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Hyperglycemic hyperosmolar syndrome (HHS) is a potentially life-threatening condition involving extremely high blood sugar (glucose) levels. According to Medscape, any illness that causes dehydration or reduced insulin activity can lead to HHS; however, it is most commonly a result of uncontrolled or undiagnosed diabetes (Medscape, 2012). Diabetic HHS is usually triggered by infection or illness, or by failure to monitor and control blood glucose.
When blood sugar gets too high, the kidneys try to compensate by removing some of the excess glucose through urination. If you do not drink enough fluids to replace the fluid you are losing, or if you drink sugary beverages, blood sugar levels spike and blood becomes more concentrated. This condition is called hyperosmolarity. Once blood becomes concentrated, it begins to draw water out of other organs, including the brain.
Among possible symptoms are excessive thirst, increased urination, and fever. Symptoms may develop slowly and increase over a period of days or weeks.
Treatment involves reversing or preventing dehydration and getting blood glucose levels under control. Prompt treatment can relieve symptoms within a few hours. Untreated, diabetic HHS can lead to serious life-threatening complications, including dehydration, shock, or coma.
If you have symptoms of HHS, go to an emergency room or call 911 for help. This is a medical emergency.
Older people with type 2 diabetes are more likely to develop HHS. A number of factors can contribute to HHS, including:
HHS can happen to anyone, but is more common in older people who have type 2 diabetes.
Symptoms may begin gradually and worsen over a few days or weeks. A high blood sugar level is a warning sign of HHS. Symptoms include:
If you have symptoms of HHS, go to the emergency room or call 911 immediately.
Untreated, HHS can lead to life-threatening complications such as:
A physical exam will reveal if you are suffering from dehydration, fever, low blood pressure, or rapid heart rate. This condition is most often diagnosed with a blood test to determine your current blood sugar level–your doctor will diagnose HHS if your blood sugar is 600 mg/dL or higher.
Your doctor may perform other tests to confirm diagnosis or to gauge potential complications as a result of HHS. This testing may include:
If the cause of HHS is not associated with diabetes, a urinalysis may be performed to diagnose diabetes. According to the Mayo Clinic, HHS may occur in people who have not yet been formally diagnosed with diabetes (Mayo Clinic, 2012).
Due to the risk for serious complications, HHS is treated as a medical emergency. Emergency treatment will include:
Any complications from HHS must also be addressed.
When given promptly, treatment can improve symptoms within a few hours.
Approximately 10 to 20 percent of HHS cases end in death. Old age, severity of dehydration at time of treatment, and the presence of other illnesses all increase the risk for serious complications and death. Delayed treatment also greatly increases risk (Medscape, 2012).
The most important thing you can do to prevent HHS is to carefully monitor and control diabetes. Preventative measures include:
failure to do so will put your life at risk
Written by: Ann Pietrangelo
Published on: Sep 16, 2012
Medically reviewed on: Jan 13, 2016: [Ljava.lang.Object;@25491f93
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