Hyperosmolar hyperglycemic syndrome ( HHS )

HYPEROSMOLAR HYPERGLYCEMIC SYNDROME ( HHS ) complication of diabetes ( type 2 diabetes in 90 % to 95 % of cases ) previously know by other names as non-ketotic hyperglycemic coma , hyperosmolar hyperglycemic non ketotic syndrome and hyperosmolar non-ketotic coma ( HONK ) Main features related to HHS are severe hyperglycemia ( e.g bl glucose > 30 mmol / L ) , high serum osmolality and extreme dehydration in the absence of ketoacidosis

Presentation - usually has a slower onset than DKA , develops over several days or weeks can be precipitated by infectious diseases , disorders of the respiratory , circulatory and genitourinary systems presentation can be with fatigue ( glucose cannot be utilized for energy ) , polyuria , polydipsia , weakness , blurred vision altered level of consciousness to confused , lethargic or comatose usually develops in the elderly mortality rates of 8 % to 20 % ( about 10 times higher than DKA patients )

Enquire - ask about insulin regimen ,compliance , missed doses infection is the most common precipitant ( particularly pneumonia & UTI ) over consumption of carbohydrate rich food chest pain , tightness , headache , dizziness , palpitations conditions as...