Predisposing or precipitating factors for diabetic ketoacidosis and hyperosmolar hyperglycemic state

DKA

HHS

Inadequate insulin treatment or nonadherence

New-onset diabetes (20 to 25%)

Acute illness

Infection (30 to 40%)
Stroke or transient ischemic attack
Myocardial infarction
Acute pancreatitis

Drugs/therapy

Clozapine or olanzapine
Cocaine
Glucocorticoids
Lithium
SGLT2 inhibitors
Terbutaline

Inadequate insulin treatment or nonadherence (21 to 41%)

Acute illness

Infection (32 to 60%)
Pneumonia
Urinary tract infection
Sepsis
Stroke or transient ischemic attack
Myocardial infarction
Acute pancreatitis
Acute pulmonary embolus
Intestinal obstruction
Mesenteric thrombosis
Kidney failure
Heat stroke
Hypothermia
Subdural hematoma
Severe burns

Endocrine

Acromegaly
Thyrotoxicosis
Cushing syndrome

Drugs/therapy

Beta-adrenergic blockers
Calcium channel blockers
Chlorpromazine
Cimetidine
Clozapine
Diazoxide
Diuretics
Glucocorticoids
Immunosuppressive agents
L-asparaginase
Loxapine
Olanzapine
Phenytoin
Total parenteral nutrition

Previously undiagnosed diabetes mellitus

The most common precipitating factors for DKA are infection (30 to 40%) and new-onset diabetes (20 to 25%), and the most common precipitating factors for HHS are inadequate insulin treatment or nonadherence (21 to 41%) and infection (32 to 60%).

DKA: diabetic ketoacidosis; HHS: hyperosmolar hyperglycemic state; SGLT2: sodium-glucose cotransporter 2.

Data from: Kitabchi AE, Umpierrez GE, Murphy MB, et al. Management of hyperglycemic crises in patients with diabetes mellitus (Technical Review). Diabetes Care 2001; 24:131.

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خرید پکیج

Predisposing or precipitating factors for diabetic ketoacidosis and hyperosmolar hyperglycemic state