Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes that involves extremely high blood sugar (glucose) levels without the presence of ketones. Ketones are byproducts of fat breakdown.
Alternative NamesHyperglycemic hyperosmolar coma; Nonketotic hyperglycemic hyperosmolar coma (NKHHC); Hyperosmolar nonketotic coma (HONK)
Causes, incidence, and risk factorsDiabetic hyperglycemic hyperosmolar syndrome is a condition of:
The buildup of ketones in the body (ketoacidosis) may also occur.
This condition is usually seen in people with type 2 Diabetes. It may occur in those who have not been diagnosed with diabetes, or in people who have not been able to control their diabetes. The condition may be brought on by:
Normally, the kidneys try to make up for high glucose levels in the blood by allowing the extra glucose to leave the body in the urine. If you do not drink enough fluids, or you drink fluids that contain sugar, the kidneys can no longer get rid of the extra glucose. Glucose levels in the blood can become very high as a result. The blood then becomes much more concentrated than normal (hyperosmolarity).
Hyperosmolarity is a condition in which the blood has a high concentration of salt (sodium), glucose, and other substances that normally cause water to move into the bloodstream. This draws the water out of the body's other organs, including the brain. Hyperosmolarity creates a cycle of increasing blood glucose levels and dehydration.
Risk factors include:
Symptoms may get worse over a period of days or weeks.
Other symptoms that may occur with this disease:
Signs may include:
Test results include:
Evaluation for possible causes may include:
TreatmentThe goal of treatment is to correct the dehydration. This will improve the blood pressure, urine output, and circulation.
Fluids and potassium will be given through a vein (intravenously). High glucose levels are treated with intravenous insulin.
Expectations (prognosis)Patients who develop this syndrome are often already ill. The Death Rate with this condition is as high as 40%.
ComplicationsThis condition is a medical emergency. Go to the emergency room or call the local emergency number (such as 911) if you develop symptoms of diabetic hyperglycemic hyperosmolar syndrome.
PreventionControlling type 2 diabetes and recognizing the early signs of dehydration and infection can help prevent this condition.
ReferencesKitabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006;29:2739-2748.
Cydulka RK, Maloney Jr. GE. Diabetes mellitus and disorders of glucose homeostasis. In: Marx J, Hockberger R, Walls R, eds. Rosen's Emergency Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier;2009.
Diabetic hyperglycemic hyperosmolar syndrome (HHS) is a complication of type 2 diabetes that involves extremely high blood sugar (glucose) levels without the presence of ketones. Ketones are byproducts of fat breakdown.
Alternative NamesHyperglycemic hyperosmolar coma; Nonketotic hyperglycemic hyperosmolar coma (NKHHC); Hyperosmolar nonketotic coma (HONK)
Causes, incidence, and risk factorsDiabetic hyperglycemic hyperosmolar syndrome is a condition of:
The buildup of ketones in the body (ketoacidosis) may also occur.
This condition is usually seen in people with type 2 diabetes. It may occur in those who have not been diagnosed with diabetes, or in people who have not been able to control their diabetes. The condition may be brought on by:
Normally, the kidneys try to make up for high glucose levels in the blood by allowing the extra glucose to leave the body in the urine. If you do not drink enough fluids, or you drink fluids that contain sugar, the kidneys can no longer get rid of the extra glucose. Glucose levels in the blood can become very high as a result. The blood then becomes much more concentrated than normal (hyperosmolarity).
Hyperosmolarity is a condition in which the blood has a high concentration of salt (sodium), glucose, and other substances that normally cause water to move into the bloodstream. This draws the water out of the body's other organs, including the brain. Hyperosmolarity creates a cycle of increasing blood glucose levels and dehydration.
Risk factors include:
Symptoms may get worse over a period of days or weeks.
Other symptoms that may occur with this disease:
Signs may include:
Test results include:
Evaluation for possible causes may include:
TreatmentThe goal of treatment is to correct the dehydration. This will improve the blood pressure, urine output, and circulation.
Fluids and potassium will be given through a vein (intravenously). High glucose levels are treated with intravenous insulin.
Expectations (prognosis)Patients who develop this syndrome are often already ill. The death rate with this condition is as high as 40%.
