non-ketotic-hyperglycemic-state
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Non Ketotic Hyperglycemic State

Non Ketotic Hyperglycemic State

Last Reviewed : 12/24/2020

Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes mellitus (predominantly type 2) in which high blood sugarscause severe dehydration, increases in osmolarity (relative concentration of solute) and a high risk of complications, coma and death. It is diagnosed with blood tests. It is related to diabetic ketoacidosis (DKA), another complication of diabetes more often (but not exclusively) encountered in people with type 1 diabetes; they are differentiated with measurement of ketone bodies, organic molecules that are the underlying driver for DKA but are usually not detectable in HHS.

The treatment of HHS consists of correction of the dehydration with intravenous fluids, reduction of the blood sugar levels withinsulin, and management of any underlying conditions that might have precipitated the illness, such as an acute infection.

Older names for HHS are hyperosmolar hyperglycemic nonketotic coma (HHNC), hyperosmolar non-ketotic coma (HONK),nonketotic hyperosmolar coma, hyperosmolar hyperglycemic nonketotic syndrome (HHNS, favoured by the American Diabetes Association)

We researched this topic for you and found the following best online resources. They are categorized into basic, advanced, and research level based on the extent of information you need. You will be taken to the respective websites by pressing on the links below.

 

Basic information:

https://www.nlm.nih.gov/medlineplus/ency/article/000304.htm medline plus diabetic hyperglycemic hyperosmolar syndrome

http://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/nonketotic-hyperosmolar-syndrome-nkhs merck manuals (professional version)nonketotic hyperosmolar syndrome (nkhs)

http://www.mayoclinic.org/diseases-conditions/diabetic-hyperosmolar-syndrome/basics/definition/con-20026142 mayoclnic definition

http://www.webmd.com/diabetes/type-2-diabetes-guide/hyperglycemic-hyperosmolar-nonketonic-syndrome web md diabetic coma and type 2 diabetes

http://www.healthline.com/health/type-2-diabetes/hyperglycemic-hyperosmolar-syndrome health line diabetic hyperglycemic hyperosmolar syndrome

http://www.diapedia.org/acute-and-chronic-complications-of-diabetes/71040851425/diabetic-ketoacidosis-and-hyperglycaemic-hyperosmolar-state diapedia diabetic ketoacidosis and hyperglycaemic hyperosmolar state

http://lifeinthefastlane.com/ccc/hyperosmotic-hyperglycaemic-syndrome-hhs/ lfe in the fast lane hyperosmotic hyperglycaemic syndrome (hhs)

 

Advanced information:

http://emedicine.medscape.com/article/1914705-overview medscape hyperosmolar hyperglycemic state

http://www.aafp.org/afp/2005/0501/p1723.html hyperosmolar hyperglycemic state gregg d. stoner, m.d., university of illinois college of medicine, peoria, illinois am fam physician. 2005 may 1;71(9):1723-1730.

http://patient.info/in/doctor/hyperosmolar-hyperglycaemic-state patent hyperosmolar hyperglycaemic state

http://www.diabetologists-abcd.org.uk/jbds/jbds_ip_hhs_adults.pdf the management of the hyperosmolar hyperglycaemic state (hhs) in adults with diabetes joint british diabetes societies inpatient care group august 2012

http://radiopaedia.org/articles/non-ketotic-hyperglycaemic-hemichorea radiopedia non-ketotic hyperglycaemic hemichorea

https://online.epocrates.com/diseases/101121/hyperosmolar-hyperglycemic-state/definition epocrates hyperosmolar hyperglycemic state

http://www.rlbuht.nhs.uk/education%20and%20learning/documents/emergency%20medicine%20handbook%20trust%20policies/management%20of%20hyperosmolar%20hyperglycaemic%20state.pdf the management of hyperosmolar hyperglycaemic state

http://diabetesmanager.pbworks.com/w/page/17680206/hyperglycemic%20crises%3a%20diabetic%20ketoacidosis%20%28dka%29%2c%20and%20hyperglycemic%20hyperosmolar%20state%20%28hhs%29%20 hyperglycemic crises: diabetic ketoacidosis (dka), and hyperglycemic hyperosmolar state (hhs)

 

