Hyperosmolar hyperglycemic state historical perspective: Difference between revisions
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* In 2011, Pediatric Endocrine Society guidelines for treatment of HHS in children were published. | * In 2011, Pediatric Endocrine Society guidelines for treatment of HHS in children were published. | ||
==Landmark Events in the Development of Treatment Strategies== | ==Landmark Events in the Development of Treatment Strategies== | ||
The landmark events in the treatment of hyperosmolar hyperglycemic state are:<ref name="pmid820228">{{cite journal |vauthors=Kitabchi AE, Ayyagari V, Guerra SM |title=The efficacy of low-dose versus conventional therapy of insulin for treatment of diabetic ketoacidosis |journal=Ann. Intern. Med. |volume=84 |issue=6 |pages=633–8 |year=1976 |pmid=820228 |doi= |url=}}</ref><ref name="pmid4065612">{{cite journal |vauthors=Fisher JN, Shahshahani MN, Kitabchi AE |title=Diabetic ketoacidosis: low-dose insulin therapy by various routes |journal=N. Engl. J. Med. |volume=297 |issue=5 |pages=238–41 |year=1977 |pmid=406561 |doi=10.1056/NEJM197708042970502 |url=}}</ref><ref name="pmid820228">{{cite journal |vauthors=Kitabchi AE, Ayyagari V, Guerra SM |title=The efficacy of low-dose versus conventional therapy of insulin for treatment of diabetic ketoacidosis |journal=Ann. Intern. Med. |volume=84 |issue=6 |pages=633–8 |year=1976 |pmid=820228 |doi= |url=}}</ref> | |||
{{Family tree/start}} | {{Family tree/start}} | ||
{{familytree | boxstyle= text-align: Center; | | | |B01| | | | |B01='''''Preinsulin era'''''<br> •The treatment modalities used for diabetic coma include blood transfusion, castor oil with potassium citrate, and saline solutions with sodium carbonate among other therapies. | {{familytree | boxstyle= text-align: Center; | | | |B01| | | | |B01='''''Preinsulin era'''''<br> •The treatment modalities used for diabetic coma include blood transfusion, castor oil with potassium citrate, and saline solutions with sodium carbonate among other therapies. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Historical Perspective
- The known history of diabetes dates back to the Egyptian era, and the first documented evidence was found in an Egyptian papyrus dating back to 1552 BC.
- In 1828, von Stosch for the first time described diabetic coma in detail.
- In 1857, Petters discovered acetone in the urine of patients with diabetes.
- In 1865, Gerhardt discovered acetoacetic acid in the urine of patients with diabetes.
- In 1874, Kussmaul also described diabetic coma in detail.
- In 1878, Foster described some cases of diabetic coma and acetonemia.
- In 1883–1884, Stadelmann, Külz, Minkowski found out that in addition to acetone patients with diabetic coma also have β-hydroxybutyric acid.
- In 1884–1886, von Frerichs and Dreschfeld described some cases of patients with diabetic coma but without kussmaul breathing or ketones.[1]
- In 1922, insulin was discovered and isolated by Banting and Best.
- In 1909–1923, Lépine, Revillet, McCaskey and Bock et al also described some cases of patients with diabetic coma without ketonuria.
- In 1930–1935, Lawrence and Joslin described the management of diabetic coma.
- In 1957, Sament, Schwartz, Graeff, and Lips also described some case reports of diabetic coma without ketones and hyperosmolality.
- In 1962, Singer et al explained the relationship of hyperglycemia and osmolality.
- In 1971, Arieff, Carroll and Gerich et al described the modern definition and initial criteria of the hyperosmolar hyperglycemic state which they called hyperosmolar hyperglycemic non-ketotic state.
- In 1973, Arieff and Kleeman explained the mechanism of cerebral edema in the treatment of hyperosmolar hyperglycemic state.
- In 1976–1977, Alberti, Hockaday and Kitabchi et al described the low-dose insulin protocols.[2]
- In 2004–2009, American Diabetes Association has consensus for the management of the hyperosmolar hyperglycemic state in adults.
- In 2011, Pediatric Endocrine Society guidelines for treatment of HHS in children were published.
Landmark Events in the Development of Treatment Strategies
The landmark events in the treatment of hyperosmolar hyperglycemic state are:[3][4][3]
| Preinsulin era •The treatment modalities used for diabetic coma include blood transfusion, castor oil with potassium citrate, and saline solutions with sodium carbonate among other therapies. | |||||||||||||||||||
| 1930–1950 •The usual practice was to use insulin in 20–100 units i.v. or s.c. bolus followed by 20 units s.c. every 30–60 min depending on glucosuria. | |||||||||||||||||||
| 1950–1970s • In that period, the insulin was given as 2 units/kg bolus of crystalline insulin; up to 920 units in the first 7 h. | |||||||||||||||||||
| Early 1970s • Insulin was given as low-dose insulin regimens with Regular insulin 0.1 units/kg i.v. followed by 0.1–0.3 units/h i.v., s.c., or i.m. | |||||||||||||||||||
| 1990s • Insulin was administered as 0.1 units/kg i.v. bolus, then 0.1 units/kg/h as continuous infusion until glucose level <13.8 mmol/L (250 mg/dL) | |||||||||||||||||||
| 2004–2009 • ADA consensus for treatment of DKA and HHS in adult patients according to which Initial bolus (0.1 units/kg i.v.), followed by 0.1 units/kg/h until glucose <250 mg/dL, then reduce insulin by 50% | |||||||||||||||||||
References
- ↑ Dreschfeld J (1886). "The Bradshawe Lecture on Diabetic Coma". Br Med J. 2 (1338): 358–63. PMC 2256374. PMID 20751675.
- ↑ Fleckman AM (1993). "Diabetic ketoacidosis". Endocrinol. Metab. Clin. North Am. 22 (2): 181–207. PMID 8325282.
- ↑ 3.0 3.1 Kitabchi AE, Ayyagari V, Guerra SM (1976). "The efficacy of low-dose versus conventional therapy of insulin for treatment of diabetic ketoacidosis". Ann. Intern. Med. 84 (6): 633–8. PMID 820228.
- ↑ Fisher JN, Shahshahani MN, Kitabchi AE (1977). "Diabetic ketoacidosis: low-dose insulin therapy by various routes". N. Engl. J. Med. 297 (5): 238–41. doi:10.1056/NEJM197708042970502. PMID 406561.