HHS is a life-threatening emergency associated with very high blood glucose levels (generally greater than 500 mg/dl which may be reflected as a "HI" reading on home glucose meters), that occurs in people with Type 2 Diabetes. It is an uncommon, but life threatening situation.
Acute: Hyperglycemic Hyperosmolar States (HHS)
HHS is a vicious cycle of high blood glucose levels that lead to excessive urination and dehydration. The dehydration causes the blood to become more concentrated and the blood glucose to rise even more. The higher the blood glucose the more the body tries to dispose of the excess glucose in the urine, which just worsens the dehydration. There is usually just enough insulin produced by the pancreas to keep fat in fat cells and prevent ketone formation, so ketone levels are normal or only slightly elevated in HHS.
Ultimately the person has very high blood glucose and is very dehydrated and is confused or in a coma (unconscious). This is a serious medical emergency that can lead to death. Immediate hospitalization is required.
HHS usually happens to people who don’t know they have Diabetes. It also happens to people who know they have Diabetes and are sick with something else and don’t check their blood glucose or drink enough fluid.
Symptoms:
- Greatly increased urination
- Thirst
- Extreme fatigue
- Confusion
- Seizure
- Coma
- Blood glucose "HI" or >500 mg/dl
- No ketone or low ketone levels
Treatment:
HHS is a life-threatening medical emergency requiring hospitalization. Treatment often includes IV fluids, low dose insulin and close monitoring and treatment in a hospital setting.