Hyperglycaemic hyperosmolar non-ketotic state

Medium urgency
-Moderately severe

Complication of type 2 diabetes in which there is an extremely high level of sugar (glucose) in the blood without the presence of ketones.

The condition can be caused by other diseases, infections, dehydration and medicines that reduce the effect of insulin.

It presents with increased thirst, nausea, dry mucous membranes, fever and/or seizures.

It is diagnosed clinically by physical examination and regular additional tests (blood tests, cultures).

The aim of treatment is to correct the loss of water and blood glucose, provide supportive care to maintain vital signs and relieve symptoms.

Bibliographic references
  1. Irl B Hirsch, MD, Michael Emmett, MD. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis. UpToDate. Jul 05, 2016.
  2. Irl B Hirsch, MD, Michael Emmett, MD. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. UpToDate. Dec 07, 2016.
  3. Irl B Hirsch, MD, Michael Emmett, MD. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. UpToDate. Dec 07, 2015.
  4. Kitabchi AE, Razavi L.Hyperglycemic Crises: Diabetic Ketoacidosis (DKA), And Hyperglycemic Hyperosmolar State (HHS). In: http://www.endotext.org/diabetes/diabetes24/diabetesframe24.htm. (Accessed on July 02, 2014).
  5. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care 2009; 32:1335.
  6. Elena García Fernández, Helena Requejo Salinas, Roberto González Fuentes, Juan Torres Macho. Diabetes Mellitus, Hipoglucemia. Manual de diagnóstico y terapéutica médica Hospital Universitario 12 de octubre. 6ª edición. 2007. 857-879.
Author
Dr. Oscar Garcia-Esquirol
Copyright
© TeckelMedical 2026

Symptoms

    Blood sugar levels over 600 mg/dl / 33.3 mmol/L


    Signs of dehydration


    Blood sugar above 400 mg/dL or 22.2mmol/L


    Dry skin


    Drowsiness