Diabetes Control Matters
What Is Hyperglycemic Hyperosmolar Non-Ketotic Syndrome?
Hyperglycemic hypersomolar non-ketotic syndrome (HHNS) is
a life threatening complication of diabetes. When HHNS occurs,
it occurs in a person who has Type 2 diabetes. HHNS is also
sometimes called hypersomolar coma, which means "coma
due to too thick blood".
In HHNS the sugar level is almost always over 600mg/dl and
can actually reach 1,500 or 2,000 mg/dl. The blood sugar goes
up so much that the blood is actually thicker, or hyperosmolar.
As the blood sugar goes up, the person urinates frequently
and becomes dehydrated. A vicious cycle is set up in which
the blood sugar goes up, dehydration follows, and that increases
the blood sugar still more.
Prevention of HHNS depends on catching it before it becomes
severe. Taking even the simplest measures, such as calling
your physician, increasing water intake and treating a rising
blood sugar with insulin as directed by your physician, is
usually enough to prevent a hospital admission.
Symptoms of HHNS
- Increased thirst & urination
- Nausea, vomiting, and/or stomach pain
- Changes in or difficulty breathing
- Blurred vision
- Dry mouth
- Fatigue
- Sleepiness
- Confusion
How Can You Prevent HHNS?
- Follow sick day guidelines.
- Never stop taking your usual insulin or oral medication
doses.
- Test blood glucose every 2 – 4 hours.
- If you do not have a plan to take extra insulin, call
your physician if you have 2 unexplained blood sugars of
over 240mg/dl in a row.
- It is very important to increase fluid intake –
drink sugar-free, caffeine-free fluids such as water, diet
soda, broth or tea.
- If persistent vomiting, inability to tolerate fluids
by mouth, or persistent diarrhea with progressive weakness
or confusion is present, call your doctor immediately.
How Is HHNS Treated?
- Large amounts of fluids
- Insulin
- Usually an IV is started
- Careful monitoring
- Treatment of the cause
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