Diabetes Mellitus

First Things First (assess & treat for the following)

• Keep in mind: diabetic ketoacidosis (DKA) & hyperglycemic hyperosmolar syndrome (HHS) or hyperosmolar nonketotic syndrome (HONK) occur in their pure forms as well as in combination anywhere along the spectrum between the two.
• Is pt obtunded?
  • Does pt need airway protection?
• Does pt have evidence of shock or hypotension?
  • If so, in addition to severe dehydration, consider sepsis, MI or PE.
• Is there clear evidence of a contributing cause (MI, infection, trauma, etc.) that requires immediate, simultaneous attention?