Kussmaul respiration, acetone breath, nausea, vomiting, abdominal pain. Hyperosmolar hyperglycemic state hhs most commonly occurs in patients with type 2 diabetes mellitus who have some concomitant illness that leads to reduced fluid intake. Hyperosmolar hyperglycemic state inpatient care what. Diabetic ketoacidosis and hyperglycemic hyperosmolar state asped. Hyperosmolar hyperglycemic nonketotic syndrome hhns, also known as hyperosmolar hyperglycaemic state hhs is a dangerous condition resulting from very high blood glucose levels. Click export csv or ris to download the entire page or use the checkboxes to select a subset of records to download. Results for hyperosmolar hyperglycemic state 1 10 of 15 sorted by relevance date. However, hhs is different and treatment requires a different approach. Hyperosmolar hyperglycemic state hhs is a serious medical condition that develops if your blood sugar levels get very high. Diabetic ketoacidosis dka and hyperosmolar hyperglycaemic state hhs are acute severe metabolic complications of uncontrolled diabetes mellitus.
Symptoms include signs of dehydration, weakness, leg cramps, vision problems, and an altered level of consciousness. Hyperosmolar hyperglycaemic state hhs simplifiedmed. Hyperosmolar hyperglycemic nonketotic syndrome hhns. Nonketotic hyperosmolar syndrome is a complication seen in diabetes mellitus in which very marked hyperglycemia occurs such as levels exceeding 800 mgdl, causing osmotic shifts in water in brain cells, and resulting in coma. Dka is caused by absolute insulin deficiency and is usually seen in the context of type 1 diabetes. Hyperglycaemic hyperosmolar nonketotic coma is a dangerous condition brought on by very high blood glucose levels in type 2 diabetes above 33 mmoll. Hyperosmolar hyperglycaemic state linkedin slideshare. V2 approved by policy and guideline committee on 29 november 2019 trust ref. Hyperosmolar hyperglycemic state hhs is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis. Hyperosmolar hyperglycemic state hhs by jorge mejia. Management of the hyperosmolar hyperglycaemic state hhs.
Excessive synthesis of ketone bodies from free fatty acids. State of hyperosmolality with low or no ketone bodies. Souto 1,olindamarques 1 1endocrinologydepartment,hospitalbraga,portugal. Management of hyperosmolar hyperglycaemic state in adults with.
Hyperosmolar hyperglycaemic state hhs occuring in type 2 diabetes. Hyperosmolar hyperglycemic state linkedin slideshare. Management of the hyperosmolar hyperglycemic syndrome. Introduction hyperosmolar hyperglycemic state hhs and diabetic ketoacidosis dka represent two distinct metabolic derangements manifested by insulin deficiency and severe hyperglycemia dka is defined as the presence of all three of the following. Abstract hyperglycaemic hyperosmolar state hhs is a medical. Infection is the most common cause, but many other conditions can cause altered mentation, dehydration, or both. If the address matches an existing account you will receive an email with instructions to reset your password. Hyperosmolar hyperglycaemic state acute medicine wiley online. Hyperglycaemic hyperosmolar nonketotic coma is a short term complication requiring immediate treatment by a healthcare professional.
Hyperglycaemic hyperosmolar nonketotic syndrome hhns is a lifethreatening complication of uncontrolled diabetes mellitus. It is an emergency and the prognosis for recovery is poor. Hhnk syndrome is characterized by extremely high blood glucose levels. Summary hyperosmolar hyperglycaemic state hhs typically occurs in patients with type 2 diabetes, but can also occur in type 1 diabetes. The management of the hyperosmolar hyperglycaemic state in. This syndrome is characterised by severe hyperglycaemia, a marked increase in serum osmolality, and clinical evidence of dehydration without significant accumulation of ketoacids. Diabetic ketoacidosis and hyperosmolar crisis in adults. Hyperglycaemic, hyperosmolar nonketotic hhnk syndrome is an uncommon complication of untreated canine diabetes. Hyperosmolar hyperglycemic state hhs endocrine and. Hhns can affect both types of diabetics, yet it usually occurs amongst people with type 2 diabetes usually, hhns is brought on by an illness or infection. It can develop over a course of weeks through a combination of illness e. Hyperosmolar hyperglycaemic state hhs in adults uhl guideline.
The hyperglycemic hyperosmolar state hhs or hyperglycemic hyperosmolar nonketotic coma hhnk is a serious and potentially lethal acute complication of diabetes. Hyperosmolar hyperglycaemic state hhs is a diabetic emergency that although typically occurring in the elderly, is presenting in younger adults and teenagers, often as the initial presentation of type 2 diabetes mellitus t2dm. The management of the hyperosmolar hyperglycaemic state hhs. Hyperglycaemic hyperosmolar state british journal of. Hyperglycaemic, hyperosmolar, nonketotic hhnk syndrome. Symptoms of honk before loss of consciousness and coma takes place. Hhs can occur in people with type 1 or type 2 diabetes, but is more common in people with type 2 diabetes. Hyperosmolar nonketotic coma hyperglycemic hyperosmolar. Quality standards for diabetes care toolkit implementation advice uncontrolled diabetes should be recognised and appropriate management and followup arranged by a specialist diabetes team. It can be fatal or lead to permanent neurologic damage. In the majority of cases, people with uncontrolled diabetes should be managed in hospital by specialist care. Hyperosmolar hyperglycaemic state hhs occurs in people with type 2 diabetes who experience very high blood glucose levels often over 40mmoll.
Hyperosmolar hyperglycaemic state hhs formerly known as honk or hyperosmolar non ketotic coma is the typical hyperglycaemic emergency of type 2 diabetes. Now it is being diagnosed with increasing frequency in obese children with type 2 diabetes mellitus. Hyperosmolar hyperglycaemic state diagnosis history. Unlike the other common diabetes emergency, diabetic ketoacidosis dka, guidelines on the management of the hyperglycaemic hyperosmolar state hhs in adults are uncommon and often there is little to differentiate them from the management of dka. Treatment of hyperglycaemic hyperosmolar nonketotic. D anaesthesiologist and intensive care practitioner swagat slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Hyperosmolar hyperglycaemic state hhs is a diabetic emergency that. Hyperosmolar hyperglycaemic state an intensivists perspective presenter. Your body gets rid of the extra sugar through your urine. While they may each be seen in pure form, features of the two disorders may also coexist.
1165 1305 1113 1492 433 324 645 1175 256 1637 346 41 1567 319 1324 859 260 164 929 573 768 652 1517 593 124 566 234 234 825 1573 1365 862 1177 606 505 907 296 656 1313 1408 1108 1080 638