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All Journal Jurnal Biologi Tropis Jurnal Ilmu Kedokteran dan Kesehatan
Husodo, Dewi Puspitorini
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Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State: Diagnosis and Management in Emergency Condition – A Literature Review Wongso Prawiro, Aurellia; Rofilah, Alita Khainur; Putri, Imey Pinasty Harianto; Praditna, Lalu M. Ardi; Hasanah, Mielosita; Husodo, Dewi Puspitorini
Jurnal Biologi Tropis Vol. 25 No. 4a (2025): Special Issue
Publisher : Biology Education Study Program, Faculty of Teacher Training and Education, University of Mataram, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jbt.v25i4a.11083

Abstract

Diabetic ketoacidosis (DKA) commonly occurs in type 1 diabetes due to absolute insulin deficiency, whereas HHS typically develops in type 2 diabetes with relative insulin deficiency. These distinct mechanisms result in different clinical and laboratory profiles. This review aims to compare the pathogenesis, clinical features, and current management of DKA and HHS. This study employed a narrative literature review design. Articles were retrieved from PubMed, Scopus, and Google Scholar using the keywords “diabetic ketoacidosis,” “hyperosmolar hyperglycemic state,” “diabetes mellitus,” and “complications,” covering publications from 2015 to 2025. A descriptive analysis was performed to highlight epidemiology, pathogenesis, clinical manifestations, and emergency management principles. The review indicates that DKA is more frequent and associated with lower mortality when promptly recognized and treated. In contrast, HHS is less common but carries a higher mortality rate, mainly due to severe dehydration, insidious onset, and delayed diagnosis. Management principles for both conditions are similar, including fluid resuscitation, insulin therapy, electrolyte correction, and treatment of precipitating factors. A comprehensive understanding of the differences between DKA and HHS is essential to support early diagnosis, guide appropriate treatment, and reduce mortality.
Diagnosis And Comprehensive Management Of Thyroid Storm: A Literature Review Husodo, Dewi Puspitorini; Pramudiantara, Gede Naradhea; Wibawa, Galang Edi; Suryantarini, Ni Wayan Puspa Wijaya; Widad, Najwa; Bramantyo, Rofi
Jurnal Ilmu Kedokteran dan Kesehatan Vol 13, No 4 (2026): Volume 13 Nomor 4
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v13i4.23240

Abstract

Thyroid storm is a life-threatening endocrine emergency characterized by severe hypermetabolism and multiorgan dysfunction with mortality rates ranging from 10–30%. Delayed diagnosis and inappropriate management significantly contribute to poor clinical outcomes. This study is a literature review conducted through systematic searches in PubMed, Google Scholar, Wiley, Springer, and ScienceDirect databases for articles published between 2015 and 2025 using keywords “thyroid storm,” “hyperthyroidism,” “emergency,” “diagnosis,” and “management.” A total of 30 relevant articles, including case reports, cohort studies, and original research, were analyzed descriptively. The findings show that thyroid storm occurs in approximately 1–2% of hospitalized hyperthyroid patients, with global mortality reaching 20–30% and 8–25% in Indonesia. Early diagnosis using the Burch-Wartofsky Point Scale (score 45), combined with Japanese Thyroid Association criteria, improves diagnostic accuracy and facilitates prompt treatment. Initial management focuses on ABCDE stabilization, fluid resuscitation, and supportive care, followed by pharmacological therapy including antithyroid drugs (propylthiouracil or methimazole), iodine, beta-blockers, and corticosteroids. In refractory cases, plasmapheresis may be required, while definitive therapy such as thyroidectomy or radioiodine is performed after achieving euthyroid status. Thyroid storm requires rapid recognition and a structured, multidisciplinary management approach, and integration of validated diagnostic tools with comprehensive treatment strategies is essential to improve patient outcomes and reduce mortality.
Co-Authors Bramantyo, Rofi Hasanah, Mielosita Praditna, Lalu M. Ardi Pramudiantara, Gede Naradhea Putri, Imey Pinasty Harianto Rofilah, Alita Khainur Suryantarini, Ni Wayan Puspa Wijaya Wibawa, Galang Edi Widad, Najwa Wongso Prawiro, Aurellia