Hyperosmolar nonketotic state (HHS) or coma happens in people with
diabetes. It is a severe event that needs care.
is caused by very high glucose in the blood. It is often set off by an illness or infection.
It can also happen if the diabetes treatment plan is not followed. The body passes extra glucose out in the urine. Too much urine will lower the levels of other important things in the body such as water. This can make it hard for the brain and heart to work.
HHS can happen at any age. It is more common in older adults and people with type 2 diabetes. Other things that may increase the chance of HHS are:
Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009 Jul;32(7):1335-43EBSCOhost Full Text full-text, commentary can be found in Diabetes Care 2009 Dec;32(12):e157.
Scott A, Claydon A. Joint British Diabetes Societies Inpatient Care Group. The management of hyperosmolar hyperglycaemic state (HHS) in adults with diabetes. Joint British Diabetes Societies (JBDS) 2012 Aug PDF, summary of report can be found in Diabet Med 2015 Jun;32(6):714
Umpierrez G, Korytkowski M. Diabetic emergencies - ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol. 2016 Apr;12(4):222-32
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