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The SimKit Podcast

Piece of Cake: DKA/HHS Update Part II​ with George Willis

Feb 18, 2025
Join George Willis, an endocrinology expert, as he unpacks the 2024 ADA consensus report on diabetic emergencies. They delve into revised diagnostic criteria for DKA and HHS, shedding light on new glucose testing methods and the vital role of beta hydroxybutyrate. Discover advancements in treatment protocols, including fluid administration and potassium management, while challenging old beliefs. Willis emphasizes the critical differences between DKA and HHS, the importance of patient education, and innovative approaches to diabetic emergencies.
57:52

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Quick takeaways

  • The updated diagnostic criteria for DKA lower the glucose threshold to 200 mg/dL, enhancing early identification of cases.
  • New treatment guidelines recommend balanced fluid solutions for DKA management, shifting away from the traditional use of normal saline.

Deep dives

Updated Diagnostic Criteria for DKA

The new guidelines for diagnosing Diabetic Ketoacidosis (DKA) now set the glucose threshold for diagnosis at 200 mg/dL, a notable decrease from the previous standard of 250 mg/dL. This adjustment aims to better identify cases, particularly euglycemic DKA, where patients can present with normal glucose levels but still have underlying DKA. The updated criteria also include the consideration of beta-hydroxybutyrate levels as a critical diagnostic tool, which can now be checked at point-of-care rather than dependent on delayed lab results. These changes are intended to refine diagnostic accuracy and ensure timely treatment for patients at risk of DKA.

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