Journal of Diabetes & Clinical Practice
Open Access

Introduction

Hyperosmolar hyperglycemic is a type of diabetes mellitus complication in which high blood sugar causes excessive osmolarity but no ketoacidosis. Dehydration, weakness, limb cramps, eyesight issues, and an altered degree of awareness are among symptoms. The onset usually takes a few days to a few weeks. Seizures, disseminated intravascular coagulopathy, mesenteric artery blockage, and rhabdomyolysis are all possible complications. A history of type 2 diabetes is the most important risk factor. It can happen to people who have never had diabetes before or who have diabetes type 1 on rare occasions. Infections, strokes, trauma, some drugs, and heart attacks are all potential triggers. Blood tests reveal a blood sugar level of more than 30 mmol/L (600 mg/dL), an osmolarity level of more than 320 mOsm/kg, and a pH level of less than 7. Treatment generally involves intravenous therapy which It is a medical procedure that involves directly injecting fluids, drugs, and nutrients into a person's vein. Intravenous administration is widely used to rehydrate or supply nutrients to patients who are unable to take food or drink through their mouth. It can also be used to treat electrolyte imbalances by administering drugs or other medical therapies such as blood products or electrolytes. Intravenous therapy has been attempted as early as the 1400s, but the practice did not become common until the 1900s, with the development of safe and successful procedures.

Symptoms of HHS include

Altered level of consciousness, Neurologic signs including: blurred vision, headaches, focal seizures, myoclonic jerking, reversible paralysis, Motor abnormalities including flaccidity, depressed reflexes, tremors or fasciculations, Hyperviscosity and increased risk of blood clot formation, Dehydration, Weight loss, Nausea, vomiting, and abdominal pain, Weakness, Low blood pressure with standing. It is due to Pneumonia or a urinary tract infection. Poor blood sugar control and/or failure to take diabetes drugs as prescribed. Taking such drugs, such as glucocorticoids and diuretics (which affect glucose levels) (which increase urine output) Reduce the insulin infusion rate by 0.5-1.0 U/h until the blood glucose concentration exceeds 300 mg/dL. Dextrose should be added to the IV fluids. The insulin drip should not be stopped. Continue to administer IV insulin at a target glucose level of 250- 300 mg/dL until the patient becomes more alert and the hyperosmolarity subsides. Hyperosmolar hyperglycemic state causes due to Lack of sufficient insulin, Poor kidney function, Poor fluid intake (dehydration), Older age (50–70 years), Certain medical condition and Certain medications. In the absence of ketoacidosis, current HHS diagnostic requirements include a plasma glucose level >600 mg/dL and an improved effective plasma osmolality >320 mOsm/kg. The prevalence of HHS is projected to be 1% of all diabetes-related hospital admissions.

Treatment typically includes:

Fluids given through a vein (intravenously) to treat dehydration.

Insulin is a drug that lowers blood sugar levels by injecting it into a vein (intravenously).

Potassium and sodium phosphate replacement is provided intravenously (through a vein) to help the cells work properly.

HHS is a medical condition that is extremely dangerous. Seizures, come can occur if it is not treated