Research:

http://spectrum.diabetesjournals.org/content/15/1/28 diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome by guillermo e. umpierrez, md, facp, mary beth murphy, rn, ms, cde, mba and abbas e. kitabchi, phd, md, facp, face diabetes spectrum 2002 jan; 15(1): 28-36. http://dx.doi.org/10.2337/diaspect.15.1.28

http://care.diabetesjournals.org/content/37/11/3124 hyperosmolar hyperglycemic state: a historic review of the clinical presentation, diagnosis, and treatment by francisco j. pasquel and guillermo e. umpierrez diabetes care 2014 nov; 37(11): 3124-3131. http://dx.doi.org/10.2337/dc14-0984

http://medind.nic.in/icb/t06/i1/icbt06i1p55.pdf hyperglycemic hyperosmolar nonketotic syndrome by r. venkatraman and sunit c. singhi [indian j pediatr 2006; 73 (1) : 55-60]

https://www.pedsendo.org/education_training/healthcare_providers/consensus_statements/assets/hyperosmolar.pdf hyperglycemic hyperosmolar syndrome in children: pathophysiological considerations and suggested guidelines for treatment by zeitler et al the journal of pediatrics www.jpeds.com vol. 158, no. 1

http://journals.plos.org/plosone/article?id=10.1371%2fjournal.pone.0094155 increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study by jen-yu wang, cheng-yi wang, yung-sung huang, pin-fan chen, kuang-yung huang, pesus chou, wei-cheng lian, ching-chih lee http://dx.doi.org/10.1371/journal.pone.0094155

http://www.moshp.com/associations/10761/files/hhs.pdf hyperglycemic crisis: hyperosmolar hyperglycemic state by corey doss, pharm.d. candidate, university of missouri-kansas city

http://ijbm.org/articles/article4_3_crep1.pdf a case of hyperosmolar hyperglycemic state caused by ischemic pancreatitis by e. leung et al / international journal of biomedicine 4(3) (2014) 159-161

http://www.medigraphic.com/pdfs/imss/im-2011/im113s.pdf hypernatremia in hyperosmolar hyperglycemic syndrome by jorge blas-macedo,viridiana blas-soto rev med inst mex seguro soc 2011; 49 (3): 335-337

http://www.hindawi.com/journals/crinm/2014/652523/ karla victoria rodríguez-velver, analy j. soto-garcia, maría azucena zapata-rivera, juan montes-villarreal, jesús zacarías villarreal-pérez, and rené rodríguez-gutiérrez, “osmotic demyelination syndrome as the initial manifestation of a hyperosmolar hyperglycemic state,” case reports in neurological medicine, vol. 2014, article id 652523, 5 pages, 2014. doi:10.1155/2014/652523

http://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-6-325 an unusual case of central diabetes insipidus & hyperglycemic hyperosmolar state following cardiorespiratory arrest by muhammad qamar masood et al., bmc research notes20136:325 doi: 10.1186/1756-0500-6-325

http://www.kjim.org/journal/view.php?number=15923 extensive venous thrombosis of the upper extremity in a diabetic patient with a hyperosmolar hyperglycemic state by juri park et al., the korean journal of internal medicine 2006; 21(4): 244-247. doi: http://dx.doi.org/10.3904/kjim.2006.21.4.244

http://pubmedcentralcanada.ca/pmcc/articles/pmc3276522/ hyperglycemic hyperosmolar syndrome at the onset of type 2 diabetes mellitus in an adolescent male by sarah l tsai et al., paediatr child health. 2012 january; 17(1): 24–26.

chang y, zhang mc, wan hh, xin h. magnetic resonance imaging features in seizures associated with nonketotic hyperglycemia. neurol india [serial online] 2013 [cited 2016 jul 12];61:528-30. available from: http://www.neurologyindia.com/text.asp?2013/61/5/528/121937

 

Other helpful resources(support groups):

https://www.diabetes.org.uk/guide-to-diabetes/complications/hyperosmolar_hyperglycaemic_state_hhs/ diabetes uk

 

Related videos:

https://www.youtube.com/watch?v=ikkf5yuxvg8 acute complications of diabetes - hyperosmolar hyperglycemic nonketotic state

https://www.youtube.com/watch?v=lzvvrijtzey hyperosmolar hyperglycemic nonketotic syndrome (hhns) nursing care nclex® review

https://www.youtube.com/watch?v=mke87hrw6ku acute complications of diabetes: hyperosmolar hyperglycemic non-ketotic state

https://www.youtube.com/watch?v=lyexa5oj5xy hyperglycemic hyperosmolar nonketotic syndrome hhs | hhns nursing & pathophysiology

https://www.youtube.com/watch?v=-movg3ubcea hyperglycemic crises: dka and hhs - part 1 of 2

https://www.youtube.com/watch?v=4nr9wo--eha hyperglycemic crises: dka and hhs - part 2 of 2

https://www.youtube.com/watch?v=sghkkh1dqvk diabetic ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome

 

Presentations/quiz/newspaper articles:

http://www.slideshare.net/drmdsadiq/hyperosmolar-hyperglycemic-state hyperosmolar hyperglycemic state by dr.sudeepta rao

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