A narrative review of the diabetic ketoacidosis and hyperosmolar hyperglycemic state overlap syndrome.

ABSTRACT:

Background

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are life-threatening acute complications of diabetes. Up to one-third of patients present with overlapping features of both syndromes, complicating diagnosis and management. This overlap is associated with higher mortality than isolated DKA or HHS.

Objective

This narrative review synthesizes current evidence on the epidemiology, pathophysiology, and management of DKA-HHS overlap in both adult and pediatric populations with either type 1 or type 2 diabetes, highlighting the distinct challenges in recognition, treatment, and outcomes across these groups.

Findings

While DKA is defined by ketosis and metabolic acidosis, and HHS by profound hyperglycemia and hyperosmolality, overlap presentat

SUBMITTER: Abady E 

PROVIDER: S-EPMC12639725 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature