Sunday, April 3, 2016

Q: How volume expansion works in Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS)?


Answer: 

Volume expansion causes fall in serum glucose primarily via 2 mechanisms.


1) dilution, and
2) Urinary loss as renal perfusion improved

Just volume repletion alone (without insulin) can reduce the serum glucose by 35 to 70 mg/dL per hour.

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