Criteria for resolution of DKA includes a glucose <200 mg/dl, serum bicarbonate ≥18 mEq/l, and a venous pH of >7.3. Once DKA is resolved, if the patient is NPO, continue intravenous insulin and fluid replacement and supplement with subcutaneous regular insulin as needed every 4 h.

Level 2 hypoglycemia, defined by a glucose concentration less than 54 mg/dL, represents clinically significant hypoglycemia requiring immediate action to resolve.

DKA usually evolves rapidly. In HHS, there is little or no ketoacidosis and the serum glucose concentration frequently exceeds 1000 mg/dL. HHS usually evolves over a period of several days. Overlap between DKA and HHS occurs in more than one-third of patients.

Insulin glulisine (Apidra)

Defining cutoff: There is no specific cutoff that defines hypoglycemia, as there is considerable variability in the serum glucose level at which a person will experience symptoms of hypoglycemia. : generally described as ≤ 70 mg/dL (≤ 3.9 mmol/L).

Common causes of diabetic ketoacidosis are dehydration, increasing blood sugar levels, infections, diarrhea, vomiting and missed doses of insulin or inadequate insulin levels.

In diabetic ketoacidosis, ketones build up in the blood, seriously altering the normal chemistry of the blood and interfering with the function of multiple organs. They make the blood acidic, which causes vomiting and abdominal pain. If the acid level of the blood becomes extreme, ketoacidosis can cause falling blood pressure, coma and death.

The ADA’s guidelines state that most adults with diabetes and hypertension should have a target blood pressure of <140/90 mmHg and that risk-based individualization lowers targets, such as 130/80 mmHg, may be appropriate in some patients.

Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can’t produce enough insulin.