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Hi, I was wondering what generates a diabetic ketoacidosis and hyperosmolar hyperglycemic state. My wife is having problems with this and I'm to understand this is very serious. How can I help her stabilize her blood sugar levels so this doesn't happen. I'm really worried about her. I don't think she takes this very seriously. I really don't know what to do. Does anyone have any advice for me. Perhaps you had the same problem and somehow figured out what to do? I've thought about talking to her doctor about it but I don't know if that's okay. Any advice would be greatly appreciated. Thanks.


Diabetic ketoacidosis and hyperosmolar hyperglycemic state are serious complications of diabetes. Both of these states are a result of hyperglycemia (very high blood sugar levels). These two states differ from each other by the presence or absence of ketoacidosis and the degreee of hyperglycemia.


In ketoacidosis, blood sugar levels are often around in below 800 mg/dL (44 mmol/L) but they can go above 900 mg/dL (50 mmol/L) who are in a coma. In this state sugar levels are really high but generally not as high as with the hyperosmolar hyperglycemic state. Ketoacidosis is where you have produced high levels of ketone molecules that brings the body to a very acid state. This is deadly. The pH of blood runs around 7.35 which is somewhat alkaline and that's important for metabolic processes. Too much acid brings about a disease state.


The hyperosmolar hyperglycemic state has very little to no ketoacid buildup but blood sugar levels often are higher than the keotacid state. In the hyperosmolar hyperglycemic state sugar levels can go above 1000 mg/dL (56 mmol/L) and blood osmolality may go as high as 380 mosmol/kg. The person becomes severely dehydrated and coma can set in. There is a lot of overlap between these two states in a number of patients.


These are very serious states and require hospitalization. If they can stabilize her, then she can come home but this will be touch and go. You will need to monitor her blood glucose levels often. She will need fluid replacement because she is urinating a lot so she will be thirsty as well. She also needs vitamin and mineral replacement so a good multivitamin should be administered. You need to watch her diet closely. I think if she has a really serious bout of this, she won't want that to happen again.