The article "Hyperglycemic Crisis: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State" by Pasupuleti K Kumar et al. discusses the two most severe metabolic complications of diabetes mellitus (DM): diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemia state (HHS). Both conditions can occur in both type 1 and type 2 diabetics, with DKA more common in young people with type 1 diabetes and HHS more frequent in adult and elderly patients with type 2 diabetes. The primary causes of these conditions are inadequate insulin action, leading to hyperglycemia, ketone body production, and metabolic acidosis in DKA, and hyperosmolality, high blood glucose, and minimal ketosis in HHS. The article highlights the importance of prompt diagnosis and treatment, which typically involve intravenous insulin, fluid replacement, and managing the underlying causes. Despite advancements, there is a lack of consensus on diagnostic criteria and treatment protocols, and a significant overlap between the two conditions. Key signs and symptoms include polyuria, polydipsia, weakness, changes in mental status, and dehydration. Laboratory findings such as elevated blood glucose, serum ketones, and osmolality are crucial for diagnosis. Treatment focuses on correcting dehydration, hyperglycemia, electrolyte imbalances, and ketone bodies. Intravenous fluids are essential for expanding intravascular volume and restoring renal perfusion. Insulin therapy is the mainstay of treatment, with rapid-acting insulin analogs being a time-efficient alternative to intravenous insulin. The article also discusses the importance of potassium and bicarbonate management, as well as the transition to maintenance insulin regimens after resolving DKA or HHS. The authors emphasize the need for early diagnosis and rapid treatment to reduce the prevalence and improve the prognosis of these conditions, which remain significant health concerns despite ongoing research and advancements.The article "Hyperglycemic Crisis: Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State" by Pasupuleti K Kumar et al. discusses the two most severe metabolic complications of diabetes mellitus (DM): diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemia state (HHS). Both conditions can occur in both type 1 and type 2 diabetics, with DKA more common in young people with type 1 diabetes and HHS more frequent in adult and elderly patients with type 2 diabetes. The primary causes of these conditions are inadequate insulin action, leading to hyperglycemia, ketone body production, and metabolic acidosis in DKA, and hyperosmolality, high blood glucose, and minimal ketosis in HHS. The article highlights the importance of prompt diagnosis and treatment, which typically involve intravenous insulin, fluid replacement, and managing the underlying causes. Despite advancements, there is a lack of consensus on diagnostic criteria and treatment protocols, and a significant overlap between the two conditions. Key signs and symptoms include polyuria, polydipsia, weakness, changes in mental status, and dehydration. Laboratory findings such as elevated blood glucose, serum ketones, and osmolality are crucial for diagnosis. Treatment focuses on correcting dehydration, hyperglycemia, electrolyte imbalances, and ketone bodies. Intravenous fluids are essential for expanding intravascular volume and restoring renal perfusion. Insulin therapy is the mainstay of treatment, with rapid-acting insulin analogs being a time-efficient alternative to intravenous insulin. The article also discusses the importance of potassium and bicarbonate management, as well as the transition to maintenance insulin regimens after resolving DKA or HHS. The authors emphasize the need for early diagnosis and rapid treatment to reduce the prevalence and improve the prognosis of these conditions, which remain significant health concerns despite ongoing research and advancements.