What happens in HHS?
HHS occurs when the blood sugar of a person with diabetes becomes too high (hyperglycemia) for a long time. The extra sugar is passed into the urine, which causes the person to urinate frequently. As a result, he or she loses a lot of fluid, which can lead to severe dehydration (extreme thirst).
How do you diagnose HHS?
Current diagnostic HHS criteria include a plasma glucose level >600 mg/dL and increased effective plasma osmolality >320 mOsm/kg in the absence of ketoacidosis. The incidence of HHS is estimated to be <1% of hospital admissions of patients with diabetes.
When do you suspect HHS?
The hyperglycaemic complications of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) can be life-threatening and require emergency hospital admission if suspected. Polydipsia and polyuria. Weight loss. Abdominal pain, nausea and/or vomiting.
What infection causes HHS?
This condition is called hyperosmolarity. Blood that’s too concentrated begins to draw water out of other organs, including the brain. Any illness that makes you dehydrated or reduces your insulin activity can lead to HHS.
What brings blood sugar down quickly?
When your blood sugar level gets too high — known as hyperglycemia or high blood glucose — the quickest way to reduce it is to take fast-acting insulin. Exercising is another fast, effective way to lower blood sugar. In some cases, you should go to the hospital instead of handling it at home.
What is the mortality rate for HHS?
The mortality rate for patients with HHS is between 10 and 20 percent, which is approximately 10 times higher than that for DKA [7]. The mortality rate for hyperglycemic crisis declined between 1980 and 2009 [8].
Why are there no ketones in HHS?
Ketones develop when the blood glucose level is high due to lack of insulin which is needed to allow glucose to enter the cells for energy. Because people with Type 2 diabetes may still be producing some insulin, ketones may not be created.
Is HHS the same as honk?
Hperglycemic hyperosmolar state (HHS) previously known as hyperosmolar nonketotic (HONK) coma is a syndrome characterized by extreme elevations in serum glucose concentrations, hyperosmolality and dehydration without significant ketosis (1,2).
How is hyperosmolar hyperglycemic state diagnosed?
Hyperosmolar hyperglycemic state is diagnosed by blood tests that show very high levels of glucose and very concentrated blood. Treatment is intravenous fluids and insulin. Complications include coma, seizures, and death.
Does HHS cause acidosis?
Arterial Blood Gases In HHS, pH is usually above or around 7.30 The pC0 might be low from hyperventilation. In DKA, serum pH is usually much lower ranging from 6.8 to around 7.2 on initial presentation. Acidosis in HHS is mainly as a result of dehydration and compromised end-organ perfusion.
What is the full meaning of HHS?
Department of Health and Human Services
What lab do you see with hyperglycemic hyperosmolar syndrome?
Plasma glucose level of 600 mg/dL or greater. Effective serum osmolality of 320 mOsm/kg or greater. Profound dehydration, up to an average of 9 L. Serum pH greater than 7.30.
Do you give insulin in HHS?
As with DKA, a FRIII is preferred, though generally lower doses are required. Patients with HHS are potassium deplete but less acidotic than those with DKA so potassium shifts are less pronounced, the dose of insulin is lower, and there is often co-existing renal failure.
Can HHS occur in type 1 diabetes?
HHS is characterized by severe hyperglycemia and hyperosmolality without significant ketosis and acidosis. HHS has been frequently reported in adult patients with type 2 DM (T2DM), but other than at academic meetings, no pediatric cases with HHS have been reported in Japanese patients with type 1 DM (T1DM).
What causes hyperosmolar hyperglycemic state?
HHNS is typically brought on by: An infection, such as pneumonia or a urinary tract infection. Poor management of blood sugar and/or not taking diabetes medications as prescribed. Taking certain medications, such as glucocorticoids (which alter glucose levels) and diuretics (which increase urine output)