HHS (Hyperosmotic Hyperglycaemic Syndrome)

Exam Cram

• HHS (Hyperosmolar hyperglycaemic syndrome) caused by prolonged hyperglycaemia in type 2 diabetes

• Associated with significant mortality, profound dehydration

• Diagnosis: raised osmolarity-  2( Na+) + Glucose + urea + 2(K+)  > 295

• Management: IVF, preferably in HDU

Further Notes

Management

• Profound dehydration: 6-12L deficit

• Aim to give 4-6L/ first 24hrs

• Aim to correct osmolality and blood glucose by c.5 units/ 24hrs

• Manage hyperglycaemia with IVF first, discuss with endocrine ?insulin if persistent

• Requires urinary catheter to assess input/ output

• Septic screen on admission, infection common cause

Resources and References

Written in 2025