Your risk of developing diabetic hyperosmolar syndrome might be higher if you. As, for examples, in hyperglycemic hyperosmolar syndrome and hyperosmolar coma. Hyperosmolar nonketotic coma definition of hyperosmolar. Hyperosmolar hyperglycemic nonketotic syndrome hhns, also known as hyperosmolar hyperglycaemic state hhs is a dangerous condition resulting from very high blood glucose levels. Its usually caused by a traumatic event like an illness or heart condition. Hyperosmolar hyperglycemic state is a lifethreatening emergency. Identification and treatment of underlying and precipitating causes are. Find powerpoint presentations and slides using the power of, find free presentations research about hyperglycemia hyperosmolar non ketotic coma ppt.
Hyperosmolar hyperglycemic nonketotic syndrome symptoms. What is hyperosmolar hyperglycemic nonketotic syndrome hhns. Hyperosmolar syndrome or diabetic hyperosmolar syndrome is a medical emergency caused by a very high blood glucose level the prefix hyper means high, and osmolarity is a measure of the concentration of active particles in a solution, so the name of the syndrome simply refers to the high concentration of glucose in the blood. Hyperglycemia hyperosmolar non ketotic coma ppt xpowerpoint. Diabetic ketoacidosis dka is a potentially lifethreatening complication of diabetes mellitus. Careful monitoring of glucose levels and ensuring adequate hydration in patients at risk of hhns, including those receiving medications that interfere with the. Pdf only acetazolamideassociated hyperosmolar hyperglycemic nonketotic syndrome yeddi, ahmed md 1. The loss of water also makes the blood more concentrated than normal. Oct 27, 2012 hyperglycaemic hyperosmolar nonketotic syndrome hhns is a lifethreatening complication of uncontrolled diabetes mellitus. Feb 17, 2019 hyperglycemic hyperosmolar nonketotic syndrome is an extremely serious complication that can lead to diabetic coma and even death in type 2 diabetes. What is hyperglycemic hyperosmolar nonketotic syndrome.
Feb 26, 2019 nonketotic hyperosmolar coma is a life threatening metabolic derangement that can develop in people with diabetes mellitus, usually due to illness, infection or failure to monitor blood glucose. Some medications for the treatment of other ailments and conditions. The hyperosmolar hyperglycemic state hhs is a syndrome characterized by severe hyperglycemia. Download file to see previous pages she was accompanied by her daughter. Now it is being diagnosed with increasing frequency in obese children with type 2 diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion and occasionally loss of consciousness. Dec 10, 2018 hyperosmolar hyperglycemic nonketotic syndrome hhns mostly affects elderly people. Five cases are described, in all of which excessive consumption of lucozade, a proprietary glucose drink, played an important part in the development of their hyperosmolar state. Hyperosmolar hyperglycemic state is a relatively common, lifethreatening endocrine emergency that is reported in all age groups,1 but it most frequently affects older patients with type 2 diabetes. Patients with hyperosmolar hyperglycemic syndrome are often chronically ill, and they may have major total body deficits of potassium, phosphate and magnesium, as well as bcomplex vitamins.
Stay alert for symptoms of skin infections and other skin disorders common in people. Mar 06, 2012 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. The hyperglycaemic hyperosmolar state hhs is a medical emergency. The management of the hyperosmolar hyperglycaemic state hhs. It is a lifethreatening emergency that, although less common than its counterpart, diabetic ketoacidosis dka, has a much higher mortality rate, reaching up to 510%. Traumatic brain injuries are the most frequent cause.
Hyperglycemic hyperosmolar nonketotic syndrome medind. She complained of thirst for the last one week, drinking more than eight pints of water a day. Jan 19, 2019 hyperosmolar hyperglycemic nonketotic syndrome, or hhns, is a serious condition most frequently seen in older persons. Diabetic ketoacidosis and hyperglycemic hyperosmolar. As a result of diabetic hyperosmolar syndrome, your body tries to rid itself of the excess blood sugar by passing. Patients were managed with relatively small amounts of fluid, and the type.
Your kidneys try to get rid of the extra blood sugar by putting more sugar into the urine. A form of diabetic coma seen in type 2 diabetes mellitus. Diagnosis and treatment of diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in. Hyperosmolar hyperglycemic nonketotic syndrome hhns is a very serious condition. Usually, hhns is brought on by an illness or infection. Hhs hyperosmolar hyperglycemic nonketotic syndrome youtube.
The exact incidence of hhs is not known, but it is estimated to account for hyperosmolar nonketotic syndrome hyperglycemic hyperosmolar nonketotic syndrome occurs at a frequency of 17. In this study, hyperosmolarity was not related to coma or to final outcome of treatment. View and download powerpoint presentations on hyperglycemia hyperosmolar non ketotic coma ppt. Hyperglycemic hyperosmolar nonketotic syndrome hhns was infrequently diagnosed till recently. Hyperosmolar hyperglycemic state previously referred to as hyperglycemic hyperosmolar nonketotic coma hhnk and nonketotic hyperosmolar syndrome nkhs is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to 20%, which is significantly higher than the mortality for diabetic ketoacidosis currently pdf only acetazolamideassociated hyperosmolar hyperglycemic nonketotic syndrome yeddi, ahmed md 1. Hyperosmolar hyperglycemic state hhs is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis. Hhns can affect both types of diabetics, yet it usually occurs amongst people with type 2 diabetes. Management of the hyperosmolar hyperglycemic syndrome. Diabetes increases your risk for many serious health problems. Hyperosmolar hyperglycemic syndrome hhs is a clinical condition that. Pathophysiological considerations and suggested guidelines for treatment phil zeitler, md, phd, andrea haqq, md, arlan rosenbloom, md, and nicole glaser, md for the drugs and therapeutics committee of the lawson wilkins pediatric endocrine society h yperglycemic hyperosmolar syndrome hhs, charac. This draws the water out of the bodys other organs, including the brain. More detailed information about the symptoms, causes, and treatments of hyperosmolar hyperglycemic nonketotic syndrome is available below. L had a threeday history of confusion, lethargy and drowsiness.
