3.
  • DKA hydration is variable (mild to severe dehydration); HHS causes severe dehydration.
Source:Oxford Handbook of Adult Nursing, Third Edition· Diabetes· p. 465–473
Cover of Oxford Handbook of Adult Nursing, Third Edition

Oxford Handbook of Adult Nursing, Third Edition

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Third Edition · Oxford University Press

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