Ketoacidosis and hyperosmolar hyperglycemiaare the two most seriousacute metabolic complicationsof diabetes, even if managed properly.These disorders can occur in both type 1and type 2 diabetes. The mortality rate inpatients with diabetic ketoacidosis (DKA)is
5% in experienced centers, whereasthe mortality rate of patients with hyperosmolarhyperglycemic state (HHS) stillremains high at 15%. The prognosis ofboth conditions is substantially worsenedat the extremes of age and in the presenceof coma and hypotension (1–10).

     

     This position statement will outlineprecipitating factors and recommendationsfor the diagnosis, treatment, andprevention of DKA and HHS. It is basedon a previous technical review (11),which should be consulted for further information.