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The major differential diagnosis is diabetic ketoacidosis (DKA). In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL). [6] Metabolic acidosis is absent or mild. [6] A temporary state of confusion (delirium) is also more common in HHS than DKA. HHS also tends to affect older people more.
hyperosmolar non-ketotic state (HONK) or Hyperglycemia hyperosmolar state (HHS) is an acute complication sharing many symptoms with DKA, but an entirely different origin and different treatment. [15] Oppositely, the prevalence of HHS is common in individuals with T2D.
Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. [1] Signs and symptoms may include vomiting , abdominal pain , deep gasping breathing , increased urination , weakness, confusion and occasionally loss of consciousness . [ 1 ]
Hyperosmolar syndrome or diabetic hyperosmolar syndrome is a medical emergency caused by a very high blood glucose level. The prefix " hyper- " means high, and " osmolarity " is a measure of the concentration of active particles in a solution , so the name of the syndrome simply refers to the high concentration of glucose in the blood .
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Blood tests for the diagnosis of diabetic ketoacidosis measure glycemia (sugar level), pH (blood acidity), and ketone bodies. As urgent medical treatment is often required when DKA is suspected, the tentative diagnosis can be made based on clinical history and by calculating the anion gap from the basic metabolic panel , which would demonstrate ...
Also, a life-threatening consequence of hyperglycemia can be nonketotic hyperosmolar syndrome. [16] Perioperative hyperglycemia has been associated with immunosuppression, increased infections, osmotic diuresis, delayed wound healing, delayed gastric emptying, sympatho-adrenergic stimulation, and increased mortality.
The most common causes of high anion gap metabolic acidosis are: ketoacidosis, lactic acidosis, kidney failure, and toxic ingestions. [3]Ketoacidosis can occur as a complication of diabetes mellitus (diabetic ketoacidosis), but can occur due to other disorders, such as chronic alcoholism and malnutrition.