hyperosmolar hyperglycemic state
A serious diabetic emergency characterized by severe hyperglycemia, hyperosmolality, and dehydration without significant ketoacidosis.
Full Definition
Hyperosmolar hyperglycemic state (HHS), formerly called hyperosmolar non-ketotic coma, is a life-threatening complication of type 2 diabetes characterized by severe hyperglycemia (typically >600 mg/dL), hyperosmolality (>320 mOsm/kg), profound dehydration, and altered mental status without significant ketoacidosis. Unlike DKA, patients with HHS retain enough insulin to prevent lipolysis and ketone formation but insufficient insulin to prevent severe hyperglycemia. HHS typically develops over days to weeks and is often precipitated by infection, medications, or inadequate fluid intake, particularly in elderly patients. Treatment focuses on gradual fluid replacement, cautious insulin therapy, and electrolyte correction, with careful monitoring to prevent rapid osmolality changes that could cause cerebral edema.
Usage
Usage note: No hyphens between the three words; HHS is preferred abbreviation over HHNS.
In Context
- "The elderly patient developed hyperosmolar hyperglycemic state during a UTI with glucose exceeding 800 mg/dL." — Geriatric medicine consultation
- "HHS treatment requires more gradual fluid replacement compared to DKA to avoid rapid osmolality shifts." — Endocrinology treatment protocol