458: A Case Series: Mixed Presentations of Hyperglycemic Hyperosmolar Syndrome and Diabetic Ketoacidosis

Abstract

INTRODUCTION: Hyperglycemic hyperosmolar syndrome (HHS) in children presents a unique set of clinical challenges for which there is currently a paucity of data on management and complications. In addition to the rare occurrence of HHS in children (0.8%) often leading to delay in recognition, a mixed diabetic ketoacidosis (DKA)-HHS presentation is noted in up to 13.8% of hyperglycemic emergencies. The aim of this study was to describe the clinical characteristics of children presenting with a mixed DKA/HHS picture and to describe the association between presentation, initial management, and incidence of complications.