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: medline plus diabetic hyperglycemic hyperosmolar syndrome merck manuals (professional version)nonketotic hyperosmolar syndrome (nkhs) mayoclnic definition web md diabetic coma and type 2 diabetes health line diabetic hyperglycemic hyperosmolar syndrome diapedia diabetic ketoacidosis and hyperglycaemic hyperosmolar state lfe in the fast lane hyperosmotic hyperglycaemic syndrome (hhs)


Advanced information: medscape hyperosmolar hyperglycemic state 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. patent hyperosmolar hyperglycaemic state the management of the hyperosmolar hyperglycaemic state (hhs) in adults with diabetes joint british diabetes societies inpatient care group august 2012 radiopedia non-ketotic hyperglycaemic hemichorea epocrates hyperosmolar hyperglycemic state the management of hyperosmolar hyperglycaemic state hyperglycemic crises: diabetic ketoacidosis (dka), and hyperglycemic hyperosmolar state (hhs)


Research: 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. 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. hyperglycemic hyperosmolar nonketotic syndrome by r. venkatraman and sunit c. singhi [indian j pediatr 2006; 73 (1) : 55-60] hyperglycemic hyperosmolar syndrome in children: pathophysiological considerations and suggested guidelines for treatment by zeitler et al the journal of pediatrics vol. 158, no. 1 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 hyperglycemic crisis: hyperosmolar hyperglycemic state by corey doss, pharm.d. candidate, university of missouri-kansas city a case of hyperosmolar hyperglycemic state caused by ischemic pancreatitis by e. leung et al / international journal of biomedicine 4(3) (2014) 159-161 hypernatremia in hyperosmolar hyperglycemic syndrome by jorge blas-macedo,viridiana blas-soto rev med inst mex seguro soc 2011; 49 (3): 335-337 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 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 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: 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:


Other helpful resources(support groups): diabetes uk


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Presentations/quiz/newspaper articles: hyperosmolar hyperglycemic state by dr.sudeepta rao

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