Why is high osmolality in HHS?
Patients with hypernatremia usually have elevated plasma osmolality and are more often found with neurologic symptoms. Hypokalemia or hyperkalemia may be present. Commonly, at time of presentation of HHS, serum potassium may be elevated due to an extracellular shift caused by insulin deficiency.
Is HHS same as honk?
Hperglycemic hyperosmolar state (HHS) previously known as hyperosmolar nonketotic (HONK) coma is a syndrome characterized by extreme elevations in serum glucose concentrations, hyperosmolality and dehydration without significant ketosis (1,2).
How do you calculate osmolarity in HHS?
Osmolarity can be approximately calculated as: plasma osmolarity = 2 (Na mmol/L + K mmol/L) + urea mmol/L + glucose mmol/L.
What’s the difference between DKA and HHS?
DKA is characterized by ketoacidosis and hyperglycemia, while HHS usually has more severe hyperglycemia but no ketoacidosis (table 1). Each represents an extreme in the spectrum of hyperglycemia. The precipitating factors, clinical features, evaluation, and diagnosis of DKA and HHS in adults will be reviewed here.
Why are there no ketones in HHS?
Serum ketones are not present because the amounts of insulin present in most patients with type 2 diabetes are adequate to suppress ketogenesis.
Can dehydration cause HHS?
Patients with underlying renal dysfunction, congestive heart failure (CHF), or both are at increased risk. Drugs that raise serum glucose levels, inhibit insulin, or cause dehydration may contribute to development of HHS.
Why does HHS cause dehydration?
HHS occurs when the blood sugar of a person with diabetes becomes too high (hyperglycemia) for a long time. The extra sugar is passed into the urine, which causes the person to urinate frequently. As a result, he or she loses a lot of fluid, which can lead to severe dehydration (extreme thirst).
Why is HHS more common in type 2?
HHS is more often seen in people with type 2 diabetes who don’t have their diabetes under control. It may also occur in those who have not been diagnosed with diabetes. The condition may be brought on by: Infection.
What are the 4 most common leading complications of diabetes?
Here are the four most common complications associated with diabetes:
- Heart disease. A diabetic has twice a non-diabetic’s likelihood of dying of heart disease, including stroke.
- Foot problems. Diabetes reduces circulation.
- Kidney disease. Diabetes is the foremost cause of kidney disease.
- Eye problems.
Who are the core members of the JBDs?
These are the most up to date JBDS guidelines. All previous versions have been archived. Please ensure you are using the most up to date guidelines because they may have changed. The core members of JBDS-IP (listed below) include diabetes consultants and diabetes specialist nurses from across the UK, with all 4 nations represented.
Who are the joint British Diabetes Societies ( JBDs )?
The JBDS–IP group was created and supported by Diabetes UK, ABCD and the Diabetes Inpatient Specialist Nurse (DISN) UK group, and works with NHS England, TREND-UK and with other professional organisations. A SurveyMonkey of JBDS-IP guidelines undertaken at the end of 2012 revealed:
Who is the JBDs IP Group supported by?
The JBDS – IP group was created and supported by Diabetes UK, ABCD and the Diabetes Inpatient Specialist Nurse (DISN) UK group, and works with NHS England, TREND-UK and with other professional organisations.
How many JBDs guides have been published in the UK?
Since the original JBDS guideline document was published over 10,000 downloads have been reported in the UK and the more concise version published in Diabetic Medicine was in the top 10 of article downloads in 2019.