Full text get a printable copy pdf file of the complete article 907k, or click on a page image below to browse page by page. If you have symptoms of high blood sugar, such as extreme thirst and excessive urination, for a few days, check your blood sugar level and call your doctor for advice. We discuss the management of hyperosmolar hyperglycemic syndrome. Hyperosmolar hyperglycemic state is a lifethreatening emergency manifested by marked eleva ada american diabetes association. Hyperglycemic hyperosmolar syndrome hhs is a potentially life threatening condition involving extremely high blood sugar glucose levels when your blood sugar gets too high, the kidneys try. Water shift from intracellular to intravascular compartment resulting in hypernatremia and increased osmolarity. Symptoms include signs of dehydration, weakness, legs cramps, trouble seeing, and an altered level of consciousness. 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. Complications may include seizures, disseminated intravascular coagulopathy. Arieff and carrolls diagnostic criteria included a blood glucose level. In biochemistry, pertaining to an osmolar concentration of the body fluids that is abnormally increased.
Symptoms include signs of dehydration, weakness, leg cramps, vision problems, and an altered level of consciousness. Hyperglycemic hyperosmolar nonketotic syndrome is an extremely serious complication that can lead to diabetic coma and even death in type 2 diabetes. Hyperosmolar hyperglycemic nonketotic syndrome sciencedirect. American diabetes association the choice of fluid for further repletion depends on the hydration status, serum electrolyte levels, and urinary output. Diabetic ketoacidosis dka and hyperosmolar hyperglycemic state hhs, also known as hyperosmotic hyperglycemic nonketotic state hhnk are two of the most serious acute complications of diabetes. Hyperglycemic hyperosmolar nonketotic syndrome hhns caused by lack of insulin or insulin resistance with resulting hyperglycemia which causes osmotic diuresis.
The exact incidence of hhs is not known, but it is estimated to account for 250 mgdl, ii ketosis, and iii acidemia ph file to see previous pages she was accompanied by her daughter. Hhs is different from diabetic ketoacidosis dka and treatment requires a different approach. Hyperosmolar hyperglycemic state previously referred to as hyperglycemic hyperosmolar nonketotic coma hhnk and nonketotic hyperosmolar syndrome nkhs is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to 20%, which is significantly higher than the mortality for diabetic ketoacidosis currently hyperosmolar hyperglycemic nonketotic syndrome as firstlisted diagnosis in adults with diabetes, united states sex ageadjusted rate. Jan 14, 2019 hyperosmolar hyperglycemic state hhs is one of two serious metabolic derangements that occur in patients with diabetes mellitus dm. With the correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of complications. Hospitalizations for hyperosmolar hyperglycemic nonketotic syndrome as firstlisted diagnosis in adults with diabetes, united states sex ageadjusted rate.
Dka is characterized by ketoacidosis and hyperglycemia, while hhs usually has more severe hyperglycemia but no ketoacidosis table 1. The hyperosmolar hyperglycemic state hhs is a syndrome characterized by severe hyperglycemia, hyperosmolality, and dehydration in the absence of ketoacidosis. This condition combines high blood glucose hyperglycemia and severe dehydration. Acetazolamideassociated hyperosmolar hyperglycemic. Feb 28, 2018 this is a follow up to the dka episode launched on 21418. This syndrome is characterised by severe hyperglycaemia, a marked increase in serum osmolality, and clinical evidence of dehydration without significant accumulation of ketoacids. If you continue browsing the site, you agree to the use of cookies on this website. Although typically occurring in the elderly, hhs is presenting in ever younger adults and teenagers, often as the initial presentation of type 2 diabetes mellitus t2dm. People with type 2 diabetes are at risk for a problem called hyperosmolar hyperglycemic nonketotic syndrome hhns. Hyperosmolar hyperglycemic state previously referred to as hyperglycemic hyperosmolar nonketotic coma hhnk and nonketotic hyperosmolar syndrome nkhs is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to 20%, which is significantly higher than the mortality for diabetic ketoacidosis currently mar, 2020 hyperosmolar hyperglycemic nonketotic syndrome hhns. What is hyperosmolar hyperglycemic nonketotic syndrome. Diabetic hyperosmolar syndrome symptoms and causes. Hyperglycemic hyperosmolar syndrome hhs, charac terized by extreme. The condition most commonly occurs in people with type 2 diabetes.
Oct 10, 2014 the hyperosmolar hyperglycemic state hhs is a syndrome characterized by severe hyperglycemia, hyperosmolality, and dehydration in the absence of ketoacidosis. An acute decompensated state in which patients manifest a change in mental status in the setting of hyperglycemia, hyperosmolarity and. Hyperosmolar hyperglycemic state is a lifethreatening emergency manifested by marked eleva tion of blood glucose, hyperosmolarity, and little or no ketosis. People with type ii diabetes mellitus can also develop hyperosmolar hyperglycemic nonketotic syndrome.
Hhns is an emergency caused by very high blood sugar, often over 600 mgdl. Treatment of hyperglycaemic hyperosmolar nonketotic syndrome. However, although treatment of diabetic ketoacidosis dka in children is familiar. Hyperglycemic hyperosmolar syndrome in children diabetes. Hyperosmolar hyperglycemic state linkedin slideshare.
1062 81 178 775 782 130 1182 374 686 1417 299 1176 507 1092 419 58 617 1566 1147 1127 912 898 662 296 235 227 1479 142 943 291 1190