DKA/HHS present - YES
Commence DKA/HHS protocol
(Local or JBDS)
Admission
Arrange admission
Mild ketosis could be managed in Same Day Emergency Care Unit (SDEC) or equivalent with diabetes team support
Refer to diabetes team
For further management, education and patient support
Discharge and follow up
Criteria for discharge
Metabolic
- glucose ≤15 mmol/l (ideally <10.0mmol/l)
- capillary ketones ≤1.0 mmol/l
Physiological
- NEWS2 score ≤2
- Capillary refill time ≤2 seconds
- No postural drop
Functional
- Able to drink and/or eat (depending on pre-morbid state)
- Back to pre-morbid state
- Minimal osmotic symptoms
Clinical
- No other clinical reason for admission
Support diabetes self-management
Provide your patient with this QR code to upload supporting information to their phone eg sick day rules
