Why is diabetic ketoacidosis different than hyperosmolar state?

Both conditions (Diabetic Ketoacidosis/DKA and Hyperglycemia Hyperosmolar State/HHS) are due to hyperglycemic states. The simple difference between the two is that DKA causes more severe ketosis and metabolic acidosis whereas HHS causes significantly more volume loss.  The diagnosis can only be made with laboratory tests. Both can appear similar clinically in the prehospital field: Altered, hyperglycemic, dehydrated, with other potential abnormal vital signs. The prehospital treatment is supportive for both and IV fluids if the patient is hypotensive. 

Cardiac/Circulation,Intravenous and Fluid Therapy

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