DKA vs. HHNS Lecture Notes

Introduction

• Speaker: Sarth, Registered Nurse
• Topic: Differences between DKA (Diabetic Ketoacidosis) and HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome)
• Purpose: Simplify signs and symptoms for exams
• Related Content: Previous videos cover in-depth details and free quiz available on registerrn.com

Definitions

• DKA (Diabetic Ketoacidosis):

  • Mainly seen in Type 1 diabetics
  • Presence of ketones and acidosis due to fat breakdown
  • Caused by absolutely no insulin in the body

• HHNS (Hyperosmolar Hyperglycemic Nonketotic Syndrome):

  • Mainly seen in Type 2 diabetics
  • No breakdown of ketones or acidosis
  • Some insulin present, preventing ketosis

Comparison of DKA and HHNS

• DKA:

  • Hyperglycemia > 300 mg/dL
  • Variable osmolarity
  • Rapid onset
  • Causes: No insulin, illness, infection, new diagnosis
  • Symptoms:
    • Polyuria, polydipsia
    • Kussmaul breathing (due to metabolic acidosis)
    • Acetone breath and abdominal pain

• HHNS:

  • Severe hyperglycemia > 600 mg/dL
  • High osmolarity due to concentrated glucose
  • Gradual onset
  • Causes: Cells not receptive to insulin, severe infection/illness
  • Symptoms:
    • Polyuria, polydipsia
    • Severe dehydration
    • Mental status changes

Key Points

• DKA:

  • Blood pH < 7.5
  • Bicarbonate < 15
  • Common in young, newly diagnosed diabetics

• HHNS:

  • Common in older adults with severe infection
  • Focus on rehydration to manage symptoms

Treatments

• Both conditions:

  • IV fluids
  • Insulin
  • Electrolyte replacement (e.g., potassium)

• HHNS Specific:

  • Rehydration crucial to alleviate symptoms and decrease blood sugar

Conclusion

• Understanding the differences is crucial for diagnosis and treatment.
• Further learning: Take the quiz at registerrn.com and subscribe to the YouTube channel for more content.