Hyperosmolar Hyperglycemic State
DEFINITION
- Characterized by severe hyperglycemia, hyperosmolality, and dehydration, in the absence of significant ketoacidosis (plasma glucose >600 mg/dL, arterial pH > 7.30, serum bicarbonate >18 meq/L, effective serum osmolality >320 mOsm/kg)[1].
- Initiated by osmotic diuresis due to hyperglycemia. Maintained by insulin levels sufficient to prevent lipolysis and subsequent ketogenesis, but inadequate to appropriately reduce blood glucose levels[6].
- Associated with proinflammatory state, reversed by effective hydration and insulin treatment[1].
- Usually seen in patients with type 2 diabetes (T2DM), in whom it may be the initial presentation. Occurs rarely in children or patients with type 1 diabetes[6][7].
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Last updated: June 4, 2019
Citation
Gonciulea, Anda, et al. "Hyperosmolar Hyperglycemic State." Johns Hopkins Diabetes Guide, 2019. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547065/all/Hyperosmolar_Hyperglycemic_State.
Gonciulea , Rastogi Kalyani R, Harris V. Hyperosmolar Hyperglycemic State. Johns Hopkins Diabetes Guide. 2019. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547065/all/Hyperosmolar_Hyperglycemic_State. Accessed June 2, 2023.
Gonciulea, ., Rastogi Kalyani, R., & Harris, V. (2019). Hyperosmolar Hyperglycemic State. In Johns Hopkins Diabetes Guide https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547065/all/Hyperosmolar_Hyperglycemic_State
Gonciulea , Rastogi Kalyani R, Harris V. Hyperosmolar Hyperglycemic State [Internet]. In: Johns Hopkins Diabetes Guide. ; 2019. [cited 2023 June 02]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547065/all/Hyperosmolar_Hyperglycemic_State.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Hyperosmolar Hyperglycemic State
ID - 547065
A1 - Gonciulea, Anda,M.D.
AU - Rastogi Kalyani,Rita,M.D., M.H.S.
AU - Harris,Vanessa Walker,M.D.
Y1 - 2019/06/04/
BT - Johns Hopkins Diabetes Guide
UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547065/all/Hyperosmolar_Hyperglycemic_State
DB - Johns Hopkins Guides
DP - Unbound Medicine
ER -