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Patient education: Hyperosmolar hyperglycemic state (The Basics)

Patient education: Hyperosmolar hyperglycemic state (The Basics)

What is hyperosmolar hyperglycemic state? — Hyperosmolar hyperglycemic state is a serious problem that can happen in people with type 2 diabetes. It happens when their blood sugar level gets very high. It is sometimes called "hyperosmolar nonketotic coma."

When a person's blood sugar level gets too high for a long time, the kidneys try to get rid of the extra sugar through the urine. When a person is urinating a lot, their body also loses water. If they aren't taking in enough water to make up for this, it can lead to problems.

Hyperosmolar hyperglycemic state is most common in older adults with type 2 diabetes. It can also happen in people who have type 2 diabetes, but don't yet know it.

Hyperosmolar hyperglycemic state is an emergency and needs treatment right away.

What causes hyperosmolar hyperglycemic state? — Most often, this problem happens after a person with diabetes:

Gets an infection or other illness

Stops taking their diabetes medicine, or doesn't take the medicine the way they are supposed to

Takes other medicines that affect their blood sugar levels

Gets dehydrated, which is when the body loses too much water

What are the symptoms of hyperosmolar hyperglycemic state? — Hyperosmolar hyperglycemic state causes a person to pass out (lose consciousness) and go into a coma. But before that happens, people usually have symptoms for a few days. These can include:

Urinating much more than usual

Being very thirsty, and drinking much more than usual

Losing weight

Having dark yellow or brown urine

Should I see a doctor or nurse? — See your doctor or nurse right away if you have the symptoms listed above. If is not treated quickly, hyperosmolar hyperglycemic state will lead to coma.

Is there a test for hyperglycemic state? — Yes. Tests for hyperosmolar hyperglycemic state usually include:

Blood tests

Urine tests

An electrocardiogram (ECG) – This test measures the electrical activity in the heart (figure 1).

Other tests to look for an infection or illness – These might include other blood tests or a chest X-ray.

How is hyperosmolar hyperglycemic state treated? — People with hyperosmolar hyperglycemic state are treated in the hospital with:

Fluids and electrolytes – In hyperosmolar hyperglycemic state, the body loses a lot of fluids. It also loses electrolytes, which are salts (such as sodium and potassium) that keep cells working normally. People will get fluids and electrolytes through a thin tube that goes into their vein, called an "IV."

Insulin – Insulin is a medicine that lowers a person's blood sugar level. The insulin is also usually given into a vein through an IV.

The doctor will also treat any infection or illness causing the hyperosmolar hyperglycemic state.

Can hyperosmolar hyperglycemic state be prevented? — To reduce the chances of getting this condition again, people with diabetes should:

Take their diabetes medicines as directed

Follow their doctor's instructions for checking their blood sugar level – A device called a "blood glucose meter" can be used to check blood sugar levels at home.

Learn how to change their dose of diabetes medicine when they get sick

Call their doctor or nurse if they measure their blood sugar and it is higher than usual

More on this topic

Patient education: Type 2 diabetes (The Basics)
Patient education: Treatment for type 2 diabetes (The Basics)
Patient education: Using insulin (The Basics)
Patient education: Diabetic ketoacidosis (The Basics)

Patient education: Type 2 diabetes: Overview (Beyond the Basics)
Patient education: Type 2 diabetes: Treatment (Beyond the Basics)
Patient education: Type 2 diabetes: Insulin treatment (Beyond the Basics)
Patient education: Blood glucose monitoring in diabetes (Beyond the Basics)
Patient education: Preventing complications from diabetes (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 01, 2023.
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