It is a life-threatening emergency that, although less common than its counterpart, diabetic ketoacidosis (DKA), has a much higher mortality rate, reaching up to 5-10%. HHS is characterized by hyperglycemia, hyperosmolarity, and dehydration without significant ketoacidosis.
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People also ask, what is the difference between HHS and DKA?
Although both conditions can occur at any age, diabetic ketoacidosis typically develops in younger patients, less than 45 years, who have little or no endogenous insulin production, whereas HHS usually occurs in much older non-insulin-dependent patients (who are often greater than 60 years old).
Secondly, can you have DKA and HHS at the same time? Both DKA and HHS are characterized by hyperglycemia and absolute or relative insulinopenia. Clinically, they differ by the severity of dehydration, ketosis and metabolic acidosis (11). DKA most often occurs in patients with type 1 diabetes mellitus (T1DM).
In this way, why is blood sugar higher in HHS than DKA?
In addition, DKA patients tend to be younger than HHS patients, and thereby have a higher glomerular filtration rate. Accordingly, DKA patients have a greater ability to excrete glucose in urine and can thereby limit the hyperglycemia.
Why are there no ketones in HHS?
HHS is a potentially life-threatening emergency 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.
Related Question AnswersHow long does it take DKA to develop?
SIGNS AND SYMPTOMS DKA can develop in less than 24 hours. 3 Metabolic changes occur one and one half to two hours earlier in patients who are managed only with a short-acting insulin such as lispro (Humalog).Which condition is seen in a patient with hyperosmolar hyperglycemic syndrome HHS?
Hyperosmolar hyperglycemic state is diagnosed by severe hyperglycemia and plasma hyperosmolality and absence of significant ketosis. Treatment is IV saline solution and insulin. Complications include coma, seizures, and death. (See also Diabetes Mellitus and Complications of Diabetes Mellitus.)How is HHS and DKA treated?
TREATMENT- Fluid Therapy. Patients with DKA and HHS are invariably volume depleted, with an estimated water deficit of ∼100 ml/kg of body weight.
- Insulin Therapy. The cornerstone of DKA and HHS management is insulin therapy.
- Potassium.
- Bicarbonate.
- Phosphate.
How is hyperosmolar hyperglycemic state diagnosed?
What are the ADA diagnostic criteria for hyperosmolar hyperglycemic state (HHS)?- 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.
- Bicarbonate concentration greater than 15 mEq/L.
What causes hyperosmolar hyperglycemic state?
Causes. Also, certain drugs, such as corticosteroids, can raise blood glucose levels and cause hyperosmolar hyperglycemic state. Drugs such as diuretics, which people often take to treat high blood pressure, can worsen dehydration and trigger hyperosmolar hyperglycemic state.Why is the anion gap important to follow in the treatment of DKA?
Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. DKA is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia. Treatment involves volume expansion, insulin replacement, and prevention of hypokalemia.What is the standard treatment for hyperosmolar hyperglycemic syndrome?
Treatment typically includes: Intravenous fluids to counter dehydration. Intravenous insulin to lower your blood sugar levels. Intravenous potassium, and occasionally sodium phosphate replacement to help your cells function correctly.What causes hyperosmolar hyperglycemic syndrome?
It's often triggered by illness or infection. As a result of diabetic hyperosmolar syndrome, your body tries to rid itself of the excess blood sugar by passing it into your urine. Left untreated, diabetic hyperosmolar syndrome can lead to life-threatening dehydration. Prompt medical care is essential.What does hyperosmolar mean?
Medical Definition of Hyperosmolar Hyperosmolar: In biochemistry, pertaining to an osmolar concentration of the body fluids that is abnormally increased.How do you treat HHS?
The main goals in the treatment of hyperosmolar hyperglycemic state (HHS) are as follows:- To vigorously rehydrate the patient while maintaining electrolyte homeostasis.
- To correct hyperglycemia.
- To treat underlying diseases.
- To monitor and assist cardiovascular, pulmonary, renal, and central nervous system (CNS) function.
