What is HHS in diabetes?

What is HHS in diabetes?

Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes. It involves extremely high blood sugar (glucose) level without the presence of ketones.

What does HHS stand for?

Department of Health and Human Services

What is the difference between HHS and DKA?

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.

What causes hyperosmolar hyperglycemic state?

It’s often triggered by illness or infection. In diabetic hyperosmolar syndrome, your body tries to rid itself of the excess blood sugar by passing it into your urine. Left untreated, diabetic hyperosmolar syndrome can lead to life-threatening dehydration.

How do you treat HHS?

Treatment typically includes:

1. Fluids given through a vein (intravenously) to treat dehydration.
2. Insulin given through a vein (intravenously) to lower your blood sugar levels.
3. Potassium and sometimes sodium phosphate replacement given through a vein (intravenously) to help your cells function correctly.

Which is worse DKA or HHS?

Hyperosmolar hyperglycemic state (HHS) is one of two serious metabolic derangements that occur in patients with diabetes mellitus (DM). It is a life-threatening emergency that, although less common than its counterpart, diabetic ketoacidosis (DKA), has a much higher mortality rate, reaching up to 5-10%.

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.

What can cause HHS?

What causes hyperosmolar hyperglycemic syndrome (HHS)?

• Have an illness or infection, such as pneumonia or a urinary tract infection.
• Stop taking medication to manage their diabetes.
• Have a heart attack or stroke.
• Take certain medications—such as steroids or diuretics—that can cause the syndrome.

Does HHS cause acidosis?

Acidosis in HHS is mainly as a result of dehydration and compromised end-organ perfusion. Arterial blood gases should be monitored every 2 to 3 hours in HHS. The BUN and creatine levels are usually elevated reflecting prerenal azotemia.

How is hyperosmolar hyperglycemic state diagnosed?

Current diagnostic HHS criteria include a plasma glucose level >600 mg/dL and increased effective plasma osmolality >320 mOsm/kg in the absence of ketoacidosis. The incidence of HHS is estimated to be <1% of hospital admissions of patients with diabetes.

Is HHS the same as honk?

HHS is a potentially life-threatening emergency It does not usually lead to the presence of ketones in the urine, as occurs in diabetic ketoacidosis (DKA), which is why it was previously referred to as HONK (hyperglycaemic hyperosmolar non-ketotic coma).

Do you give insulin in HHS?

As with DKA, a FRIII is preferred, though generally lower doses are required. Patients with HHS are potassium deplete but less acidotic than those with DKA so potassium shifts are less pronounced, the dose of insulin is lower, and there is often co-existing renal failure.

How is HHS and DKA treated?

TREATMENT

1. Fluid Therapy. Patients with DKA and HHS are invariably volume depleted, with an estimated water deficit of ∼100 ml/kg of body weight.
2. Insulin Therapy. The cornerstone of DKA and HHS management is insulin therapy.
3. Potassium.
4. Bicarbonate.
5. Phosphate.

Why is blood sugar higher in HHS than DKA?

In addition, DKA patients tend to be younger than HHS patients, and thereby have a higher glomerular filtration rate. Accordingly, DKA patients have a greater ability to excrete glucose in urine and can thereby limit the hyperglycemia.

How do you manage hyperglycemia emergency?

Emergency treatment for severe hyperglycemia

1. Fluid replacement. You’ll receive fluids — usually through a vein (intravenously) — until you’re rehydrated.
2. Electrolyte replacement. Electrolytes are minerals in your blood that are necessary for your tissues to function properly.
3. Insulin therapy.

What lab test confirms HHNS?

HHNS is diagnosed based on symptoms and by measuring blood glucose levels, which can be performed with a finger stick. A blood glucose level of 600 mg/dL and low ketone levels are the main factors for diagnosis of HHNS.

Is HHS metabolic alkalosis?

Metabolic alkalosis presents in severe HHS.

What is the usual treatment procedure for correction of HHS?

Treatment. Treatment consists of IV saline, correction of hypokalemia, and IV insulin (1). Treatment is 0.9% (isotonic) saline solution at a rate of 15 to 20 mL/kg/hour, for the first few hours. After that, the corrected sodium should be calculated.

What is the standard treatment for hyperosmolar hyperglycemic syndrome quizlet?

Rationale: The primary goal of treatment in hyperosmolar hyperglycemic syndrome (HHS) is to rehydrate the client to restore fluid volume and to correct electrolyte deficiency. An external insulin pump is prescribed for a client with diabetes mellitus.

How can I lower my hyperglycemia quickly?

Here’s our process. When your blood sugar level gets too high — known as hyperglycemia or high blood glucose — the quickest way to reduce it is to take fast-acting insulin. Exercising is another fast, effective way to lower blood sugar….Eat a consistent diet

1. whole grains.
2. fruits.
3. vegetables.
4. lean proteins.

What is hyperglycemic emergency?

Hyperosmolar hyperglycemic state occurs primarily in people with type 2 diabetes. This state is characterized by hyperglycemia often greater than 30 mmol/L, and severe dehydration. During a hyperglycemic episode, the accumulation of glucose in the blood increases the frequency and volume of urination.

What are the three classic signs of hyperglycemia?

What are the symptoms of hyperglycemia?

• High blood sugar.
• Increased thirst and/or hunger.
• Blurred vision.
• Frequent urination (peeing).
• Headache.

How do you bring sugar levels down?

Here are 15 easy ways to lower blood sugar levels naturally:

1. Exercise regularly.
2. Manage your carb intake.
3. Increase your fiber intake.
4. Drink water and stay hydrated.
5. Implement portion control.
6. Choose foods with a low glycemic index.
7. Manage stress levels.
8. Monitor your blood sugar levels.

Can stress cause high glucose?

Stress blocks your body from releasing insulin, and that lets glucose pile up in your blood. If you’re stressed for a long time, your sugar levels will keep building.

Is sweating a sign of high blood sugar?

Diabetes can result in nerve damage, so that, for some people, the nerves that control sweat glands are always “switched on.” This can result in excessive sweating, known as hyperhidrosis.

What autoimmune disease causes excessive sweating?

Many of the most common autoimmune diseases—Rheumatoid arthritis, Celiac disease, Lupus, Multiple sclerosis, etc. —all share night sweats, fever, and hot flashes as symptoms.