» Articles » PMID: 39052901

Hyperglycemic Crises in Adults With Diabetes: A Consensus Report

Abstract

The American Diabetes Association (ADA), European Association for the Study of Diabetes (EASD), Joint British Diabetes Societies for Inpatient Care (JBDS), American Association of Clinical Endocrinology (AACE), and Diabetes Technology Society (DTS) convened a panel of internists and diabetologists to update the ADA consensus statement on hyperglycemic crises in adults with diabetes, published in 2001 and last updated in 2009. The objective of this consensus report is to provide up-to-date knowledge about the epidemiology, pathophysiology, clinical presentation, and recommendations for the diagnosis, treatment, and prevention of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) in adults. A systematic examination of publications since 2009 informed new recommendations. The target audience is the full spectrum of diabetes health care professionals and individuals with diabetes.

Citing Articles

Gentiopicroside targeting AKT1 activates HIF-1α/VEGF axis promoting diabetic ulcer wound healing.

Wang X, Liu M, Wu Y, Sun J, Liu L, Pan Z Front Pharmacol. 2025; 16:1506499.

PMID: 40078292 PMC: 11897484. DOI: 10.3389/fphar.2025.1506499.


Diabetic ketoacidosis and hyperglycemic hyperosmolar state are associated with higher in-hospital mortality and morbidity in diabetes patients hospitalized with ST-elevation myocardial infarction, but not within 30 days of readmission.

Almutairi T, Dargham S, Jayyousi A, Suwaidi J, Abi Khalil C PLoS One. 2025; 20(2):e0318774.

PMID: 39913488 PMC: 11801527. DOI: 10.1371/journal.pone.0318774.


Continuous Glucose Monitoring in Hospitalized Adults With Diabetic Ketoacidosis: A Prospective Open-Label Pilot Study.

Bogun M, Wang C, Kurlansky P, Bedeir N, Umpierrez G J Diabetes Sci Technol. 2025; :19322968251316887.

PMID: 39907056 PMC: 11800229. DOI: 10.1177/19322968251316887.


Insulin Titration Recommendations When Using Glucagon-Like Peptide 1 Receptor Agonist Therapy in Adults With Type 1 Diabetes.

Saeed Z, Akturk H, Aleppo G, Kruger D, Levy C, Mader J Clin Diabetes. 2025; 43(1):131-138.

PMID: 39829697 PMC: 11739354. DOI: 10.2337/cd24-0067.


Elective peri-operative management of adults taking glucagon-like peptide-1 receptor agonists, glucose-dependent insulinotropic peptide agonists and sodium-glucose cotransporter-2 inhibitors: a multidisciplinary consensus statement: A consensus....

El-Boghdadly K, Dhesi J, Fabb P, Levy N, Lobo D, McKechnie A Anaesthesia. 2025; 80(4):412-424.

PMID: 39781571 PMC: 11885194. DOI: 10.1111/anae.16541.


References
1.
Laffel L . Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes Metab Res Rev. 2000; 15(6):412-26. DOI: 10.1002/(sici)1520-7560(199911/12)15:6<412::aid-dmrr72>3.0.co;2-8. View

2.
Nyenwe E, Kitabchi A . Evidence-based management of hyperglycemic emergencies in diabetes mellitus. Diabetes Res Clin Pract. 2011; 94(3):340-51. DOI: 10.1016/j.diabres.2011.09.012. View

3.
Wei W, Lin S, Hsu J, Wu Y, Loh C, Huang H . Association between Hyperosmolar Hyperglycemic State and Venous Thromboembolism in Diabetes Patients: A Nationwide Analysis in Taiwan. J Pers Med. 2022; 12(2). PMC: 8880712. DOI: 10.3390/jpm12020302. View

4.
Nip A, Lodish M . Trend of Diabetes-Related Hospital Admissions During the Transition Period From Adolescence to Adulthood in the State of California. Diabetes Care. 2021; 44(12):2723-2728. DOI: 10.2337/dc21-0555. View

5.
Umpierrez G, Latif K, Stoever J, Cuervo R, Park L, Freire A . Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. Am J Med. 2004; 117(5):291-6. DOI: 10.1016/j.amjmed.2004.05.010. View