- HHS is defined by hyperglycemia and hyperosmolarity due to volume depletion with resultant altered mental status
- Profound hypokalemia is common as a result of osmotic diuresis. Replete aggressively
- Hypokalemia = hypomagnesemia. Replete both of these electrolytes simultaneously
- Fluid repletion is the key point in management but careful repletion is vital as patients may not tolerate aggressive administration
- All patients should have an exhaustive investigation of the cause of their decompensation. Look for signs of infection, ischemia, trauma etc.
