Hyperglycemic Crises in Adult Patients With Diabetes: A Consensus Statement From the American Diabetes Association
Response to Rosival
- Abbas E. Kitabchi, PHD, MD1,
- Guillermo E. Umpierrez, MD2,
- Mary B. Murphy, RN, MBA, CDE1 and
- Robert A. Kreisberg, MD3
- 1Division of Endocrinology, Diabetes, and Metabolism, University of Tennessee Health Science Center, Memphis, Tennessee
- 2Clinical Research Center and Diabetes Unit, Grady Memorial Hospital/Emory University School of Medicine, Atlanta, Goergia
- 3University of South Alabama, Baptist Health System, Birmingham, Alabama
- Address correspondence to Dr. Abbas E. Kitabchi, Director, Division of Endocrinology, Diabetes, and Metabolism, University of Tennessee Health Science Center, 956 Court Ave., Suite D334, Memphis, TN 38163. E-mail: akitabchi{at}utmem.edu
In response to the comments by Dr. Rosival (1), we point out that impaired mental status is present in 52% of adult patients with diabetic ketoacidosis (DKA) and 74% of patients with hyperglycemic hyperosmolar syndrome (HHS) (2). Although most patients are lethargic or stuporous on arrival, 13% of admissions for DKA and 23% for HHS present with loss of consciousness. In previous reports (3–6), we evaluated the relationship between the initial biochemical data and level of consciousness in adult patients with DKA (4). In 1980, we reported that age, admission plasma …