ComplicationsThis condition is a medical emergency. Go to the emergency room or call the local emergency number (such as 911) if you develop symptoms of diabetic hyperglycemic hyperosmolar syndrome.
PreventionControlling type 2 diabetes and recognizing the early signs of dehydration and infection can help prevent this condition.
ReferencesKitabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006;29:2739-2748.
Cydulka RK, Maloney Jr. GE. Diabetes mellitus and disorders of glucose homeostasis. In: Marx J, Hockberger R, Walls R, eds. Rosen's Emergency Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier;2009.
Reviewed ByReview Date: 05/10/2010
Ari S. Eckman, MD, Division of Endocrinology and Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
please answer the question
Acute complications of diabetes are severe and can lead to coma. They are directly related to blood glucose levels and include: Diabetic ketoacidosis, this more common in Type I diabetes and is caused by the breakdown of fatty acids into ketones when there is not enough glucose stored in the cells for energy; Hyperglycemic Hyperosmolar Non-Ketotic Syndrome (HHNS) usually associated with insulin deficiency and dehydration; and hypoglycemia due to too much insulin/oral medication is used or too little glucose. All three of these conditions are emergencies and failure to treat quickly can lead to coma and/or death.
It is a type of type 2 diabetes. It is a serious condition caused by extremely high blood sugar levels and can cause acute dehydration.
Genetic Diabetic Syndrome called G.D.S. is a newly found chromosome based disease which comes from diabetic parents. As a sexologist, i know that there is no medicine for it. but American scientists found the "Like pairing method", making love with a boy of same blood group but of opposite sign, which is the only solution for it. For further details about this, mail to the scientist : johnhamy11@gmail.com
Some diabetes medications, such as metformin, are used in people without diabetes to treat other conditions, such as metabolic syndrome or polycystic ovarian syndrome.
Kabuki Make-Up Syndrome (not on MeSH) Kallmann Syndrome Kanner's Syndrome Kaposi Disease Kartagener Syndrome Kartagener Triad Kawasaki Disease Kearns Syndrome Kearns-Sayer Syndrome Keloid Kennedy Syndrome Keratitis Keratitis, Ulcerative Keratoconus Keratosis Follicularis Keratosis, Actinic (not on MeSH) Keratosis, Seborrheic Kernicterus Ketoacidosis, Diabetic Ketosis, Diabetic Kidney Calculi Kidney Diseases Kidney Diseases, Cystic Kidney Failure, Acute Kidney Failure, Chronic Kidney Stones Kidney Tubular Necrosis, Acute Kienbock Disease Kimura Disease Kinky Hair Syndrome Kissing Disease Klebsiella Infections Kleine-Levin Syndrome Klein-Waardenburg Syndrome Kleptomania Klinefelter Syndrome Klippel-Feil Syndrome Klippel-Trenaunay Disease Klippel-Trenaunay-Weber Syndrome Klumpke Paralysis Kniest Dysplasia Koehler Disease Konzo Krabbe Disease Krukenberg Tumor Kufs Disease Kugelberg-Welander Disease Kuru Kuru Encephalopathy Kussmaul Aphasia Kwashiorkor
It can be used to treat neuropathic pain occurring in the legs and feet due to diabetic neuropathy. It can also be used to treat carpel tunnel syndrome.
The first two things you have to look at are diabetic neuropathy and carpal tunnel syndrome. Diabetic neuropathy is more of a burning pins and needle feeling and can effect the feet as well and of course you would have to have diabetes. Carpal tunnel syndrome classically will give you numbness and tingling of the first 2 or 3 fingers at night and upon waking. You may have a history of diabetes, hypothyroidism or repetitive use of hands. It effects women 2:1 usually in the 35-55 year old range and unlike diabetic neuropathy it won't effect your feet and it may be in one hand.
I would look at rheumatoid arthritis, lupus, diabetic neuropathy and lastly carpal tunnel syndrome.
Syndactyly is a characteristic of Apert syndrome, Poland syndrome, Jarcho-Levin syndrome, oral-facial-digital syndrome, Pfeiffer syndrome, and Edwards syndrome
Stockholm syndrome.
The Koro syndrome is a culture-specific syndrome. The individual with Koro syndrome has an overpowering belief that his or her genitals are retracting and disappearing.