If a patient is brought to the emergency department with signs and symptoms of hyperglycemia (polyuria, polydipsia, and abdominal pain), volume depletion, acidotic breath, and changes in mental status (even without a history of diabetes), then plasma glucose and urine ketones should be checked. In the presence of high plasma glucose and/or positive urine ketones, full diagnostic laboratory evaluations for diabetic ketoacidosis and HHS should be performed.
In hospitalized patients with diabetes who are eating, glucose monitoring should be performed before meals. In those who are not eating, glucose monitoring is advised every 4 to 6 hours.
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