Hyperglycemic hyperosmolar state

It is a severe decompensation of diabetic patients, in which there are extremely high blood sugar levels, significant dehydration and low level of consciousness. It usually occurs in type 2 diabetic patients (non-insulin-dependent).

It is triggered by infections, serious diseases, impaired renal function and by medications that diminish the effect of insulin or its suspension. It is favored by dehydration and advanced age.

Symptoms appear slowly, even in weeks. The most common symptoms are dry skin and mucous membranes, severe thirst and decreased consciousness up to coma. It may be accompanied by fever, nausea, weight loss and convulsions.

Diagnosis is made by clinical examination, physical examination and blood tests. Unlike diabetic ketoacidosis, the presence of ketone bodies in urine is very rare.

For treatment, it is essential to correct the triggering cause. It should be performed in a hospital center ensuring proper hydration with intravenous serum therapy and the administration of insulin to correct high glucose levels.

It is considered a medical emergency with an associated mortality of 40%.