What is diabetic HHS? | ContextResponse.com

Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis. Symptoms include signs of dehydration, weakness, leg cramps, vision problems, and an altered level of consciousness.

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Thereof, 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).

Furthermore, how do you treat HHS? Treatment. Treatment consists of IV saline, correction of hypokalemia, and IV insulin (1). Treatment is 0.9% (isotonic) saline solution at a rate of 15 to 20 mL/kg/h, for the first few hours.

Thereof, what does HHS stand for in diabetes?

hyperglycemic hyperosmolar syndrome

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.

Related Question Answers

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.

How is hyperosmolar hyperglycemic state diagnosed?

What are the ADA diagnostic criteria for hyperosmolar hyperglycemic state (HHS)?

1. Plasma glucose level of 600 mg/dL or greater.
2. Effective serum osmolality of 320 mOsm/kg or greater.
3. Profound dehydration, up to an average of 9 L.
4. Serum pH greater than 7.30.
5. Bicarbonate concentration greater than 15 mEq/L.

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.

What happens in HHS?

Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis. Symptoms include signs of dehydration, weakness, leg cramps, vision problems, and an altered level of consciousness. Onset is typically over days to weeks.

How 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).

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.

Which is worse DKA or HHS?

Hyperosmolar hyperglycemic state (HHS) is one of two serious metabolic derangements that occur 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 does hyperosmolar mean?

Medical Definition of Hyperosmolar Hyperosmolar: In biochemistry, pertaining to an osmolar concentration of the body fluids that is abnormally increased.

What is nephrogenic diabetes insipidus?

In nephrogenic diabetes insipidus, the kidneys produce a large volume of dilute urine because the kidney tubules fail to respond to vasopressin (antidiuretic hormone) and are unable to reabsorb filtered water back into the body. Symptoms include excessive thirst and excretion of large amounts of urine.

What causes diabetic Polyphagia?

In uncontrolled diabetes where blood glucose levels remain abnormally high ( hyperglycemia ), glucose from the blood cannot enter the cells – due to either a lack of insulin or insulin resistance – so the body can't convert the food you eat into energy. This lack of energy causes an increase in hunger.

What diseases cause high blood sugar?

Other conditions that can cause high blood sugar are pancreatitis, Cushing's syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses. Insulin is the treatment for people with type 1 diabetes, and for life-threatening increases in glucose levels.

Is diabetes a syndrome?

Diabetes mellitus is a disorder in which blood sugar (glucose) levels are abnormally high because the body does not produce enough insulin to meet its needs. Diabetes damages blood vessels and increases the risk of heart attack, stroke, chronic kidney disease, and vision loss.

Is Blood Sugar 600 high?

If your blood sugar level tops 600 milligrams per deciliter (mg/dL), or 33.3 millimoles per liter (mmol/L), the condition is called diabetic hyperosmolar syndrome. Severely high blood sugar turns your blood thick and syrupy.

Which medications can precipitate a hyperosmolar hyperglycemic state?

Which drugs increase the risk for hyperosmolar hyperglycemic state (HHS)?

• Alcohol and cocaine.
• Anesthesia.
• Antiarrhythmics (eg, encainide and propranolol)
• Antidiabetic medications (sodium-glucose cotransporter-2 [SGLT-2] inhibitors)
• Antiepileptics (eg, phenytoin)

Who is Type 2 Diabetes?

Type 2 diabetes is a lifelong disease that keeps your body from using insulin the way it should. People with type 2 diabetes are said to have insulin resistance. People who are middle-aged or older are most likely to get this kind of diabetes, so it used to be called adult-onset diabetes.

What are HHS programs?

The United States Department of Health & Human Services (HHS) aims to "protect the health of all Americans and provide essential human services, especially for those who are least able to help themselves." These federal programs consist of social service programs, civil rights and healthcare privacy programs, disaster

What causes HHS?

Some factors that can contribute to HHS are:

• extremely high blood sugar levels due to uncontrolled or undiagnosed diabetes.
• an infection.
• medications that lower glucose tolerance or contribute to fluid loss.
• recent surgery.
• a stroke.
• a heart attack.
• impaired kidney function.

What is the standard treatment for hyperosmolar hyperglycemic syndrome?

Rapid and aggressive intravascular volume replacement is always indicated as the first line of therapy for patients with HHS. Isotonic sodium chloride solution is the fluid of choice for initial treatment because sodium and water must be replaced in these severely dehydrated patients.

What is a dangerous level of a1c?

A normal A1C level is below 5.7%, a level of 5.7% to 6.4% indicates prediabetes, and a level of 6.5% or more indicates diabetes. Within the 5.7% to 6.4% prediabetes range, the higher your A1C, the greater your risk is for developing type 2 diabetes.