Overly rapid correction of hyperglycemia

[zzyzx]

What is the result of correcting blood sugar levels to quickly in DKA, and also in HHS? I have trouble finding an answer for this. One source says rebound ketoacidosis, and another says brain edema.

Also, in peds, has there been a consensus as to the cause of cerebral edema?

[offlabel]

When serum glucose levels are lowered with insulin too quickly, an osmotic gradient from brain to plasma occurs and cerebral edema can result. As far as kids and HHS, since treatment involves fluid resuscitation, the risk of cerebral edema is greater in kids with aggressive volume loading, coupled with the changes in osmotic gradients.