Hyperosmolar hyperglycemic state primary prevention: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hyperosmolar hyperglycemic state}} | {{Hyperosmolar hyperglycemic state}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{HS}} | ||
==Overview== | ==Overview== | ||
Effective measures for the primary prevention of hyperosmolar hyperglycemic state (HHS) include recognition of early [[signs]] of HHS, implementation of early and aggressive interventions (especially in patients with recurrent episodes of (HHS), tight [[glycemic control]] especially in patients with [[chronic]] illnesses, and education of patients and their family members. | |||
[ | |||
==Primary Prevention== | ==Primary Prevention== | ||
Effective measures for the primary prevention of hyperosmolar hyperglycemic state include:<ref name="pmid18551826">{{cite journal |vauthors=Vanelli M, Scarabello C, Fainardi V |title=Available tools for primary ketoacidosis prevention at diabetes diagnosis in children and adolescents. "The Parma campaign" |journal=Acta Biomed |volume=79 |issue=1 |pages=73–8 |year=2008 |pmid=18551826 |doi= |url=}}</ref><ref name="urlManagement of Diabetic Ketoacidosis - American Family Physician">{{cite web |url=http://www.aafp.org/afp/1999/0801/p455.html |title=Management of Diabetic Ketoacidosis - American Family Physician |format= |work= |accessdate=}}</ref><ref name="pmid4085289">{{cite journal |vauthors=Zhou HC |title=[Preliminary studies of cardiac function in pre-eclamptic patients with echocardiography and systolic time intervals] |language=Chinese |journal=Zhonghua Fu Chan Ke Za Zhi |volume=20 |issue=5 |pages=266–9, 317 |year=1985 |pmid=4085289 |doi= |url=}}</ref><ref name="urlwww.aace.com">{{cite web |url=https://www.aace.com/files/position-statements/SGLT-2-position-statement.pdf |title=www.aace.com |format= |work= |accessdate=}}</ref> | |||
* '''Recognition of early signs:''' | |||
** [[Vomiting]] | |||
* | ** [[Hyperglycemia]] | ||
**[ | ** [[Dehydration]] | ||
**[ | ** [[Weakness]] | ||
**[ | |||
**[ | |||
* '''Early recognition of inciting event:''' | |||
** Missed [[insulin]] dose or error in dosing | |||
** Intercurrent illness, especially [[infection]] | |||
** [[Psychologic stress]] | |||
** [[Surgery]] or [[trauma]] | |||
* '''Early intervention:''' | |||
** Enhanced and more frequent monitoring of [[blood glucose]] | |||
** Increased [[fluid]] intake | |||
** Seek advice from health care team | |||
* '''Aggressive intervention in patients with recurrent episodes:''' | |||
** [[Psychiatric]] evaluation | |||
** Individual and family evaluation/intervention | |||
** Continuous [[subcutaneous]] [[insulin]] [[infusion]] helpful in some patients | |||
** Possible out-of-home placement | |||
** Never discontinue [[insulin]] during illness without contacting health care provider | |||
** Having [[medication]] available to treat an [[infection]] | |||
==References== | ==References== | ||
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{{WS}} | {{WS}} | ||
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[[Category:Endocrinology]] | |||
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[[Category:Emergency medicine]] | |||
Latest revision as of 18:00, 17 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]
Overview
Effective measures for the primary prevention of hyperosmolar hyperglycemic state (HHS) include recognition of early signs of HHS, implementation of early and aggressive interventions (especially in patients with recurrent episodes of (HHS), tight glycemic control especially in patients with chronic illnesses, and education of patients and their family members.
Primary Prevention
Effective measures for the primary prevention of hyperosmolar hyperglycemic state include:[1][2][3][4]
- Recognition of early signs:
- Early recognition of inciting event:
- Missed insulin dose or error in dosing
- Intercurrent illness, especially infection
- Psychologic stress
- Surgery or trauma
- Early intervention:
- Enhanced and more frequent monitoring of blood glucose
- Increased fluid intake
- Seek advice from health care team
- Aggressive intervention in patients with recurrent episodes:
- Psychiatric evaluation
- Individual and family evaluation/intervention
- Continuous subcutaneous insulin infusion helpful in some patients
- Possible out-of-home placement
- Never discontinue insulin during illness without contacting health care provider
- Having medication available to treat an infection
References
- ↑ Vanelli M, Scarabello C, Fainardi V (2008). "Available tools for primary ketoacidosis prevention at diabetes diagnosis in children and adolescents. "The Parma campaign"". Acta Biomed. 79 (1): 73–8. PMID 18551826.
- ↑ "Management of Diabetic Ketoacidosis - American Family Physician".
- ↑ Zhou HC (1985). "[Preliminary studies of cardiac function in pre-eclamptic patients with echocardiography and systolic time intervals]". Zhonghua Fu Chan Ke Za Zhi (in Chinese). 20 (5): 266–9, 317. PMID 4085289.
- ↑ "www.aace.com" (PDF).