What is the pathophysiology of HHS?
Pathophysiology. Elevated levels of counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone) initiate HHS by stimulating hepatic glucose production through glycogenolysis and gluconeogenesis, leading to hyperglycemia, intracellular water depletion, and subsequent osmotic diuresis.
What is hyperosmolar hyperglycemia?
Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes. It involves extremely high blood sugar (glucose) level without the presence of ketones.
What causes hyperosmolar hyperglycemic state?
Diabetic hyperosmolar (hi-pur-oz-MOE-lur) syndrome is a serious condition caused by extremely high blood sugar levels. The condition most commonly occurs in people with type 2 diabetes. It’s often triggered by illness or infection.
What is the physiologic mechanism for the clinical presentation of hyperosmolar hyperglycemic state?
The typical clinical presentation of patients with HHS is increased urination (polyuria) and increase water intake (polydipsia). This is a result of the stimulation of the thirst center in the brain from severe dehydration and increased serum osmolarity.
Does HHS cause hyponatremia?
Hyperglycemia may cause dilutional hyponatremia, so measured serum sodium is corrected by adding 1.6 mEq/L (1.6 mmol/L) for each 100 mg/dL (5.6 mmol/L) elevation of serum glucose over 100 mg/dL (5.6 mmol/L). BUN and serum creatinine levels are markedly increased.
Which symptom is associated with hyperosmolar hyperglycemic syndrome?
A serious complication of diabetes mellitus, hyperosmolar hyperglycemic syndrome (HHS) happens when blood sugar levels are very high for a long period of time. Symptoms of HHS can include extreme thirst, frequent urination, changes in your vision and confusion.
What is the difference between HHS and HHNS?
Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is also known as hyperglycemic hyperosmolar syndrome (HHS). It involves very high blood sugar levels and can be life threatening. HHNS can happen to anyone, but it’s more common in older people who have type 2 diabetes.
What causes honk?
Causes of HONK Causes of hyperglycaemic hyperosmolar non-ketotic coma may include undiagnosed type 2 diabetes that has been developing over a number of years. Alternatively, HONK could be brought on by diabetic medication not being taken or very high blood glucose resulting from a period of illness.
Does HHS cause hypotension?
Signs and symptoms of hyperosmolar hyperglycemic state Vital signs related to HHS include the following: Tachycardia. Orthostatic decrease in blood pressure. Hypotension.
Does hyperglycemia cause hypernatremia or hyponatremia?
Hyperglycemia causes hyperosmolality, and the water moves from intracellular space to extracellular space, which in turn produces a dilutional decrease in serum sodium level. Therefore, hyperglycemic patients are mostly mildly hyponatremic.
Does HHS cause hypernatremia or hyponatremia?
Hyperosmolar hyperglycemic state (HHS) is a life-threatening endocrine disorder that most commonly affects adults with type 2 diabetes mellitus. It is characterized by severe dehydration with hypernatremia, marked hyperglycemia, variable degrees of neurologic impairment and mild or no ketosis.
What is DM with hyperosmolarity?
Hyperosmolar hyperglycemic state (HHS) is one of two serious metabolic derangements that occurs in patients with diabetes mellitus (DM).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%.
What is a hyperosmolar nonketotic coma?
A hyperosmolar coma, also known as a hyperosmolar nonketotic coma (HONK), is a serious complication associated with type 2 diabetes. Resulting from the development of hyperosmolarity, or extremely high blood glucose levels, there are a number of risk factors associated with the development of this condition.
What does hyperosmolar coma mean?
Hyperosmolar-coma meaning Any coma that results from a greater than normal amount of glucose in the blood .
How to diagnose HHS?
Your doctor will likely use a blood test to diagnose this condition. The blood test checks your current blood sugar level. Your doctor will diagnose HHS if your blood sugar is 600 milligrams per deciliter (mg/dL) or higher. Your doctor may perform other tests to confirm a diagnosis or see if there are any other potential complications.