Distinguishing Diabetic Ketoacidosis, a Hyperosmolar Hyperglycemic State, and Hyperosmolar Diabetic Ketoacidosis in an Emergency Setting

Needs Statement

Faculty, fellows, residents, and other healthcare professionals and trainees in pediatric emergency medicine need to receive regular updates on recent advances in the emergency care of children. Complex cases will be used as an impetus for discussion, particularly with regard to morbidity and mortality. The series aims to expand the knowledge of learners, promote the implementation of evidence-based guidelines in clinical practice, enhance the quality of pediatric emergency care, and improve patient outcomes

Educational Objectives

At the conclusion of the session, the participants should be able to:

• Recognize the difficulties of distinguishing diabetic ketoacidosis from diabetic crises in an emergency setting.
• Demonstrate greater understanding of the pathophysiology of diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), and hyperosmolar DKA (mixed DKA-HHS).
• Compare and contrast DKA, HHS, and mixed DKA-HHS.
• Review a treatment algorithm for mixed DKA-HHS and the evidence for its use.

Target Audience

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Maintenance of Certification (MOC) Recognition Statement: Successful completion of this CME activity, which
includes participation in the evaluation component, enables the learner to earn up to 1 MOC point in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.

By signing in, you give Baylor College of Medicine permission to share your participation information/completion data with the specialty board referenced above through the ACCME Program and Activity Reporting System (PARS). Your MOC credit equates to the number of CME credits claimed for the activity and pending completion of the post-test with a minimum passing score of 70%. You can access your MOC credit(s) through the ABP website at www.abp.org.

Disclosure Policy

Baylor College of Medicine (BCM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians. BCM is committed to sponsoring CE activities that are scientifically based, accurate, current, and objectively presented.

In accordance with the ACCME Standards for Commercial Support, BCM has implemented a mechanism requiring everyone in a position to control the content of an educational activity (i.e., directors, planning committee members, faculty) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships at the time of the activity or within 24 months prior.

In addition, BCM has requested activity faculty/presenters to disclose to participants any unlabeled use or investigational use of pharmaceutical/device products; to use scientific or generic names (not trade names) in referring to products; and, if necessary to use a trade name, to use the names of similar products or those within a class. Faculty/presenters have also been requested to adhere to the ACCME's validation of clinical content statements.

BCM does not view the existence of financial relationships with commercial interests as implying bias or decreasing the value of a presentation. It is up to participants to determine whether the relationships influence the activity faculty with regard to exposition or conclusions. If at any time during this activity you feel that there has been commercial/promotional bias, notify the Activity Director or Activity Coordinator. Please answer the questions about balance and objectivity in the activity evaluation candidly.

All of the relevant financial relationships listed for these individuals have been mitigated.