Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) remain two of the most commonly encountered metabolic emergencies. They are both potentially life-threatening when not managed correctly. DKA occurs most frequently (but not exclusively) in people with type 1 diabetes mellitus, who are absolutely insulin-deficient. HHS (formerly known as hyperosmolar non-ketotic state) occurs most frequently (but not exclusively) in older people with type 2 diabetes, who have insufficient insulin concentration to lower blood glucose, but enough to prevent ketone production.
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