CHSU Discovery

Abstract

• Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic
state (HHS) are life-threatening hyperglycemic emergencies
• Management includes fluid resuscitation, insulin therapy, and
electrolyte correction
• Cerebral edema (CE) is a rare, but serious complication
associated with the management of HHS and DKA
• Exact pathogenesis of CE is unknown, but is thought to result
from rapid reductions in glucose and osmolality
• 2024 American Diabetes Association Guidelines recommend
decreasing glucose levels at a rate of 90-120 mg/dL/h to
minimize the risk of CE in the management of HHS, but do not
provide specific recommendations for minimizing the risk of
cerebral edema in DKA
• However, literature supporting guideline recommendations is
scarce and hyperglycemia is associated with adverse neurologic
outcomes

Purpose

• Evaluate CE rates associated with two different serum glucose
correction rates in adults presenting with hyperglycemic
emergencies