The SimKit Podcast Piece of Cake: DKA/HHS Update Part I with Dr. George Willis
Feb 3, 2025
Join Dr. George Willis, an expert in endocrinology, as he dives into the latest American Diabetes Association guidelines on DKA and HHS management. The discussion unveils the rising prevalence of these hyperglycemic crises and emphasizes the critical role of mental health in effective diabetes care. Dr. Willis highlights the complex pathophysiology of DKA, the importance of sodium levels in HHS, and offers vital insights for recognizing these conditions in pediatric patients, especially during respiratory illnesses.
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Rising DKA/HHS Rates
- DKA/HHS rates are rising, potentially due to increasing diabetes diagnoses and rising insulin prices.
- Many patients ration insulin due to cost, leading to increased DKA admissions, especially in urban minority populations.
DKA's Five 'I's
- Remember the five 'I's of DKA: infection, ischemia/infarction, insulin noncompliance, infant/pregnancy, and inhibitors.
- Consider SGLT2 inhibitors and checkpoint inhibitors as potential DKA causes, especially in new-onset diabetes.
Sodium's Role in HHS
- HHS is driven by hyperglycemia causing pseudo-hyponatremia, which can mask elevated corrected sodium levels.
- Focus on corrected sodium in HHS, as it's the primary driver of osmolarity and neurological complications.