# DKA vs HHNK



## SMButton91 (Mar 26, 2011)

Hello, i'm having the opportunity to give a presentation about DKA vs. HHNK and identification and management in our paramedic class. The book we have gives a lot of information over the signs and symptoms of DKA, but lacks information about HHNK? I know that it differs because DKA produces Ketones, but HHNK does not because some or little insulin is present to prevent fat being used as energy, but not enough to prevent glucose being used by the peripheral tissue and gluconeogenesis. And prehospital treatment is basically the same for both. But does acidosis happen at all? It seems like it would produce a little acidosis because of gluconeogenesis. potasium loss? Kussmal breathing at all? I'm interested to hear your replies, very interesting topic...


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## Shishkabob (Mar 26, 2011)

Taken from my replies on the same topic:

"If your glucometer goes high enough (instead of just saying 'high'), HHNK tends to be much higher in BGL than DKA. HHNK also tends to be a longer onset (usually days to weeks) while DKA tends to be much shorter in onset. Also, even though we don't have direct access to labs in the field usually, HHNK tends to not affect the pH of blood as much as DKA. Not to mention the acetone smell that might accompany DKA, but not HHNK. "

You need not have a history of diabetes to have HHNK.  Also, nausea / vomitting tends to be more prevalent in DKA as opposed to HHNK.


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