Hyperosmolar hyperglycemic state (HHS) occurs in people with diagnosed and undiagnosed type 2 diabetes, who may be experiencing very high blood glucose levels (often over 720mg/dl). It can develop over the course of weeks through a combination of illness, dehydration and an inability to take normal diabetes medication due to the effect of illness. Symptoms can include:
- Frequent urination
- Extreme thirst
- Nausea
- Dry skin
- Confusion
- Eventually drowsiness and a gradual loss of consciousness
Unlike diabetic ketoacidosis, which occurs in type 1 diabetes, there are no ketones in the urine. This is because people with type 2 diabetes may still be producing some insulin so ketones are not produced. HHS is qualified as a medical emergency. Should HHS present, it is recommended to go straight to the Emergency Department for immediate treatment. Hospital treatment for HHS involves replacing the lost fluid caused by high glucose levels and the administration of insulin through a vein, to bring the blood glucose level down.
