Hypertonic hyperglycemic syndrome (HHS) is an acute complication of diabetes mellitus that is very dangerous and requires immediate medical attention to relieve this emergency.
Hypertonic hyperglycemic syndrome (HHS) is characterized by severe hyperglycemia, high plasma osmolality, and dehydration without significant ketosis, and patients may have varying degrees of unconsciousness or coma (<10%). Some patients may be accompanied by ketosis. It is mainly seen in older patients with type 2 diabetes mellitus (T2DM), and more than 2/3 of patients have no original history of diabetes.
HHS is often precipitated by certain causes, including acute infection, trauma, surgery, cerebrovascular accidents, and other stressful conditions. HHS has also been precipitated or exacerbated by misdiagnosis and the administration of large amounts of glucose fluids or the ingestion of large amounts of sugary drinks due to thirst.
HHS starts slowly and initially presents with polyuria, polydipsia, and loss of appetite. Gradually, severe dehydration and neuropsychiatric symptoms develop, with patients becoming unresponsive, irritable or indifferent, drowsy, and gradually slipping into coma, with little or no urination in the late stages. The patient was severely dehydrated at the time of consultation.
HHS glucose at or above 33.3 mmol/L (typically 33.3-66. 8mmol/L) and effective plasma osmolality at or above 320 mOsm/L (typically 320-430 mOsm/L) are diagnostic of the disease. The disease is critical, has many complications, and has a high mortality rate, which is very dangerous and requires prompt medical attention to relieve the condition.