What conditions contribute to HHNK?
Overview. Diabetic hyperosmolar (hi-pur-oz-MOE-lur) syndrome is a serious condition caused by extremely high blood sugar levels. The condition most commonly occurs in people with type 2 diabetes. It’s often triggered by illness or infection.
How do I confirm HHNS?
Diagnosis. 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.
Are HHS and HHNK the same?
Hyperosmolar hyperglycemic syndrome is also known by many other names, including: Diabetes-related HHS. Diabetes-related hyperosmolar syndrome. Hyperglycemic hyperosmolar nonketotic coma (HHNK).
What are the diagnostic criteria for HHS?
Current diagnostic criteria of HHS recommended by the American Diabetes Association (ADA) and international guidelines include a plasma glucose level >600 mg/dL, plasma effective osmolarity >320 mOsm/L, and an absence of significant ketoacidosis (Table 2) (4,58,59).
What is HHNK?
Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS), also known as Hyperosmolar Hyperglycaemic State (HHS) is a dangerous condition resulting from very high blood glucose levels. HHNS can affect both types of diabetics, yet it usually occurs amongst people with type 2 diabetes.
What is serum osmolality in HHS?
Normal serum osmolality ranges from 280 to 290 mOsm/kg. A serum osmolality of 320 mOsm/kg or higher defines HHS. Rarely, serum osmolality may exceed 400 mOsm/kg. In HHS, higher serum osmolality relates to greater impairment of the level of consciousness.
Can you have both HHS and DKA?
Over 30% of patients have features of both DKA and HHS (16) with most recent evidence confirming that about 1 out of 4 patients will have both conditions at the time of presentation with hyperglycemic crisis (18).
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. Renal function tests and electrolytes: dehydration and pre-renal acute kidney injury. Sodium and potassium levels are deranged.
What is osmolarity in HHS?
HHS is defined by an effective serum osmolarity ≥320 mOsm/L and a plasma glucose ≥600 in the absence of significant acidosis.
What are the criteria for resolution of HHS?
Criteria for resolution of HHS Normal plasma glucose (<250 to 300 mg/dL) Normal plasma effective osmolality (<315 mOsm/kg) Normal hemodynamic and mental status.
What is a criterion?
One is criterion, a word whose Greek plural is very much alive: criteria. Criterion is defined as “a standard on which a judgment or decision may be based” or “a characterizing mark or trait.”
Is hhnk a medical emergency?
On the other hand, HHNK is a medical emergency more commonly seen in type 2 diabetes mainly because of dehydation. It could be caused by an infection. In these cases the underlying cause of infection should be treated while simultaneously continuing hydration therapy.
What is the difference between DKA and hhnk?
DKA and HHNK are both medical emergencies and are both seen in diabetes patients. DKA occurs with the presence of ketosis while HHNK has no evidence of ketoacidosis. DKA is commonly treated with insulin therapy while HHNK’s dehydration is the first thing that is treated together with attention to infection. DKA…