Glycaemic control not meeting targets or severe hyperglycaemia requiring hospital admission.
Diabetic ketoacidosis and hyperosmolar hyperglycaemic nonketotic syndrome (HHNS)
Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes that progresses rapidly and requires immediate medical attention (Mills and Stamper 2014). DKA consists of the biochemical triad of ketonaemia (ketosis), hyperglycaemia, and acidaemia (JBS 2013). HHNS is different from DKA in that there is marked hyperglycaemia without significant hyperketonaemia or acidosis. There is characteristic hypovolaemia, and hyperosmolarity and requires a different management approach to DKA (Joint British Diabetes Societies for Inpatient Care Group 2012).