Definition
Hyperosmolar hyperglycemic state (HHS) is when a person with diabetes has very high blood glucose levels and loses too much fluid. People with HHS may lose consciousness and go into a coma. It can be deadly without treatment.
Causes
HHS happens when there is too much glucose in the blood. The body tries to fix this by passing extra glucose out in the urine. If too much water is passed out of the body as urine, it can be hard for the heart and brain to work.
It can be triggered by:
Risk Factors
HHS can happen at any age. It is more common in older adults and people with type 2 diabetes.
Symptoms
Common symtoms are:
- Dry mouth and severe thirst
- Urinating (peeing) often
- Confusion
- Seizures
- Sleepiness
- Changes in vision
- Seeing or hearing things that are not there
- Weakness
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done.
Blood tests will be done to measure blood glucose levels and check for signs of infection. Urine tests will be done to find out if your body is burning fat for energy. This may happen when there is not enough glucose in the body. Urine tests can also check for signs of infection.
The heart may also be checked. An EKG can check your heart's electrical activity.
| Electrocardiogram |
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Treatment
Emergency medical care will be needed. The goal of treatment is put the fluids and minerals a person has lost back into their body to make them feel better. Glucose will also be put back to the right level. This can be done through IV.
Other treatment may be needed if there is an infection.
Prevention
The risk of this health problem can be lowered by:
- Following your diabetes care plan
- Eating a healthful diet and drinking plenty of fluids
- Seeking care for illnesses or signs of infection
RESOURCES
American Diabetes Association http://www.diabetes.org
National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov
CANADIAN RESOURCES
Canadian Diabetes Association http://www.diabetes.ca
Health Canada http://www.hc-sc.gc.ca
References
Hyperglycemic hyperosmolar state in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hyperglycemic-hyperosmolar-state-in-adults . Accessed February 18, 2022.
Hyperglycemic hyperosmolar state in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hyperglycemic-hyperosmolar-state-in-children . Accessed February 18, 2022.
Stoner, G. Hyperosmolar hyperglycemic state. American Family Physician, 2017; 96(11): 729-736. Available at: https://www.aafp.org/afp/2017/1201/p729.html . Accessed February 18, 2022.