DKA and HHS are life-threatening acute complications of diabetes. DKA primarily affects Type 1 diabetics, whereas HHS occurs in Type 2 diabetics.
Clinical Comparison Table
- Blood Glucose: DKA is typically > 250 mg/dL | HHS is much higher, often > 600 mg/dL.
- Arterial pH: DKA is acidic (pH < 7.30) | HHS has normal pH (> 7.30).
- Ketones (Urine/Serum): Positive in DKA | Absent/minimal in HHS.
- Serum Osmolarity: Normal/mildly elevated in DKA | Highly elevated (> 320 mOsm/kg) in HHS, leading to severe dehydration and neurological symptoms.
Management Focus: Fluid resuscitation (0.9% Normal Saline) is the absolute first step in both conditions, followed by IV Regular Insulin infusion.
