Hyperosmolar Hyperglycemic Nonketotic Syndrome, or HHNS, is a serious condition most frequently seen in older persons. HHNS can happen. Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked eleva- ADA = American Diabetes Association. Hyperosmolar hyperglycemic state is a life-threatening emergency on recommendations from the American Diabetes Association (Figure 2).

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As glucose concentration improves following insulin infusion hyperosmolsr administration of the intravenous fluids, serum osmotic gradient previously contributed by hyperglycemia reduces which limits water shifts from the intracellular compartment. Its prevalence and significance. Diabetes Metab Syndr Obes.

Pediatric Diabetic Ketoacidosis With Hyperosmolarity: The most common complications of DKA and HHS include hypoglycemia and hypokalemia due hyyperosmolar overzealous treatment with insulin and bicarbonate hypokalemiabut these complications occur infrequently with current low dose insulin regimens. Management of the hyperosmolar hyperglycemic syndrome. Age-Adjusted DKA hospitalization rate per 1, persons with diabetes and in-hospital case-fatality rate, United States, — 4.

Hyperglycemic hyperosmolar non-ketotic syndrome in children with type 2 diabetes.


The temporal relationship between endogenously secreted stress hormones and metabolic decompensation in diabetic man. Severe dehydration, older age, and the presence of comorbid conditions in patients with HHS account for the higher mortality in these patients It may also occur in patients with known diabetes and in very young adults usually under 20 years of age A copy of the license can be viewed at http: Emerg Med Australas ; Treatment outcome and prognostic indices in patients with hyperglycemic emergencies.

Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)

Insulin therapy, correction of acidosis, and volume expansion decrease serum potassium concentrations. Therefore, in patients with pH between 6.

Therefore, for the diagnosis of DKA, clinical judgment and consideration of other biochemical data are required to interpret the value of positive nitroprusside reactions in patients on captopril. Insulin omission in women with IDDM. Endocrinol Metab Clin North Am ; Ultimately, the amount of excreted ketoanions depends on degree of kidney function preservation with the largest amount of ketoanion loss in patients with relatively preserved glomerular filtration rate J Toxicol Clin Huperglycemic ; It also provides a simple method for calculating anion gap and serum osmolality.


Csako G, Elin RJ. Diabetic ketoacidosis during long-term treatment with continuous subcutaneous insulin infusion. Similar results have been reported recently in pediatric patients with DKA There are no randomized controlled studies that evaluated safe and effective strategies in the treatment of HHS Severe non-ketotic hyperosmolar coma—intensive care management. Serum lipid levels in hyperosmolar non-ketotic diabetic coma. Counterproductive effects of sodium bicarbonate in diabetic ketoacidosis.

Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state.

BMJ Best Practice

Crit Care Med ; These ketosis-prone type 2 diabetic patients develop sudden-onset impairment in insulin secretion and action, resulting in profound insulinopenia The emergency management of hyperglycemic-hyperosmolar nonketotic coma in the pediatric patient. When you are sick, you will check your hyperosmplar sugar more often, and drink a glass of liquid alcohol-free and caffeine-free every hour.

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