Comparing HHNS and DKA - Flowchart
Comparing HHNS and DKA - Flowchart Comparing HHNS and DKA Comparing HHNS and DKA
Flowchart

History of diabetes mellitus

History of diabetes mellitus

History of diabetes mellitus

History of diabetes mellitus

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Yes

Yes

Yes

Yes


Drowsiness
Stupor
Coma
Polyuria
Extreme volume depletion


Drowsiness
Stupor
Coma
Polyuria
Extreme volume depletion


Drowsiness
Stupor
Coma
Polyuria
Extreme volume depletion


Drowsiness
Stupor
Coma
Polyuria
Extreme volume depletion

Yes

Yes

Yes

Yes

Suspect DKA.

Suspect DKA.

Suspect DKA.

Suspect DKA.


Slightly rapid respirations
No breath odor
Markedly elevated blood glucose level
Hypernatremia
Negative or trace serum ketone levels
Markedly elevated serum osmolality
Normal serum potassium level
No acidosis


Slightly rapid respirations
No breath odor
Markedly elevated blood glucose level
Hypernatremia
Negative or trace serum ketone levels
Markedly elevated serum osmolality
Normal serum potassium level
No acidosis


Slightly rapid respirations
No breath odor
Markedly elevated blood glucose level
Hypernatremia
Negative or trace serum ketone levels
Markedly elevated serum osmolality
Normal serum potassium level
No acidosis


Slightly rapid respirations
No breath odor
Markedly elevated blood glucose level
Hypernatremia
Negative or trace serum ketone levels
Markedly elevated serum osmolality
Normal serum potassium level
No acidosis

Yes

Yes

Yes

Yes

Suspect HHNS.

Suspect HHNS.

Suspect HHNS.

Suspect HHNS.

Type 2

Type 2

Type 2

Type 2

Yes

Yes

Yes

Yes

Slow onset

Slow onset

Slow onset

Yes

Yes

Yes

Yes

Type 1

Type 1

Type 1

Type 1

Yes

Yes

Yes Yes

No

No

No No

Rapid onset

Rapid onset

Rapid onset

Yes

Yes

Yes Yes

No

No

No No


Hyperventilation
Acetone breath odor
Slightly elevated blood glucose level
Mild hyponatremia
Positive serum ketone levels
Slightly elevated serum osmolality
Hyperkalemia initially, then hypokalemia
Metabolic acidosis


Hyperventilation
Acetone breath odor
Slightly elevated blood glucose level
Mild hyponatremia
Positive serum ketone levels
Slightly elevated serum osmolality
Hyperkalemia initially, then hypokalemia
Metabolic acidosis


Hyperventilation
Acetone breath odor
Slightly elevated blood glucose level
Mild hyponatremia
Positive serum ketone levels
Slightly elevated serum osmolality
Hyperkalemia initially, then hypokalemia
Metabolic acidosis


Hyperventilation
Acetone breath odor
Slightly elevated blood glucose level
Mild hyponatremia
Positive serum ketone levels
Slightly elevated serum osmolality
Hyperkalemia initially, then hypokalemia
Metabolic acidosis

Yes

Yes

Yes Yes

No

No

No No