What is the Difference Between DKA and HHS?
🆚 Go to Comparative Table 🆚Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two complications of diabetes that have similar symptoms, causes, and treatments, but they have distinct differences as well.
DKA is typically associated with type 1 diabetes and is characterized by hyperglycemia, ketogenesis, lipolysis, gluconeogenesis, and ketosis. It usually occurs due to a missed insulin dose or other factors such as medication, illness, or cardiac events. DKA may present with heart palpitations, headaches, and chest pain and tightness.
HHS, on the other hand, typically occurs in people with type 2 diabetes and mainly involves severe hyperglycemia and hyperosmolarity. It can develop more slowly than DKA and may present with symptoms such as weakness and a declining mental status. Compared to DKA, HHS has a higher mortality rate and can cause neurological symptoms like hallucinations, confusion, drowsiness, and loss of vision.
In some cases, up to 30% of patients with DKA may also have features of HHS, presenting with both ketoacidosis and severe hyperglycemia with glucose levels greater than 600 mg/dL. Both conditions require prompt medical attention and are treated with insulin administration to inhibit ketogenesis, lipolysis, and gluconeogenesis.
In summary, DKA is typically associated with type 1 diabetes and involves hyperglycemia, ketogenesis, and ketosis, while HHS is more common in people with type 2 diabetes and mainly presents with severe hyperglycemia and hyperosmolarity. Treatment for both conditions involves insulin administration, and early diagnosis and treatment are crucial for better outcomes.
Comparative Table: DKA vs HHS
Here is a table comparing the differences and similarities between Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS):
Feature | DKA | HHS |
---|---|---|
Affected Population | Typically occurs in people with type 1 diabetes | Usually occurs in people with type 2 diabetes |
Cause | Insulin deficiency | Insulin deficiency |
Blood Glucose Levels | High | Higher than DKA |
Acidosis | Acidosis is present | Acidosis is not present |
Ketone Production | Ketones accumulate in the blood and urine | There is no significant ketone production |
Symptoms | Polyuria, polydipsia, weight loss | Polyuria, polydipsia, weight loss |
Mental State | Mental status can be affected (e.g., confusion, drowsiness, hallucinations) | Mental status can be affected (e.g., confusion, drowsiness, loss of vision) |
Onset | Rapid | Slow, developing over several weeks |
Mortality Rate | Lower than HHS | Higher than DKA |
Both DKA and HHS are complications of diabetes that result from insulin deficiency and high blood glucose levels. They share similar symptoms, but DKA usually results in acidosis, while HHS does not. DKA typically affects people with type 1 diabetes, whereas HHS is more common in people with type 2 diabetes. HHS tends to have a higher mortality rate compared to DKA.
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